Are chlorhexidine mouthwashes safe?

Question

After having braces removed, a part of my gum was slightly larger than it was before, so my dentist suggested that I use chlorhexidine mouthwash. Is that type of mouthwash safe for general use?

Answer 1

Like almost all products, there are some side effects that come with using chlorhexidine gluconate mouthwash (CGM). Luckily, they are usually very minor and the ones that are more serious are extremely rare. WebMD¹ lists some of the common side effects of using CGM, such as teeth and mouth discoloration, taste problems, and an increase of tartar formation in the teeth. There are also more serious side effects that can come from using CGM, but these are mostly allergic reactions to its ingredients and are very rare. The FDA² has also said that serious allergic allergic reactions can occur from using products with chlorhexidine gluconate.

Anaphylaxis, as well as serious allergic reactions, have been reported during postmarketing use with dental products containing chlorhexidine.

There are studies that agree with the information that WebMD has said. Many of them are older, but the results of them are still reliable. A 1988 study³ testing out the difference between 0.1% and 0.2% CGM. It found that with both there were possible minor side effects like discoloration and loss of taste. The only noticeable difference between the two is that the test subjects preferred the taste of the 0.1% CGM.

There are also two studies from the 1980's^{4, 5} that suggest that CGM can also cause gingival bleeding. The studies did notice a slight increase in the frequency of gingival bleeding when using CGM as opposed to mechanical oral care.

Though there are side effects that can occur from using CGM, they are most likely not going to be very severe. Also, it is most likely that the benefits of using CGM will outweigh the risks. A 2006 study on both topical chlorhexidine gluconate and CGM⁶ found that the topical and mouthrinse both helped treat plaque and prevent gingivitis when used properly.

Odds are, your dentist told you to use CGM because of the swelling of your gums, a sign of gingivitis. It is more than likely that the benefits of you using CGM will outweigh the risks. If you really are worried about getting bad side effects from CGM, ask your doctor and try to find out if you are allergic to any of the ingredients.

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^{1: WebMD - Chlorhexidine Gluconate Mouthwash Side Effects}

^{2: PerioChip (chlorhexidine gluconate)}

^{3: Side-effects and patient acceptance of 0.2% versus 0.1% chlorhexidine used as post-operative prophylactic mouthwash}

^{4: Gingival bleeding after chlorhexidine mouthrinses}

^{5: Gingival bleeding after chlorhexidine rinses with or without mechanical oral hygiene}

^{6: The effect of mouthrinses and topical application of chlorhexidine on the development of dental plaque and gingivitis in man}

^{chlorhexidine gluconate}

^{chlorhexidine gluconate oral rinse (Peridex, Periogard, Periochip)}