Post-Operative Rinsing: Is Sugar Water Better Than Warm Salt Walter?

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Dr. N. asks:
Most of us have advised patients to use warm salt water rinses after the surgical placement of dental implants, extractions or bone/ soft tissue grafting. The problem though with salt rinses is osmosis — reverse osmosis to be exact — the removal of water from healthy rebuilding cells. Has anyone advised their patients to rinse with sugar water instead of salt water? I read an article that faster healing would occur if sugar was used instead of salt for post-operative rinsing. Any thoughts?

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14 Responses to “ Post-Operative Rinsing: Is Sugar Water Better Than Warm Salt Walter? ”

• Paul July 14th, 2008

  
  

  IMO, Bad idea, especially if there’s any teeth.

• Dr.Serge July 15th, 2008

  
  

  I use salt, no idea about sugar.
  Salt by the reverse Osmosis help removing water not from the rebuilding cell but mainly from the inflamed tissue where water have been accumulated due to inflamation…that need a concentration greater than the physiologic concentration…Salt in water make a dissociation into sodium ion and cholrium ion which has an antiseptic effect…so i would prefer salt until further evidence on sugar…
  but in implant i use cholerixidine mainly….

• JawGuy July 15th, 2008

  
  

  You would actually have to be well over physiological sodium cholride concentrations to have the describe scenario. Normal serum NACL concentration is roughly 0.9%. Unless you are using more than a teaspoon per a glass (8oz), I doubt you have a seriously hypertonic solution. Should taste about like seawater and that is very close to physiological concentrations.

• Alejandro Berg July 15th, 2008

  
  

  I usually recomend phys serum, and never encountered problems, sugar….. plaque would love that wouldnt it?

• Bruce G Knecht July 15th, 2008

  
  

  Use 50/50 perioxide and water. It oxegenates the tissues and they seem to heal better. This is imperical and not study based. Sugar is not good for a diabetic or some one on the verge. Also what about the remaining teeth if any.

• mike stanley, asst. July 15th, 2008

  
  

  Most studies and articles concentrate on the “expected” result, ignoring “side” issues like plaque, caries, etc. Particularly if it was in a surgical journal, they might only look at localized soft tissue response.

• JW July 15th, 2008

  
  

  Ummmm, really? Can you post the literature source, I’ve never heard this and would love to read more

• jerry Drury July 15th, 2008

  
  

  I would reccommed chlorihexidine post op. It can be used twice a day and will help reduce local bacterial load. In vitro studies demostrate possible fibroblast inhibition but this has not been substantiated clinically. Perio surgery healing seems to be enhanced especially in the smoker or immunocompromised. Saline rinses can sooth the tissue ,but could stimulate bacterial growth.

• list erine July 19th, 2008

  
  

  chlorhexidine stains teeth
  USE LISTERINE OR SALT WATER ONLY

• JW July 22nd, 2008

  
  

  The essential oil in listerine is bad for tissues. Periodontal healing is enhanced by the SUBSTANTIVITY of Chlx. Your patient’s teeth may stain a bit if they use it quite a bit, I usually get around this by having them use a cotton swab. The stain is not permanent, and if your DA’s have a coronal polish lic, they can polish the stain away in 5 minutes.

• Dr.Aslan Y.GOKBUGET July 24th, 2008

  
  

  Hi,
  I use salt but concentration of salty water is important…ıt doesn’t have osmotic effect if you prepare high concentration… after GTR procedure I dont recommend CHX or Listerine these are also harm effect the progenitor cells so for standard eudematous tissue sterile saline(Nacl) is best solution…

• Rajeev Chitguppi August 10th, 2008

  
  

  Salt water gargling to improve oral wound healing? No use. Sugar ..sorry again. Although it is very much in practice for a very very long time, it lacks scientific evidence. The roots of this therapy can be traced back to the one recommended in Throat infection where warm salt water helps to reduce the severity of congestion and make the individual more comfortable.

  In a randomized controlled trial done (published in JADA 2000-2001, not sure of the volume, but will get you that soon), they found no difference with addition of salt to water. The temperature of the water made no difference either.

  So evidence based dentistry has clearly proven that - Plain water is as good as any mixture of some different temperature. Thus one can comfortably put the theory of reverse osmosis to rest. The removal of debris from the wound area and due to rinsing with water and keeping it clean is the only thing that helps in oral wound healing.

• Mark P. Miller, DDS August 12th, 2008

  
  

  Read Jorgen Slots’ (USC perio dept.) articles on bleach rinses. A 20/1 ratio. Kills everything. Makes biologic sense. I cannot address implants specifically as relates to his articles, but we use this ratio at home as a twice daily regimen. You won’t read about it anywhere because it costs nothing and therefore won’t get any corporate traction.
  Sugar just sounds like a bad idea. If we are trying as dentists to fight bacteria, why would we want to feed them? We are trying to kill them. Even on implants.

• Jim Sylvester August 19th, 2008

  
  

  The question is a very interesting one, especially since I know of a person with a large abdominal wound who was unable to receive grafts and was given up for terminal. Someone decided to cover the wound with sugar every day for a month and watched the wound completely heal itself with new skin growth! The therory behind that was that the bacteria love sugar and will move OUT of the host and affix themselves to the sugar that can be easly rinsed away and hence actually aid in minimizing the infection. Worth doing a study, don´t you think?

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