“Miracle Mouthwashes”

Compounding dental mouthwashes or rinses may offer numerous advantages over commercially available dosage forms. Elixirs, syrups, and suspensions often contain preservatives such as alcohol which can cause reactions or gastrointestinal irritation, or sugar which makes the preparation undesirable for prolonged use in the mouth or for diabetic patients. A customized preparation without unnecessary excipients – i.e., a sugar-free, dye-free, lactose-free, and preservative-free dosage form – can eliminate concerns of palatability, alcohol content, and dyes which may stain exposed mucosa.

Various preparations are also available to treat burning mouth syndrome and anesthetic/analgesic and antibiotic/anti-infective mouthwashes are commonly requested.
Ryan et al. of the Department of Pharmacy, University of California San Diego, La Jolla, CA, sought to determine if an oral ketamine “swish and expectorate” mouthwash was a safe and effective method to alleviate mucositis pain. They concluded that a ketamine mouthwash administered using the “swish and spit” technique may be a viable treatment option in refractory mucositis pain.

J Palliat Med. 2009 Nov;12(11):989-91.
Ketamine mouthwash for mucositis pain.
Ryan AJ, Lin F, Atayee RS.
Click here to access the PubMed abstract of this article.

 


 

“Magic mouthwashes” are topical solutions or suspensions prepared to relieve symptoms of various oral pathologies. A study conducted at the Department of Clinical Pharmacy, University of California, San Francisco, described the usage of topical oral solutions in patients experiencing chemotherapy-induced oral mucositis (CIOM), and surveyed the care

of oral mucositis provided to patients by clinical oncology pharmacists in institutional settings. The top five ingredients used to compound “magic mouthwash” were reported to be diphenhydramine, viscous lidocaine, magnesium hydroxide/aluminum hydroxide, nystatin and corticosteroids. Most institutions administer the mouthwash every 4 hours or every 6 hours.

J Oncol Pharm Pract. 2005 Dec;11(4):139-43.
Survey of topical oral solutions for the treatment of chemo-induced oral mucositis.
Chan A, Ignoffo RJ.
Click here to access the PubMed abstract of this article.

 


Tranexamic acid solution (4.8%) used as a mouthwash has been used successfully to prevent postsurgical bleeding after oral surgery without dose modification of oral anticoagulants.

J Oral Maxillofac Surg 1993 Nov;51(11):1211-6
Prevention of postsurgical bleeding in oral surgery using tranexamic acid without dose modification of oral anticoagulants.
Click here to access the PubMed abstract of this article.

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