A mixture of essential oils consisting of thymol 0.06%, eucalyptol 0.09%, methyl salicylate 0.06%, and menthol 0.04% in an alcohol-based vehicle (26.9%) provides the plaque-inhibiting properties of rinsing agents such as Listerine.
Essential oils may reduce plaque levels by inhibiting bacterial enzymes and by reducing pathogenicity of plaque via reduction of the amount of endotoxin; the alcohol is probably responsible for denaturing bacterial cell walls. The substantivity of Listerine appears to be quite low, and therefore, it must be used at least twice a day to be effective. A variety of clinical studies have demonstrated that Listerine is capable of reducing plaque and gingivitis over extended periods; however, the degree of reduction is variable. Listerine will reduce plaque and gingivitis anywhere from 14.9 to 20.8% and 6.5 to 27.7%, respectively (Table 42.1). Adverse reactions include a bitter taste and burning sensation in the oral cavity. Regular use of high-alcohol rinses can aggravate existing oral lesions and desiccate mucous membranes. In addition to Listerine, a huge number of American Dental Society (ADA) approved generic equivalents available over the counter.
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