A Review on Antiseptic Gargle

Shirsath Priyanka M.*, Shirsath Rutuja P., Prof. Sayyad Tahir F.

Dept of Pharmaceutics, DCS’s A R A College of Pharmacy, Nagaon, Dhule, MS

*Correspondence: priyupatil9322@gmail.com

DOI: https://doi.org/10.71431/IJRPAS.2025.4414    

INTRODUCTION

We searched for, assessed and categorized the limited data on Camellia sinensis mouthwashes in brushing is currently the most popular self-performed oral care method for mechanically removing tooth plaque.  However, the mechanical approach used by the majority of people is often insufficiently effective, suggesting that mouthwashes that contain chemicals to manage plaque could be useful in addition to routine dental care.  The broad-spectrum antimicrobial chlorhexidine (CHX) is the gold standard for chemically controlling tooth plaque.  However, prolonged use of CHX mouth wash might harm the oral mucosa, discolor teeth & tongue, and produce taste abnormalities.  These negative side effects limit patients' adoption of CHX mouthwashes and their continued use.¹

Numerous herbal mouthwashes have been created and evaluated; nevertheless, the existing literature shows mixed results regarding the clinical effects for herbal mouthwashes on the management of dental plaque and gingival irritation when compared to a placebo.  Furthermore, there is a lack of meta-analytical data highlighting the general benefits of herbal mouth wash as supplements for gingivitis patients who take care of their own dental hygiene on a daily basis.  Without this information, comprehensive, evidence-based recommendations for patients and practitioners cannot be made.  Therefore, the aim of this study was to do a comprehensive review and meta-analysis of randomized controlled trials in order to investigate the overall effects of herbal mouthwashes as supplements to daily oral hygiene on the control of plaque and inflammation.

Antiseptic iodine gargles, which have broad-spectrum antibacterial properties, are popular mouth and throat hygiene products.  Usually povidone-iodine (PVP-I), their active ingredient is a strong antiseptic that is effective against a variety of infections.  In dental and medical contexts, these gargles are particularly well-liked for treating and preventing sore throats, mouth infections, and general disinfection.²

Antiseptic Iodine Gargle

An iodine gargle is a throat rinse made primarily with povidone-iodine, a complex of iodine with povidone (a water-soluble polymer). This compound slowly releases iodine, which exerts an antimicrobial action against bacteria, viruses, fungi, and protozoa. The solution is typically diluted with water before use and is meant for gargling in the mouth and throat without swallowing.

Common Brand Names:

a. Betadine Gargle (Markted by win medicare Pvt Ltd in India)

b. Povidone-Iodine Solution (Win Medicare, Unilab Chemicals & Pharmaceutical)

c. Viodine Gargle (Karsh Biotech, Norchem Healthcare)

How Iodine Gargle Works

Iodine is a halogen element with strong oxidizing properties. When released in solution, iodine penetrates microbial cell walls and inactivates proteins and enzymes by disrupting their structure. This leads to the rapid killing of microbes.

Povidone-iodine specifically acts:

·            By destroying cell membranes

·            By denaturing proteins

·            By inhibiting metabolic enzymes

Its action is non-selective, meaning it is effective against a wide range of microbes, including:

Gram-positive and Gram-negative bacteria, Viruses (like influenza, rhinovirus, and SARS-CoV-2), Fungi, Yeasts, Some protozoa.

Uses and Applications

a. Treating Sore Throats

Iodine gargles are commonly used to relieve sore throats caused by bacterial or viral infections. They help reduce the microbial load in the mouth and pharynx, providing symptomatic relief and potentially shortening the duration of illness.

b. Prevention of Upper Respiratory Infections (URIs)

Using iodine gargles during cold and flu seasons may help prevent respiratory tract infections by inactivating viruses on contact.

c. Dental and Oral Hygiene

Dentists often recommend iodine-based mouthwashes before and after procedures to prevent infections. It is useful in cases of:

1.         Gingivitis

2.         Periodontitis

3.         Oral thrush

d. Pre- and Post-Surgical Use

Hospitals may use iodine gargles before ENT or oral surgeries to reduce the microbial flora in the throat and outh.

e. COVID-19 and Iodine Gargle

Several studies during the COVID-19 pandemic suggested that povidone-iodine could inactivate SARS-CoV-2 in the oral cavity. Though not a cure, gargling with iodine was explored as an additional preventive measure.

