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Antibacterial mouth rinses can be divided into 1st generation and 2nd generation agents.

  • 1st generation agents such as essential oils, sanguinarine, cetylpyridinium chloride and peroxides, have been available as over-the-counter antibacterial rinses for a long time. Even though they are antibacterial, they have less substantivity than 2nd generation agents. Substantivity is the ability of an active agent to be retained in the mouth and is able to continue to be released over an extended period of time without losing its strength. Therefore, 1st generation agents need to be used more frequently to obtain results.
  • 2nd generation agents have proven substantivity and antibacterial properties. Common 2nd generation agents include chlorhexidine and stannous fluoride which require prescription for use.

There are two categories recognized by the American Dental Association (ADA) to be effective against plaque and gum disease:

  1. Mouthwash that contains essential oils as an active ingredient. For example Listerine® mouthwash and other generic equivalents sold over the counter.
  2. Mouthwash that contains chlorhexidine gluconate as an active agent which the Food and Drug Administration (FDA) has approved ONLY as prescription products. For example Peridex® and Prevident®.
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