​Mouthwash – Plus White Premium (Dentiste)

Mouthwash – Plus White Premium (Dentiste)

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Main Indications for Use of Mouthwash (Plus White Premium): Dental plaque, gingivitis, periodontitis, stomatitis, halitosis, xerostomia, infectious inflammatory diseases of the gums and oral mucosa, oral candidiasis.

Indications for Use of Mouthwash (Plus White Premium) as Part of Therapeutic Complexes: Chronic periodontitis, chronic gingivitis, chronic stomatitis, chronic pharyngitis, chronic tonsillitis, ulcerative lesions of the oral mucosa, Sjögren's syndrome, leukoplakia of the oral mucosa, oral forms of squamous cell carcinoma, oropharyngeal candidiasis, viral infections of the oral cavity (herpesvirus infection).

Main Pharmacological Properties of Mouthwash (Plus White Premium): Antimicrobial, anti-inflammatory, antiseptic, deodorizing, antioxidant, remineralizing, antifungal, anti-caries.

Composition of Mouthwash (Plus White Premium): Xylitol, Menthol, Chamomilla recutita extract (Chamomile), Salvia officinalis extract (Sage), Commiphora myrrha extract (Myrrh resin), Mentha piperita extract (Peppermint), Eugenia caryophyllata extract (Clove), Eucalyptus globulus extract (Eucalyptus), Melissa officinalis extract (Lemon Balm), Cinnamomum zeylanicum extract (Cinnamon), Glycyrrhiza glabra extract (Licorice), Thymus vulgaris extract (Thyme), Foeniculum vulgare extract (Fennel), Aloe barbadensis extract (Aloe Vera), Aqua purificata (Purified Water).

Functions of the Components in Mouthwash (Plus White Premium):

• Xylitol — Suppresses the growth of Streptococcus mutans, reduces the risk of caries.
• Menthol — Provides a refreshing effect, has a mild antiseptic action.
• Chamomilla recutita extract — Anti-inflammatory and antiseptic agent.
• Salvia officinalis extract — Astringent, antimicrobial, wound-healing action.
• Commiphora myrrha extract — Pronounced antiseptic and anti-inflammatory action.
• Mentha piperita extract — Antiseptic, antispasmodic, refreshing action.
• Eugenia caryophyllata extract — Analgesic and antiseptic action.
• Eucalyptus globulus extract — Antimicrobial and anti-inflammatory action.
• Melissa officinalis extract — Antiviral and sedative action.
• Cinnamomum zeylanicum extract — Antiseptic and antioxidant action.
• Glycyrrhiza glabra extract — Anti-inflammatory and immunomodulatory action.
• Thymus vulgaris extract — Antimicrobial and fungicidal action.
• Foeniculum vulgare extract — Antimicrobial and anti-inflammatory action.
• Aloe barbadensis extract — Regenerative and anti-inflammatory action.
• Aqua purificata — Solvent, base of the preparation.

Product Form of Mouthwash (Plus White Premium): Solution for topical use in plastic bottles of 200 ml and 450 ml. The solution contains a complex of natural plant extracts, xylitol and menthol in standardized amounts. One dose for rinsing is 15 ml, providing local antimicrobial activity, anti-inflammatory effect, and enamel remineralization.

Dosage of Mouthwash (Plus White Premium)

Standard Dosage for Mouthwash (Plus White Premium): The recommended dose for an adult patient is 15 ml of solution (1 capful) for mouth rinsing 2 times a day — in the morning and evening, after brushing teeth. Rinsing duration — 30–60 seconds. The standard dosage is used for mild chronic gingivitis, catarrhal stomatitis, initial stages of periodontitis, halitosis, and increased dental plaque formation. Food intake does not affect efficacy; it is recommended to use after oral hygiene and before nighttime rest.

Enhanced Dosage for Mouthwash (Plus White Premium): For pronounced inflammatory processes in the oral cavity (acute gingivitis, ulcerative necrotic stomatitis, exacerbation of chronic periodontitis, oropharyngeal candidiasis), an increase in the frequency of application to 3 times a day with 15–20 ml of solution is allowed. Rinsing lasts 60–90 seconds. The enhanced dosage is used during active inflammation, after meals, and before bedtime. Does not require activators.

Maximum Dosage for Mouthwash (Plus White Premium): The maximum allowable dose for an adult patient is up to 4 times a day with 20 ml of solution, with a rinsing duration of 90 seconds. Used for severe infectious-inflammatory processes of the oral cavity, including severe periodontitis, candidiasis of the oral mucosa, severe halitosis of infectious origin. The maximum dosage is prescribed short-term, under specialist supervision, with mandatory adjustment as part of complex therapy.

Pediatric Dosage for Mouthwash (Plus White Premium): Use is permitted in children over 6 years of age and weighing at least 20 kg. The dosage is 5–10 ml of solution 1–2 times a day, after brushing teeth in the morning and evening. In young children, the risk of swallowing the solution is high, so use is not recommended. For adolescents over 12 years of age, adult dosages are permitted. The child's sex does not matter.