Directions for Use

Most commercial povidone-iodine gargles are ready to use or require dilution as per label instructions. Here’s a general method:

                 i.   Pour 10–15 ml of the solution into a cup.

               ii.   Gargle and swish the solution in the mouth and throat for 30 seconds to 1 minute.

             iii.   Spit it out. Do not swallow.

             iv.   Use up to 3–4 times daily as recommended by a healthcare provider.

               v.   Always follow the dosage and frequency indicated on the label or advised by a doctor.

Benefits

Broad-spectrum efficacy: Effective against many kinds of microbes.

Fast-acting: Kills pathogens within seconds to minutes.

Reduces transmission risk: Decreases pathogen load in mouth and throat.

Symptomatic relief: Soothes irritation from infections.

Side Effects and Risks

Though generally safe for short-term use, iodine gargles can have some side effects:

a.      Common Side Effects

Mild throat or mouth irritation

Altered taste

Temporary teeth staining

b.      Rare or Serious Side Effects

Allergic reactions: itching, swelling, rash

Iodine sensitivity

Thyroid dysfunction with long-term excessive use (especially in those with thyroid disease)

Mucosal irritation with overuse

     c. Contraindications

Individuals with iodine allergy

Patients with thyroid disorders (like hyperthyroidism)

Those undergoing radioactive iodine therapy

Pregnant or breastfeeding women, unless cleared by a doctor

Special Populations

Children: Povidone-iodine gargles are generally not recommended for children under 6 due to the risk of swallowing and iodine absorption.

Pregnant Women: Caution is advised. While topical use may be safe, frequent gargling may lead to excess iodine absorption, potentially affecting fetal thyroid function.

Elderly: Generally safe, but watch for signs of irritation or thyroid sensitivity.

Storage and Shelf Life

Store at room temperature away from direct sunlight.

Keep tightly closed and out of reach of children.

Check the expiration date. Discard cloudy or discolored solutions.

CONCLUSION

The use of iodine antiseptic gargle proves to be an effective and accessible method for reducing microbial presence in the oral cavity. Its broad-spectrum antimicrobial properties help in preventing infections, particularly in the throat and upper respiratory tract. Regular use under proper guidance may contribute to improved oral hygiene and reduced incidence of common illnesses such as colds and sore throats. However, care must be taken with prolonged use, especially for individuals with thyroid conditions or iodine sensitivity. Overall, iodine antiseptic gargle is a valuable tool in personal and clinical hygiene when used safely and appropriately.

ACKNOWLEDGEMENT

We are thankful to the Principal and Management of DCS’s A R A College of Pharmacy Nagaon, Dist- Dhule for providing moral support and necessary facilities during completion of this work.

REFERENCES       

1.      Benjamin SN, Gathece LW, Wagaiyu EG. Knowledge, attitude and use of mouthwash among dental and medical students of the University of Nairobi. Int. J. Dent. Oral Health, 2016; 2(4): 01-6.

2.      Kukreja B. Jha, and Vidya dodwad, Herbal mouthwashes- A gift of nature. International Journal of Pharma and Bio Sciences, June 2012: 3(2):47-52

3.      Edris AE. Pharmaceutical and therapeutic potentials of essential oils and their individual volatile constituents: a review. Phytother Res 2007; 21(4): 308-323.

4.      Shibly O., Rifai S., and Zambon J. J., “Supragingival dental plaque in the etiology of oral diseases,” Periodontology 2000, 8(1): 42–59.  

5.      Osso D. and Kanani N., “Antiseptic mouth rinses: an update on comparative effectiveness, risks and recommendations,” Journal of Dental Hygiene, 2013: 87 (1):10–18.

6.      Chandrasekaran S, Varghese S. Validity of self-reported periodontal status in patients visiting dental hospital in Chennai-A prospective study. Int J Sci Res 2017: 6:180-182.

7.      A. Rohatgi, Web Plot Digitizer, http://automeris.io/ WebPlotDigitizer.