Dental professionals are being encouraged to reassess their approach to managing patients who seem disengaged with their oral health. The call to action is to "exhaust every option" before considering palliative care, including the broader use of clinically proven adjunctive treatments like mouthwash.
At the launch of National Smile Month 2025, Rhiannon Jones, dental therapist and President of the British Society of Dental Hygiene and Therapy (BSDHT), urged clinicians to rethink their strategies for so-called "non-engaging" patients. She also advocated for reconsidering adjuncts like mouthwash as vital components of routine care.
“Before we consider moving a patient to palliative care, we must ask: have we exhausted all options? If we haven’t explored adjuncts like mouthwashes – especially those with essential oils or cetylpyridinium chloride – then we haven’t done everything possible to help them manage their oral health,” said Jones.
Jones, currently practicing in Wales, delivered her remarks during a keynote address at the campaign’s official launch event. Her speech resonated with clinicians and oral health advocates alike, promoting open dialogue with patients and the inclusion of evidence-based adjuncts in care planning.
“I’ve seen our profession evolve, and National Smile Month evolve with it. But one thing that hasn’t changed is the need to reach every patient. For those who aren’t engaging, we have to ask better questions and offer more tools – not just fall back on the assumption that they’ve failed,” she added.
Jones highlighted new European guidelines from the EFP and ESP which define “non-engaging” patients, offering opportunities for more structured interventions. She strongly advocated for integrating mouthwash as an active clinical tool, particularly for patients who may struggle with mechanical plaque removal due to age, disability, cognitive decline, or other limiting factors.
“We need to challenge our assumptions about mouthwashes. They’re not just breath fresheners. They’re therapeutic agents backed by solid evidence. Mouth rinses, especially those with fluoride or antimicrobials, can reach areas brushes cannot and can reduce inflammation and control biofilm more effectively than brushing alone in some cases,” Jones stated.
In closing her address, Jones emphasized respecting patient preferences regarding taste and alcohol content while discussing potential side effects such as staining or allergies. This ensures patients are empowered to make informed decisions.
Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation, supported Jones' views and called for repositioning mouthwash as a core part of oral health discussions both in clinics and at home.
“A patient’s home routine is fundamentally linked to their oral health status. The key to developing and maintaining good oral health is effective daily plaque removal that can be independently achieved by the patient,” Dr Carter explained.
He warned that while brushing and interdental cleaning remain foundational practices, they often are insufficient on their own.
“While mechanical cleaning dislodges plaque bacteria, data suggests that this is not enough in a majority of people to maintain good levels of oral health. Therefore, as an addition to brushing and interdental cleaning, we would recommend the use of an effective antimicrobial mouthwash,” Dr Carter advised.
As part of National Smile Month’s 2025 theme “Feed Your Smile,” the Oral Health Foundation advocates for a holistic approach to preventive care that includes diet, hygiene, and adjunctive support like mouthwash to address ongoing oral health inequalities.
National Smile Month runs until June 12th. More information about the charity campaign can be found at www.smilemonth.org.
For updates on National Smile Month activities follow them on Twitter/X, Facebook Instagram LinkedIn using hashtags #SmileMonth #FeedYourSmile across platforms.
