Magic Mouthwash is a name given to a compounded formulation used to treat mouth sores, sore throat, and other oral conditions. The traditional formulation includes 1 part viscous lidocaine, 1 part Maalox, and 1 part diphenhydramine. However other formulations exist and there are different concentrations that can be made. Since the mouthwash is made by a pharmacy for an individual based on a prescription, there can be changes made for the individual patient.
Ingredients for Magic Mouthwash
You may have noticed that the traditional magic mouthwash contains three main types of ingredients – an antihistamine, an anesthetic, and an antacid. If you have never heard of this formulation before you may wonder why an antacid is included a mouthwash formulation. Maalox actually has dual purposes – one is to restore a pH balance and the other is to ensure that the medication coats and adheres to all of the surfaces of the mouth. Other ingredients that may be added to a magic mouthwash formulation include antifungals, antibiotics, and corticosteroids.
One major benefit of magic mouthwash is that it is a topical formulation that targets the area of concern while minimizing systemic effects. Medications that are swallowed can have gastrointestinal effects and other adverse effects like drowsiness. Your doctor may prescribe a topical medication like this first before trying a medication with more severe potential side effects.
Traditional Formulation
Viscous lidocaine 2%: Lidocaine is the most common anesthetic ingredient used in dentistry and other specialties. In topical form it is an effective way to anesthetize mucous membranes.
Aluminum hydroxide and magnesium hydroxide liquid (Maalox): This antacid typically is used to treat stomach upset, heartburn, and indigestion. In this formulation it helps the other ingredients coat the mouth. It is important to use Maalox and not another type of antacid. Bismuth subsalicylate, for example, will solidify the formulation and is not an acceptable substitute.
Diphenhydramine (Bendadryl): An antihistamine, diphenhydramine can reduce inflammation and may help reduce pain associated with oral conditions.
Other ingredients that may be added: nystatin, hydrocortisone, tetracycline, betamethasone.
Instructions for Magic Mouthwash
You should always follow the instructions given to you by your doctor and pharmacist for magic mouthwash. However common instructions for using this formulation are to swish with 5-10mL about every 4-6 hours. Usually it is recommended to be spit out after swishing but this is not the same for every form of magic mouthwash. If you swallow the formulation you may experience systemic side effects like drowsiness from the antihistamine. After using the mouthwash you should wait approximately 30 minutes before eating or drinking anything.
The formulation of magic mouthwash that includes lidocaine, Maalox, and Benadryl can be stored at room temperature however many patients store it in the refrigerator to make it taste better. Always shake the bottle well before using to make sure the ingredients are dispersed evenly.
How Can You Get Magic Mouthwash
Magic mouthwash is a formulation that must be made by a compounding pharmacy. In general health insurance does not cover most compounded formulations. However the pricing for most magic mouthwash formulations is relatively affordable for most patients. A compounding pharmacy like National Pharmacy can ship medication directly to your home if you are not located nearby. Not every pharmacy has compounding services and makes magic mouthwash.
Articles
Magic Mouthwash Demystified – Journal of Clinical Orthodontics
What to Know About Magic Mouthwash – WebMD