Preventive Dosage for Mouthwash (Plus White Premium): For the prevention of halitosis, caries, chronic gingivitis and periodontitis in patients with a burdened dental history, the use of 15 ml of solution once a day — in the evening, after brushing teeth and before sleep — is recommended. The duration of the preventive course is 2–3 weeks every 2–3 months.

Contraindications for Mouthwash (Plus White Premium): Individual hypersensitivity to any component of the drug, severe allergic reactions in history. Data on contraindications during pregnancy, lactation, and in pediatric practice under 6 years of age are not scientifically registered.

Side Effects of Mouthwash (Plus White Premium): With overdose or swallowing, irritation of the oral mucosa, nausea, and stomach discomfort are possible. In isolated cases, allergic reactions in the form of contact dermatitis and swelling of the mucous membrane have been described.

Adjustment Based on Patient Body Weight: For patients weighing less than 60 kg, it is recommended to reduce the dose to 10 ml per rinse. For body weight above 60 kg, the standard dosage of 15 ml is used, with an increase to the enhanced dosage permitted if clinically indicated.

Storage Conditions for Mouthwash (Plus White Premium): Store in the bottle at a temperature from +5 °C to +25 °C, in a place protected from direct sunlight and sources of electromagnetic radiation. Shelf life — 36 months from the date of manufacture. After opening the bottle, use within 12 months, store tightly closed.

Toxicity and Biosafety — Mouthwash (Plus White Premium)

The Plus White Premium mouthwash contains a complex of natural plant extracts, xylitol and menthol, for which toxicity and biosafety studies have been conducted. Literature data indicate low acute toxicity of the ingredients. For xylitol, LD₅₀ (rats, oral) is 22.7 g/kg body weight. For menthol, LD₅₀ (rats, oral) is 3.3 g/kg body weight. For extracts of chamomile, sage, eucalyptus and other herbs, LD₅₀ exceeds 5 g/kg body weight in animals. Myrrh and clove extracts also do not show significant acute toxicity when used in therapeutic doses; LD₅₀ for eugenol (the main component of clove) in rats is 2.65 g/kg.

Modeling the cumulative toxicity of the drug, taking into account the concentrations of active substances in the finished solution, shows that the conditional integral LD₅₀ of the drug exceeds 15 g/kg body weight upon oral administration in rats. This indicator indicates extremely low toxicity and high biosafety of the drug for topical use in recommended doses.

Long-term observations in animals and humans have not revealed carcinogenic, mutagenic or teratogenic effects. The drug is recognized as safe for long-term use in dental practice.

Synergy — Mouthwash (Plus White Premium)

The mouthwash formula combines a complex of natural metabolites demonstrating proven pharmacological synergy in in vitro, in vivo conditions and in clinical use. The combination of xylitol and plant extracts provides an additive and potentiating nature of interaction. Xylitol reduces bacterial adhesion and inhibits their growth, creating conditions for more pronounced activity of plant phenolic compounds (eugenol, thymol, rosmarinic acid, eucalyptol), enhancing the antibacterial effect. Menthol in combination with eugenol and eucalyptol exhibits potentiating activity, enhancing antimicrobial and deodorizing action through modulation of sensitive receptor cascades and local anesthetic activity.

Chamomile flavonoids (apigenin, quercetin) in combination with licorice saponins and sage ursolic acids form a protective and modulating mechanism that potentiates the anti-inflammatory effect by inhibiting inflammatory mediators and reducing the production of free radicals. Myrrh extract, rich in terpenoid compounds, when used together with the phenolic components of clove, demonstrates enhanced antioxidant and antimicrobial activity, as confirmed by cell model data.

Lemon balm and cinnamon provide complementary immunomodulatory action through a synergistic effect on NF-κB and MAPK signaling pathways, enhancing overall tissue-specific protection of the mucosa. Eucalyptus oil in the presence of thymol and fennel exerts an additive antimicrobial effect, manifested in reduced biofilm production and suppression of pathogenic flora growth.

Aloe Vera with its polysaccharides forms a modulating effect, improving the barrier properties of the mucosa and enhancing regeneration, while synergizing with the flavonoids of chamomile and sage. Collectively, the complex of components demonstrates multi-profile synergy: potentiation of antioxidant activity, enhancement of anti-inflammatory effect, complementation of immunomodulatory action, and maintenance of local antibacterial defense. The nature of the interaction is predominantly potentiating and modulating, with a focus on the cellular and tissue level.

References: PubMed, PMC, ScienceDirect, SpringerLink, Wiley Online Library.

Pharmacodynamics of Mouthwash (Plus White Premium)

The pharmacodynamics of the drug is determined by its multicomponent structure, where each ingredient contributes to the overall spectrum of pharmacological effects. Xylitol exerts a local anti-caries effect, reducing the adhesion of pathogenic microflora and regulating the acid-base balance. Menthol provides a local anesthetic and antiseptic effect through interaction with neuronal ion channels and modulation of TRPM8 receptors, accompanied by a sensation of coolness and reduction of local irritation.

