Fluoride Mouth Rinses

These are most commonly available as 0.02% NaF (100 ppm F) for twice a day rinsing, 0.05% NaF (227 ppm F) for daily rinsing and 0.2% NaF (909 ppm F) for weekly rinsing. These latter two higher concentration rinses may need a prescription even if they are intended for home use. Mouthwashes have also been formulated with acidulated phosphate fluoride, stannous fluoride, ammonium fluoride, and amine fluoride, although some of these come with precautions. For example, stannous fluoride rinses have been associated with discoloration of teeth and tooth restorations, and acidulate phosphate fluoride is contraindicated in people with porcelain or composite restorations because it can cause pitting or etching.1

Many of the fluoride mouth washes on the market internationally also contain antimicrobial ingredients. These include chlorhexidine, cetylpyridinium chloride, triclosan, delmopinol, hexetidine, and Sanguinaria extract. Many of these have little to no caries-reducing effects or have not been studied for their anti-caries effects.1

Typically, it is recommended that 10 ml of the mouth rinse solution be swirled around in the mouth for 1 minute. Clinical trials of both the daily and weekly regimen show an average caries reduction of 30%.21 The benefit of daily rinsing is marginally greater than weekly rinsing but not statistically significant. Overall, fluoride mouth rinses are considered beneficial from a public health perspective only if groups of people at high risk of caries are being targeted, since they are not cost-effective in a population with a low incidence of disease. While weekly rinsing public health programs have been used in the United States to target groups of people that are at high risk of caries, other countries stopped regular rinsing (either daily or weekly) with fluoridated mouthwashes in the 1980s.1