There can be variation in the licensing of
different medicines containing the same drug. Forms available
from special-order manufacturers include: oral solution
Tablet
CAUTIONARY AND ADVISORY LABELS 21, 27
▶Salagen (Norgine Pharmaceuticals Ltd)
Pilocarpine hydrochloride 5 mg Salagen 5mg tablets |
84 tablet P £41.14 DT = £41.14
Oral hygiene
Mouthwashes and other
preparations for oropharyngeal use
Lozenges and sprays
There is no convincing evidence that antiseptic lozenges and
sprays have a beneficial action and they sometimes irritate
and cause sore tongue and sore lips. Some of these
preparations also contain local anaesthetics which relieve
pain but may cause sensitisation.
Mouthwashes, gargles, and dentifrices
Superficial infections of the mouth are often helped by warm
mouthwashes which have a mechanical cleansing effect and
cause some local hyperaemia. However, to be effective, they
must be used frequently and vigorously. A warm saline
mouthwash is ideal and can be prepared either by dissolving
half a teaspoonful of salt in a glassful of warm water or by
diluting compound sodium chloride mouthwash p. 1277 with
an equal volume of warm water.
Mouthwashes containing an oxidising agent, such as
hydrogen peroxide p. 1276, may be useful in the treatment of
acute ulcerative gingivitis (Vincent’s infection) since the
organisms involved are anaerobes. It also has a mechanical
cleansing effect arising from frothing when in contact with
oral debris.
Chlorhexidine below is an effective antiseptic which has
the advantage of inhibiting plaque formation on the teeth. It
does not, however, completely control plaque deposition and
is not a substitute for effective toothbrushing. Moreover,
chlorhexidine preparations do not penetrate significantly
into stagnation areas and are therefore of little value in the
Ear, nose and oropharynx
control of dental caries or of periodontal disease once
pocketing has developed.
Chlorhexidine mouthwash is used in the treatment of
denture stomatitis. It is also used in the prevention of oral
candidiasis in immunocompromised patients. Chlorhexidine
mouthwash reduces the incidence of alveolar osteitis
following tooth extraction. Chlorhexidine mouthwash
should not be used for the prevention of endocarditis in
patients undergoing dental procedures.
Chlorhexidine can be used as a mouthwash, spray or gel
for secondary infection in mucosal ulceration and for
controlling gingivitis, as an adjunct to other oral hygiene
measures. These preparations may also be used instead of
toothbrushing where there is a painful periodontal condition
(e.g. primary herpetic stomatitis) or if the patient has a
haemorrhagic disorder, or is disabled.
Chlorhexidine preparations are of little value in the
control of acute necrotising ulcerative gingivitis. With
prolonged use, chlorhexidine causes reversible brown
staining of teeth and tongue. Chlorhexidine may be
incompatible with some ingredients in toothpaste, causing
an unpleasant taste in the mouth; rinse the mouth
thoroughly with water between using toothpaste and
chlorhexidine-containing products.
There is no convincing evidence that gargles are effective
in adults.
ANTISEPTICS AND DISINFECTANTS
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