What Magic Mouthwash Is and How It Works

Magic mouthwash is a mouth rinse often prescribed for people with mouth sores (oral mucositis) caused by chemotherapy, radiation therapy, and some targeted therapies. It is also used for oral thrush and oral pain caused by certain infections. The mouthwash comes in variety of formulations, under different names, and can be used by both adults and children.

Other Names

Miracle mouthwash

Mary's magic mouthwash

Duke's mouthwash

Person pouring medication into a dosage cup
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Uses

Mouth sores typical of oral mucositis are characterized by red patches, swelling, or ulcers in the mouth. Magic mouthwash is used to diminish the pain from these symptoms, which can commonly develop due to cancer chemotherapy and radiation treatment.

In some cases, chemotherapy-induced mouth sores can be so painful that they cause problems with eating, swallowing, and talking.And sometimes secondary bacterial or fungal infections can develop.

Of great concern is the weight loss that can occur when mouth sores make it painful to eat. Cancer cachexia, a syndrome that involves decreased appetite, weight loss, and muscle loss, is thought to be the direct cause of death for 20% of people with cancer. Since cachexia isn't easily treatable, preventing weight loss by managing any problem that interferes with eating is crucial.

Magic Mouthwash Ingredients

There are several different magic mouthwash products, with varying formulations.

Common magic mouthwash ingredients include:

  • Local anesthetics (such as viscous lidocaine): Anesthetics work to numb the mouth and reduce pain.
  • Corticosteroids: Steroids can reduce inflammation, resulting in less redness and swelling.
  • Antihistamine/anticholinergics (such as Benadryl): Antihistamines can reduce swelling.
  • Antibiotics (such as tetracycline): Some preparations contain antibiotics that are added to reduce the chance of secondary bacterial infection.
  • Antifungals (such as nystatin): Antifungals may be added to reduce the chance of a secondary fungal infection (thrush).
  • Antacids (such as magnesium hydroxide/aluminum hydroxide): Several different types of antacids may be added for the purpose of coating the mouth and throat.
  • Mucosal protective agents (such as sucralfate): These agents may provide a barrier to protect the underlying mouth sore from irritation by substances in the mouth.
  • Flavoring: Some preparations add a flavoring agent to improve the taste.

Can You Make Your Own Magic Mouthwash?

There are make-your-own mouth rinses that you can put together with common kitchen ingredients, but these differ from most medical formulations of magic mouthwash.

Magic mouthwash usually contains at least one (and often more) ingredient that requires a pharmacist to prepare and requires a doctor's prescription to obtain.

How It’s Used

Here are the steps to follow for using magic mouthwash properly:

  1. Pour your prescribed dose of the mouthwash into a sterile spoon or measuring cup.
  2. Keep the liquid in your mouth and swish it around for a minute or two.
  3. Spit out the mouthwash. Swallowing it can cause side effects, such as an upset stomach.
  4. Avoid eating or drinking anything for at least 30 minutes after using magic mouthwash.

Since there are so many different formulations, it's important to ask your pharmacist how to use yours properly.

Dosage and Frequency

For most preparations, instructions say to put 2 teaspoons of the solution in your mouth and swish it around or hold it for around two minutes. Then you'll spit out the mouthwash.

The process is repeated every four to six hours.

Cost and Insurance Coverage

As of 2021, the price of an 8-ounce bottle of magic mouthwash ranged from $35 to $65. It may or may not be covered by your insurance, so be sure to call your provider.

Benefits

There is currently controversy over the actual benefit of magic mouthwash, and the variations in formulas make it difficult to study. Some health experts recommend against using it, saying there's not enough evidence that it's more effective than salt or baking soda rinses.

That said, anecdotal reports from physicians and patients attest to at least some benefit in reducing pain with some formulations, so magic mouthwash is frequently prescribed.

Ask your oncologist for their input about magic mouthwash. Since mouth sores are so common, they have likely had experience with what helps and what doesn't help reduce the pain, and they will be able to give you guidance based on what has worked for other patients.

Risks

The risks of magic mouthwash depend on the ingredients in the formula.

Formulations that contain a local anesthetic could potentially mask symptoms that would normally alert you to call your healthcare provider. This numbing effect could also make it more likely that you'll bite down on the inside of your mouth or even choke when eating.

There are also potential risks associated with medications such as antihistamines, antibiotics, and antacids.

Side Effects

Side effects can vary depending on the formulation.

Local side effects may include:

  • Allergic reactions: There is the potential for an allergic reaction to one of the ingredients.
  • Tingling or burning in your mouth: Burning is often temporary and only lasts a few minutes.
  • Change in taste: This could compound the taste changes from chemotherapy that occur with some medications.
  • Dry mouth

Some of the side effects can be difficult to distinguish from an allergic reaction, and it is hard to tell which ingredient is causing the reaction.

Systemic (bodywide) side effects may include:

Other Treatments for Mouth Sores

For mild mouth sores, homemade mouthwashes, such as baking soda mixtures, may reduce the risk of developing a secondary infection.

Other treatments that have been shown to be helpful include:

  • Morphine mouthwash: Some research has found that topical morphine mouthwashes worked better than magic mouthwash for treating mouth sores in cancer patients.
  • Cryotherapy: Several studies have found cryotherapy (ice) to be beneficial, especially for more severe mouth sores.
  • Palifermin: Palifermin is a synthetic version of keratinocyte growth factor (KGF), a molecule that promotes the healing of mouth sores. Palifermin is currently approved for treatment of mouth sores in patients with blood cancers.
  • Low-level laser therapy: Low-level laser therapy has been shown to reduce pain from oral mucositis and to work more quickly in some cases than other methods.

Frequently Asked Questions

  • How long does magic mouthwash last?

    Magic mouthwash should be good for around 12 months once opened, but this may not be true for all formulations. Ask your pharmacist for details based on the formula you're using.

  • Where can I buy magic mouthwash?

    Magic mouthwash requires a doctor's prescription and must be prepared by a pharmacist.

  • What happens if you swallow magic mouthwash?

    It is not dangerous if you swallow magic mouthwash by accident, but it's better to spit it out because swallowing it can cause an upset stomach.

  • Will thrush go away on its own?

    Oral thrush, a fungal infection in the mouth, often goes away on its own. However, a healthcare provider may prescribe an anti-fungal magic mouthwash formula in cases where other treatment methods are unsuccessful.

  • Does magic mouthwash need to be refrigerated?

    Magic mouthwash does not usually need to be refrigerated, unless your specific product says otherwise.

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10 Sources
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