Oral health is an essential component of overall well-being, and among the most recommended products by dentists is mouthwash with chlorhexidine. Although it’s not a new product, it has gained popularity on social media and in the general market, which has led many people to use it without fully understanding its properties, benefits, risks, and proper usage. Below, we will explore in depth what chlorhexidine is, what it is used for, its potential side effects, and how to use it correctly to avoid complications, including the well-known tooth staining it may cause.
What is chlorhexidine?
Chlorhexidine is a broad-spectrum antiseptic, mainly used in medicine and dentistry to control bacteria. It was developed in the 1950s and has since become one of the most studied and widely used disinfectants, available in topical solutions, gels, and rinses. Its antimicrobial action is effective against both Gram-positive and Gram-negative bacteria, fungi, and some viruses.
In dentistry, chlorhexidine is commonly found in concentrations of 0.12% or 0.2% as a mouthwash. Its mechanism of action involves disrupting the cell membrane of microorganisms, causing the loss of essential cellular components and ultimately, cell death. This powerful activity is the main reason why it is widely recommended as an auxiliary treatment in various oral conditions.
Chlorhexidine: What is it used for?
Chlorhexidine mouthwash is primarily used for:
- Controlling plaque and gingivitis
This is likely its most well-known use. Chlorhexidine significantly reduces dental biofilm (plaque) formation, especially in patients with inflamed or bleeding gums. - Prevention and treatment of periodontal disease
In cases of periodontitis, a more advanced stage of gum disease, dentists often recommend chlorhexidine as a supplement to mechanical treatments like deep cleanings or scaling. - Postoperative care
After oral surgeries, tooth extractions, or dental implant procedures, it is prescribed to prevent infections and promote proper healing, since patients should not brush the affected area for the first few days. - Patients with disabilities or limited mobility
When toothbrushing cannot be performed adequately, chlorhexidine is used as a temporary antimicrobial control. - Treatment of oral ulcers or lesions
It may also be recommended to control secondary infections in cases of mouth sores or mucositis, especially in immunocompromised patients such as those undergoing chemotherapy.
Proper use of chlorhexidine
Despite its effectiveness, chlorhexidine should be used under control and for short periods. It is not intended for daily or long-term use without medical or dental supervision. Some general guidelines for its proper use include:
- Use it for short periods, usually between 7 and 14 days, unless otherwise directed by a professional.
- Rinse with 15 ml undiluted, for 30 seconds, twice a day after brushing.
- Avoid eating or drinking for at least 30 minutes after use to maintain its effectiveness.
- Do not use it in combination with toothpastes containing sodium lauryl sulfate, as this compound can inactivate chlorhexidine.
Strict adherence to these instructions is crucial to avoid adverse effects.
Does chlorhexidine stain teeth?
One of the most frequent and visible side effects of using chlorhexidine mouthwash is dental staining. This can appear after several days of use and manifests as brown or black stains on teeth, fillings, and the tongue.
This effect is not permanent and can usually be removed with a professional cleaning. However, it is a sign that the use of the product should be reevaluated. The stains result from the interaction between chlorhexidine and dietary compounds (such as coffee, tea, red wine, or tobacco), as well as existing dental plaque.
For this reason, chlorhexidine should not be used as a cosmetic mouthwash or daily maintenance rinse, but only as a temporary treatment under dental supervision.
Side effects of chlorhexidine
While chlorhexidine is safe in most cases, it may cause some adverse effects, especially if used improperly or for extended periods. Common side effects include:
- Staining of teeth and soft tissues (as mentioned above).
- Altered taste perception, especially a metallic or salty taste. This dysgeusia can persist for several days after stopping the rinse.
- Burning or irritation in the mouth.
- Peeling of the gums or tongue, in some isolated cases.
- Allergic reactions, which are rare but possible. If symptoms such as redness, swelling, or difficulty breathing occur, it should be discontinued immediately and a doctor should be consulted.
Myths and truths about chlorhexidine
Due to its rise on social media and its easy availability in pharmacies, many myths have surfaced regarding chlorhexidine. Let’s clarify a few of them:
- “You can use it every day instead of regular mouthwash”
FALSE. Chlorhexidine is not a replacement for daily mouthwash. It is a specific treatment and prolonged use may damage the natural balance of oral flora. - “It permanently eliminates bad breath”
FALSE. While it may reduce bad breath caused by bacteria, it does not treat the root cause and should only be used temporarily. - “It whitens teeth”
COMPLETELY FALSE. In fact, it may darken them if used without supervision.
Conclusion: When and how to use chlorhexidine mouthwash?
Chlorhexidine mouthwash is a valuable tool in modern dentistry. Its ability to control infections, prevent periodontal disease, and facilitate postoperative recovery makes it an essential resource. However, its use must be responsible and supervised by a professional.
Patients should avoid indiscriminate use, especially based on social media advice or unverified recommendations. As with any pharmaceutical product, the benefits of chlorhexidine are maximized when used properly, and side effects are minimized when directions and durations are respected.
If you’re unsure whether you should be using this mouthwash or if you’re using it correctly, the best approach is to consult your dentist. He or she can evaluate your specific case and recommend the most appropriate treatment for you.