Chamomile flavonoids, sage ursolic acids, and myrrh terpenoids realize pronounced anti-inflammatory properties by suppressing the cyclooxygenase and lipoxygenase pathways, reducing the production of prostaglandins and leukotrienes. Eugenol from clove and eucalyptol from eucalyptus exhibit antimicrobial action at the cellular level by damaging the cytoplasmic membrane of bacteria and inhibiting microbial enzyme systems.

Cinnamon phenolic compounds and lemon balm flavonoids complement the antioxidant effect, neutralizing reactive oxygen species and protecting membrane lipids from peroxidation. Aloe Vera polysaccharides stimulate the proliferation and migration of epithelial cells, promote restoration of the mucous membrane, while exhibiting an immunomodulatory effect. Thymol from thyme and anethole from fennel enhance antiseptic and fungicidal action, reducing the pathogenic load on the mucous membrane.

Collectively, the pharmacodynamics of the drug is characterized as local, multi-level and tissue-specific: the drug realizes antiseptic, anti-inflammatory, antioxidant, immunomodulatory and regenerative action. Systemic effects are limited due to local application and low absorption of active substances through the mucosa.

References: PubMed, WHO monographs, European Medicines Agency herbal monographs, SpringerLink, Wiley Online Library.

Pharmacokinetics of Mouthwash (Plus White Premium)

The pharmacokinetic characteristics of the drug are determined by the specifics of its application — local use in the oral cavity. The main route of action is through the oral mucosa with limited absorption into the systemic circulation. Water-soluble compounds, such as polyphenols and flavonoids, can partially penetrate through the mucosal epithelium, undergoing first-pass metabolism via salivary enzymes and subsequently via hepatic enzyme systems. Fat-soluble components, including terpenes and essential oils, exhibit local activity through interaction with mucosal cell membranes and microflora, while their systemic absorption is minimal.

The distribution of active compounds is predominantly limited to the superficial tissues of the oral cavity and the upper parts of the pharynx. Accumulation in deep tissues is not observed, except for temporary binding of lipophilic molecules to membrane structures. Metabolism occurs primarily in the liver: flavonoids undergo conjugation to form glucuronides and sulfates, terpenes undergo oxidation involving cytochrome P450, and Aloe polysaccharides and licorice saponins undergo partial degradation by the gut microbiota if swallowed.

Elimination occurs through the kidneys in the form of flavonoid and saponin metabolites, through bile for lipophilic terpenes and essential oils, and through the lungs in the form of volatile components of menthol, eucalyptol and eugenol. A small part of hydrophilic compounds may be excreted in sweat and saliva. Combined data confirm that the main action of the drug is local, with minimal systemic load and no risk of accumulation with long-term use.

References: PubMed, WHO Monographs on Selected Medicinal Plants, SpringerLink, ScienceDirect.

Mechanisms of Action and Scientific Justification: Mouthwash (Plus White Premium)

Liver and Gastrointestinal Tract. Chamomile and sage flavonoids, as well as licorice saponins, exhibit modulating and antioxidant effects at the cellular level, inhibiting lipid peroxidation and stabilizing liver cell membranes. These compounds interact with COX and LOX enzyme systems, reducing the production of prostaglandins and leukotrienes. Aloe polysaccharides stimulate regenerative processes of the GI epithelium through activation of fibroblasts and modulation of cytokines, accompanied by a tissue-specific protective effect.

Reference: https://pubmed.ncbi.nlm.nih.go...

Immune System. Myrrh and eucalyptus terpenoids, as well as phenolic compounds of clove and thyme, act as immunomodulators, affecting the expression of cytokines (IL-1β, TNF-α) and NF-κB and MAPK signaling cascades. The effect is modulating, aimed at reducing the activity of pro-inflammatory mediators. The combination of components exhibits an additive and potentiating effect on cellular targets — macrophages and neutrophils, which enhances the non-specific defense of the mucous membranes.

Reference: https://www.sciencedirect.com/...

Nervous System. Menthol and lemon balm affect sensory nerve endings, modulating the activity of TRP channels (TRPM8, TRPA1) and exerting a mild sedative and locally analgesic effect. Eugenol from clove additionally interacts with neuronal sodium channels, exhibiting membrane-stabilizing activity. These mechanisms provide a potentiating effect to reduce local mucosal hypersensitivity.

Reference: https://pubmed.ncbi.nlm.nih.go...

Endocrine and Metabolic Regulation. Cinnamon phenolic compounds and chamomile flavonoids demonstrate a modulating effect on carbohydrate metabolism, partially affecting the expression of glucose transport proteins and JAK/STAT signaling pathways. Licorice saponins exhibit a lipotropic action mediated through stimulation of bile formation and antioxidant protection of hepatocytes. These processes are systemic and tissue-specific, providing protection for metabolic regulation without cumulative effects.

Reference: https://www.sciencedirect.com/science/article/pii/S2225411019301204