Impact of Excessive Use of Oral antiseptics on the Incidence of Cardiovascular Events

Objectives: Most nitrates which are circulating in the plasma become concentrated in salivary glands and released into saliva. Oral facultative anaerobic nitrate-reducing bacteria inhabiting the oral cavity reduce the nitrate molecules to nitrites. After swallowing, some nitrites are absorbed into the blood stream and in conjunction with nitrites formed from nitric oxide (NO) metabolism, become a source of vasodilatory NO. It has been recently found that the use of antibacterial mouthwash by healthy individuals for more than one week elevates the blood pressure to some extent and reduces nitrate reduction. In the present review, our main objective is to explore the interruption of the nitrate–nitrite–NO pathway through the use of antibacterial mouthwash.

Methods: MEDLINE/PubMed and EMBASE were searched for all studies related to our key words.
Results: It was revealed that the use of antibacterial mouthwash by healthy individuals for more than one week elevated the blood pressure to some extent. As, reduction of commensal bacteria by oral antiseptics prevents endogenously produced nitrates from being recycled to systemic nitrite which could have a direct blood pressure lowering effect.
Conclusions: We concluded that excessive use of oral antiseptic mouthrinses could lead to cardiovascular events particularly in patients with high risk to cardiovascular accidents.