Purpose:
Mouthwash is used by patients with oral diseases to clean and inhibit dental plaque or mold activity, reduce the growth of oral flora, avoid bacterial infections, and restore oral health before and after surgery and treatment.
 
Applicable Situation:
Mouthwash is used for cleaning before oral surgery, after periodontal and oral surgery, after orthodontics, and during or after treatments of radiation and chemotherapy.
 
Goods Required:
  1. Choose a suitable mouthwash, such as Parmason, as instructed by the physician.
  2. Cooled boiled water.
  3. Small medicine cup and curved washbasin.
 
Steps:
  1. General gargle:
    1. Rinse and clean the mouth with cooled boiled water.
    2. Pour 10-20 cc of mouthwash into a small medicine cup.
    3. Pour mouthwash in the mouth, gargle for about 30 seconds, and then spit it out. There is no need to rinse the mouth with cold boiled water again.
    4.  Do not drink water and do not eat within half an hour after rinsing your mouth with mouthwash.
  2. Syringe mouthwash rinsing method:
    1. Take a 20 cc syringe and an 18-gauge soft needle to draw 10-20 cc of mouthwash.
    2. Insert the soft needle between the teeth or from the corner of the mouth and then slowly inject the mouthwash for rinsing.
    3. After gargling with mouthwash for about 30 seconds, tilt the head slightly to the healthy side to allow the solution to flow out from the corner of the mouth to the curved washbasin.
    4. If the patient is unable to spit out the mouthwash independently, then the caregiver needs to be guided by the nursing personnel to use an oral suction tube to draw out the mouthwash at low pressure (40-60 mmHg) to avoid touching the wound.
  3. Frequency: twice a day.


Notice:

  1. Long-term use of mouthwash will still cause side effects such as pigmentation on teeth, tongue, and resin dentures as well as temporarily influence tastes. Therefore, long-term use is not recommended. If necessary, it should be prescribed by a physician after evaluation.
  2. It is recommended to use soft-bristled toothbrushes and other auxiliary tools (such as dental floss) to implement mechanical cleaning methods to remove plaque and maintain oral cleanliness. Tooth brushing cannot be replaced by chemical inhibitors, such as mouthwash.
 
References
  1. Ishimaru, M., Matsui, H., Ono, S., Hagiwara, Y., Morita, K., & Yasunaga, H. (2018). Preoperative oral care and effect on postoperative complications after major cancer surgery. British Journal of Surgery, 105(12), 1688-1696. https://doi.org/10.1002/bjs.10915
  2. Kwak, D. Y., Kim, N. Y., Kim, H. J., Yang, S. Y., Yoon, J. E., Hyun, I. A., & Nam, S. H. (2017).Changes in the oral environment after tooth brushing and oral gargling.  Biomedical Research, 28 (16), 7093-7097
  3. Lee, J. H., Shin, Y. J., Lee, J. H., & Kim, H. D. (2018). Association of toothbrushing and proximal cleaning with periodontal health among Korean adults: Results from Korea National Health and Nutrition Examination Survey in year 2010 and 2012. Journal of clinical periodontology, 45(3), 322-335. https://doi.org/10.1111/jcpe.12846
  4. Wiley, R., Gupta, V., Daftary, R. A., Baugh, J., Tran, A. H., Cataldo, D. L., ... & Komabayashi, T. (2018). The Interprofessional Management of Geriatric Patients Undergoing Head and Neck Cancer Treatment in US Nursing Homes. Dental Medicine Faculty Publications, 10, 15-23.
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