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Smiles are always in style: Compounded medications for your mouth

BASIC ORAL HYGEINE

Toothbrushes, toothpaste, floss, and mouthwash are all tools that most people use every day. They keep our mouths healthy and happy.

We all know that poor oral hygiene can lead to cavities, infections in the mouth and gum disease. Did you know though, that there is a proven connection between our oral health and our general health?1 In addition to local infections and disorders in your mouth, poor oral hygiene can also lead to other serious health conditions. For example, endocarditis, pneumonia and cardiovascular disease can all stem from an infection in the mouth.1

Alternatively, diseases like diabetes can negatively impact your oral health. These diseases reduce our ability to fight infections and dental cavities. This occurs by disrupting the balance of bacteria in our mouths and our saliva production.1

AN EXPLANATION OF GENERAL COMPOUNDED FORMULATIONS

When injury or disease of the mouth do occur, compounded medications can be very helpful. All compounded medications can be customized to your specific needs. Let me first explain the general compounds that are used to treat ailments in the mouth and throat. Then we will conclude with specific disorders or concerns.

“Miracle Mouthwashes”

This is one of the most common types of compounds used to treat a variation of disorders in the mouth. It is a liquid formulation composed of a combination of medications, which vary based on your specific needs. This liquid is swished around in your mouth, sometimes gargled for about one minute, and then spit out. Just like a mouthwash. The medications coat the inside lining of your mouth, allowing them to act directly on the affected tissues.

Lollipops

This is a good option for youngsters, especially after a tonsillectomy. Medicated lollipops are generally placed in the mouth for about 30 seconds to a 1 minute at time and repeated every few hours through out the day.

Oral gel/pastes

These compounds are great when we want the medication to sit on the tissues for an extended amount of time. It is also helpful for focusing medication on a specific spot in the mouth.

COMPOUNDED MEDICATIONS THAT CAN BE CUSTOMIZED FOR YOU

Now, let’s get into more specific disorders and compounded medication options.

Oral Infections

  • Miracle Mouthwashes – can include a blend of antibiotics, antifungals, antivirals, pain medications, and steroids. These contain a variety of ingredients specific to what you need.

Pain/Nerve Pain/Mucositis

  • Lollipops – usually compounded with a numbing ingredient like tetracaine to help numb your mouth/throat.
  • Miracle Mouthwashes – can include pain medications, steroids, gabapentin, and ketamine.
  • Topical gel/pastes – can include pain medications, steroids, gabapentin, and ketamine.

Dry Mouth/Mucositis

  • Lollipops or mouthwashes are compounded with a medication called Pilocarpine. Pilocarpine helps to increase saliva production, reducing dryness and improving the positive effects of healthy bacteria.
  • Miracle Mouthwash compounded with a medication called Doxepin. Doxepin has been shown to be helpful for mucositis, especially when induced by chemotherapy. It helps with a pain that is often described as “burning” in the mouth. 2

Ulcers/Sores

  • Miracle Mouthwash – can include antibiotics, antifungals, antivirals, pain medications, and steroids.
  • Topical gel/paste – can include antibiotics, antifungals, antivirals, pain medications, and steroids.

Halitosis (aka Bad Breath)

  • Miracle Mouthwash compounded with a specific antibiotic called Metronidazole.3

NON-PHARMACOLOGIC TIPS FOR A HEALTHY MOUTH

  • Brush your teeth at least twice a day with a soft-bristled brush using fluoride toothpaste.
  • Floss daily after brushing your teeth.
  • Use mouthwash to help remove any particles left after brushing and flossing.
  • Maintain a healthy diet that included limited added sugars.
  • Replace your toothbrush every three months or sooner if bristles are splayed or worn.
  • Quit smoking.
  • Schedule regular dental checkups and cleanings every six months.

REFERENCES

  1. Oral health: A window to your overall health. MayoClinic.org click here.
  2. Negrin RS, Toljanic JA. Oral toxicity associated with chemotherapy. UpToDate. https://www-uptodate-com.mwu.idm.oclc.org/contents/oral-toxicity-associated-with-chemotherapy?search=mucocitis&sectionRank=1&usage_type=default&anchor=H21&source=machineLearning&selectedTitle=2~150&display_rank=2#H21
  3. Hartley G, McKenzie C, Greenman J, El-Maaytah MA, Scully C, Porter S. Tongue microbiota and malodour. Microb Ecol Health Dis. 1999;11(4):226-33.

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