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How To Remove Chlorhexidine Tongue Staining

Removing chlorhexidine tongue stains only require diligent oral hygiene which includes brushing your tongue and rinsing with a mouthwash. Although using whitening products that are peroxide based can help increase the efficacy of stain removal.


brown stains on tongue
brown stains on tongue

Table of contents:


How to get rid of chlorhexidine tongue staining

The best way to get rid of chlorhexidine tongue staining is by brushing it with whitening toothpaste and then rinsing with whitening mouthwash afterwards. Fortunately, the discoloration is not permanent because it can be removed.


How to remove chlorhexidine tongue staining:

  1. Use a peroxide based whitening toothpaste.

  2. Brush your tongue for 30-60 seconds.

  3. Use a tongue scraper for 30 seconds (optional step).

  4. Rinse with a peroxide based whitening mouthwash.



peroxide based toothpastes
peroxide based toothpastes

This routine for eliminating stains on your tongue should become a part of your oral hygiene routine while you're using this medicated mouthwash. