Practical Clinical and Patient Implications
After a thorough risk assessment is completed, the dental professional should advise the patient when to utilize additional plaque control measures that will improve treatment outcomes leading to maintaining optimal oral health. The team of dental professionals can effectively add a daily rinse to the patient’s home care routine based on the knowledge we now have. Adding a rinse that is tailored to the individual patient’s needs will create a dramatic difference in conjunction with daily oral hygiene care. Here are some considerations to help ensure compliance:
Stress that rinsing is not a replacement for mechanical hygiene – Remind patients therapeutic rinses are not intended to replace proper mechanical hygiene methods, but rather provide an additional means for improved plaque and gingivitis control. Brushing and flossing are the primary means to disrupt plaque/biofilm plaque while rinsing reduces plaque build-up, facilitates plaque removal, and prevents biofilm accumulation for 8-12 hours.
Advise patients to choose a product with a pleasant usage experience – Rinses are available in various flavors so patients can choose one that best fits their personal preference. If patients enjoy using the product, they are more likely to be compliant and realize the maximum level of benefits.
Consider a product without alcohol – Any patient taking medications where adverse reactions with alcohol may occur should select alcohol-free mouthrinses. Patients exhibiting and/or suffering from xerostomia should also be advised to select an alcohol-free mouthrinse, to prevent further dry mouth implications from alcohol.35,36 Alcohol-free rinses can prove beneficial for those patients immunocompromised, suffering from severe mucositis, and undergoing radiation therapy for head and neck cancers37 as well as recovering alcoholics and/or substance abusers. Conditions such as xerostomia and ulcerative gingivitis can be exacerbated by alcohol38 creating painful and unpleasant experiences thus preventing long-term compliance with adjunctive plaque removal.
Follow usage instructions – For example, some patients have been known to dilute alcohol-containing rinses to help with tolerability. Dilution may lower the effectiveness of some formulations, so it should only be done if stated in the usage instructions. Alcohol has been shown to primarily kill single bacteria but not as effective with biofilm prevention. Advise patients to read the label and contact the manufacturer if questions remain.