Use of Oral Antiseptics and its Association with Cardiovascular Events: Review

Most nitrates which circulate in the plasma become concentrated in salivary glands and released into saliva. Nitrate molecules are reduced to nitrites via oral facultative anaerobic bacteria. After swallowing, some nitrites are absorbed into the circulating blood and represent one of the sources of vasodilatory Nitric Oxide (NO). It has been recently found that the antiseptic mouth rinse used by healthy individuals for more than one week elevates the blood pressure to some extent and reduces nitrate reduction. In the present review, we discuss the disruption of the nitrate-nitrite-NO pathway after using the antibacterial mouthwashes. Reduction of commensal bacteria by antiseptics prevent endogenously produced nitrates from being recycled to systemic nitrite which has the potential to decrease blood pressure. Thus, it can be concluded that excessive use of oral antiseptic mouthrinses could lead to cardiovascular events particularly in patients with high risk to cardiovascular accidents.