This French phrase Chacun a son gout meaning 'everyone to his taste' conveys in just four words a universal truth: you cannot please all of the people all of the time. So when it comes to at-home, oral healthcare products, it is wise to offer patients a choice as there is no one product that will satisfy everyone.
Listerine, the antiseptic mouthwash, has been used by generations of people around the world. It is recognized for its capacity to freshen breath and to significantly reduce plaque beyond brushing and interdental cleaning alone. This is achieved by its ability to penetrate the plaque biofilm in the mouth and the effective bacterial kill power of the four essential oils that make up Listerine's formula. Because it is a mouthwash, Listerine can significantly reduce the plaque bacteria in all areas of the mouth and not just the 24 per cent that is occupied by the teeth.
While its appeal has been widespread over many decades, and sales have gradually increased around the world, the strong flavour has not been to everyone's taste. For some, the strong taste is an indication that Listerine is doing the job they bought it for; killing bacteria and cleaning and freshening their mouths and teeth. For others, the taste of Listerine, with its four essential oils solubilized by alcohol is too strong. There are others who may, for lifestyle, health or religious reasons prefer an alcohol-free, less intense mouthwash.
To satisfy all consumer groups and assist dental professionals who want to recommend Listerine to all their patients, Johnson & Johnson have introduced a new mouthwash. This has been achieved by finding a non-alcoholic solution for the four essential oils (menthol, thymol, methyl salicylate and eucalyptol) and at the same time optimizing the taste experience. The result is Listerine Zero, which contains no alcohol and has a less intense taste but kills up to 99 per cent of plaque bacteria.
In a consumer test (n=150) over 70 per cent of users ranked the overall taste/sensation of Listerine Zero as 'just about right'. According to one participant, 'It was definitely less intense than alcohol-based mouthwash, but still had enough of a 'zing' to make my mouth feel clean.'
An additional benefit of Listerine Zero is the fluoride content. It has 220 ppm (0.05 per cent) fluoride with high uptake for extra enamel protection, so it protects and maintains every aspect of tooth health. In vitro tests show that because of the way Listerine Zero is formulated, the fluoride uptake into softened enamel is significantly higher than with other products that contain similar amounts of fluoride. So in theory, with all these features, Listerine Zero should be the logical adjunct to brushing and interdental cleaning for patients who prefer an alcohol-free, less intense and fluoridated mouthwash.
When it comes to everyday oral hygiene however, patients will often put up barriers. When you have taken into account their taste, lifestyle should also be a consideration. You will need to tailor your oral health instruction to the age and lifestyle of each patient.
Prof Tim Newton, professor of psychology as applied to dentistry at King's College London, said: 'Only by understanding each individual's needs in the context of their lifestyle can we develop a programme that truly takes them from that place on the journey toward improved oral health. At the simplest level, consider whether their challenge is physical ability ('I can't do it') or a problem of finding the time or motivation ('I can't find the time to do it'). Each of these calls for a different approach, what works for one will not work for the other.'
While it should never be suggested that mouthwash on its own is sufficient, its advocates say it makes a significant difference when it is an adjunct to brushing and flossing.
References available on request.
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