Prevention of dental caries is the main focus of a child’s oral health. Dental health forms an integral part of general health in a growing kid. But, in developing countries like India, owing to improper oral hygiene practices, overconsumption of sugars, and an unhealthy diet, dental caries continue to be the most common dental problem in kids. Ironically, studies report that children with poor oral health are 3 times more likely to remain absent from school because of toothache. 

Dental problems in growing children affect their overall quality of life due to recurrent infections, toothache, poor nutrition, sleeping troubles, emergency visits to dentists, inability to concentrate and improper growth and development. Thus, these facts highlight the significance of a good oral hygiene in kids. Brushing twice a day is the most basic and fundamental method to keep the mouth clean. In addition, use of a proper mouthwash under Dentist’s recommendation helps to give an extra boost to the oral health in children.

The need for a mouthwash in kids

Plaque and tar tar deposition on tooth surface is the initiating factor for tooth cavities and hence plaque reduction should be the hallmark of preventive dental care.

One method to remove the plaque deposits is the mechanical way like toothbrushing and interdental brushing with the help of a dental floss. Even though these mechanical methods are extremely useful, population-based surveys conducted in India report that these methods are not employed properly and effectively.

Thus, the need for chemical method. Mouthwashes, are the chemical ways and an alternative to mechanical methods to reduce the formation of plaque on the tooth. Remember, rinsing with a mouthwash is a complimentary method and cannot substitute good brushing and flossing habits in children.

Right age for kids to use a mouthwash

Mouthwash can work wonders to fight the dental problems in kids if used appropriately under the guidance of a dentist. Mouthwash can be extremely beneficial if used under proper precaution and guidance. Parents have a major role to play here and should carefully monitor their child while using a mouthwash. Dentists always recommend kids above age 6 to use a mouthwash, that too under their parent’s supervision. 

But why age 6? Kids below 6 years of age do not have fully developed motor function skills or control over their mouth to rinse and spit. There is always a chance of accidental swallowing of a mouth rinse in younger children putting their health at risk. Thus, 6 years and above is the ideal age for kids to start using a Dentist recommended mouthwash.

Can kids use an adult mouthwash

A big NO. An adult oral cavity is different than a child’s mouth. There are a variety of dental problems that an adult has to face and hence there is a different requirement in any of the oral products that an adult has to use. Few of the adult mouthwashes contain alcohol in the form of methanol/eucalyptol/ethanol and many other strong ingredients. And hence for growing children, it is always recommended to stick to kid’s friendly mouthwash only.

Types of mouthwashes for kids

Chlorhexidine mouthwashes for kids

Chlorhexidine is the gold standard amongst all the mouthwashes due to its anti-microbial activity. Chlorhexidine mouthwash has proved to consistently reduce the caries causing bacteria in the mouth. Studies have proved that a single rinse of chlorhexidine mouthwash can reduce the bacterial count by up to 10-20%. Even though it’s a potent anti-microbial agent, it’s long-term use is not advocated due to certain disadvantages like-

• It causes alteration of taste sensation.
• Brown staining of teeth.
• Affects the oral mucous membrane and tongue.
• Chlorhexidine has a unpleasant taste.

Fluoridated mouthwash

Fluoridated mouthwashes are the most popular anti-cariogenic mouthwashes. Sodium fluoride is the most commonly used fluoridated mouthwash and is available in the concentration of 0.05%(220ppm). According to a survey, the average caries reduction after the use of fluoride mouthwash was almost 31%. Another study reported that, the use of fluoridated mouthwash along with toothbrushing significantly decreased the incidence of dental caries. A pilot study conducted on the urban school children reported that use of fluoridated mouthwash can strengthen the teeth up to 99%.

 The fluoride from the mouthwash bonds to the calcium and phosphorous from tooth structure to form fluorapatite which is more resistant to dental caries. Fluoride also helps in mineralization of tooth ie strengthening of the tooth and repair of the damaged tooth structure. Fluoridated mouthwash also interferes with the formation of plaque deposits and reduces the harmful effects of bacteria on the tooth surface. Thus, fluoridated mouthwashes have an excellent anti-cariogenic property and are most recommended by the Dentists as the best mouthwash for kids.

Drawback-

Accidental swallowing or over consumption of fluoridated mouthwash can lead to a dental condition called fluorosis or fluoride toxicity. Fluorosis is a patchy, discolored, unesthetic appearance of the teeth which is treatable.

Herbal mouthwash

Most of the parents prefer to use a product which is safe, non-toxic and healthy for their kids. Because of the side-effects associated with most of the synthetic mouthwashes, Scientists are encouraging more of plant based anti-microbial agents to use. Many alcohol-free herbal mouthwashes are gaining popularity due to the presence of its natural ingredients which possess excellent anti-microbial and anti-inflammatory properties.

Such herbal mouthwashes help to reduce the occurrence of dental caries as well as gum problems. In India, brushing with the neem and mango twigs is an ancient method of brushing teeth. Also, chewing the leaves of neem plant is a way of traditional Indian oral hygiene practice. Both, neem and mango plants have numerous benefits. The neem twig reduces many harmful bacteria in the mouth and thus prevents the occurrence of various oral diseases in kids. Hence, herbal mouth washes are the most preferred since they have minimum side-effects and are economical too.

Green tea as a mouthwash?

Researchers also recommend the use of green tea as a mouthwash in combination with other mouthwashes. It is a completely natural product and hence most safe to use in children. Green tea contains ample bio-active compounds like polyphenols which are excellent anti-oxidants and help to decrease the bacterial load from mouth, prevents the deposition of plaque on the tooth surface, reduces the gum problems and development of dental caries in kids. Because of these numerous benefits, research is still in progress to validate the use of green tea as a mouth wash in children.

Disclosing agents

There are a certain type of mouthwashes which are called as disclosing agents or rinses. Disclosing rinses actually stain the plaque deposits on the tooth surface and hence helps a child to actually remove the stained plaque. Thus, disclosing rinses helps a child in a way to clean their teeth more effectively.

Which is the best mouthwash for kids

As parents would always want to choose the right mouthwash for their kids. Fluoride mouthwashes are considered a,s the best possible mouthwash for kids. The reason that these fluoridated mouthwashes are so beneficial is that they actually penetrate every nook and crannies of the mouth and every groove and in between the teeth that a toothpaste cannot reach. Thus, the added protection of fluoride in the mouthwash apart from the kid’s toothpaste helps to keep the cavities at bay.

Kids with braces present with some unique set of dental problems. From the food particles being stuck to discoloration of teeth due to food debris, maintaining an oral health in kids with braces can be a real challenge. Along with mechanical cleaning with a toothbrush, a fluoridated mouthwash can work wonders in preventing the development of dental caries in such patients.

Highlights

• Mouthwash under a Dentist’s recommendation can be very beneficial in children.
• Dentists always recommend to use a mouthwash in kids above 6 years of age.
• It’s the responsibility of the parent’s to carefully supervise their kids while using a mouthwash.
• Alternate use and disuse of mouthwash in kids give optimum results.
• Use of mouthwash along with proper toothbrushing and flossing gives adequate results.
• Rinsing and swishing with fluorine containing mouthwash provides extra benefit to kids with braces since they help to loosen the stuck food particles.