Dublin Dental School and Hospital, Trinity College Dublin, Dublin, Ireland.
Faculty of Medicine, Dentistry & Health Sciences, Melbourne Dental School, University of Melbourne, Carlton, Australia.
Int Dent J. 2023 Nov;73 Suppl 2(Suppl 2):S89-S97. doi: 10.1016/j.identj.2023.08.011. Epub 2023 Oct 17.
This narrative review summarises "alternative" or "natural" over-the-counter (OTC) mouthwashes not covered elsewhere in this supplement and newly emerging products, as potential mouthwashes of the future. The "natural" mouthwashes reviewed include saltwater, baking soda, coconut oil, charcoal, propolis, seaweeds, and probiotics. Other than essential oils, it is apparent that their clinical effectiveness is still under debate, but there is some evidence to suggest that propolis reduces plaque and gingivitis. This review also covers the host immune response, via novel anti-inmmunomodulant mouthwashes, such as erythropoietin to reduce inflammation with oral mucositis (OM) after radiotherapy. The emerging concept of nanoparticle-containing mouthwashes, such as iron oxide, is further discussed for OM, this agent having the potential for more targeted delivery of chemical antimicrobials. Unfortunately, there are impacts on the environment of widening mouthwash use with more new products, including increased use of packaging, antimicrobial resistance, and possible detrimental effects on marine life. Further, there are roadblocks, relating to regularly approvals and side effects, that still need to be overcome for any OTC deivered immunomodulant or nanoformulation mouthwashes. Despite these caveats, there are many new mouthwashes under development, which could help manage major oral diseases such as caries, gingivitis, and periodontal disease.
本叙述性综述总结了本增刊未涵盖的“替代”或“天然”非处方（OTC）漱口水以及新出现的产品，它们可能是未来的漱口水。综述中所包含的“天然”漱口水包括盐水、小苏打、椰子油、木炭、蜂胶、海藻和益生菌。除了精油之外，显然它们的临床效果仍存在争议，但有一些证据表明蜂胶可以减少菌斑和牙龈炎。本综述还涵盖了通过新型抗免疫调节漱口水（如促红细胞生成素）来减轻放疗后口腔黏膜炎（OM）的宿主免疫反应。还进一步讨论了载纳米粒漱口水（如氧化铁）在 OM 中的新兴概念，这种制剂具有更靶向地输送化学抗菌剂的潜力。不幸的是，由于更多新产品的广泛使用，包括包装使用增加、抗菌药物耐药性以及对海洋生物可能产生的有害影响，这对环境造成了影响。此外，任何 OTC 递药免疫调节剂或纳米制剂漱口水的审批和副作用等问题仍存在障碍，需要克服。尽管存在这些警告，但许多新的漱口水正在开发中，它们可能有助于控制龋齿、牙龈炎和牙周病等主要口腔疾病。
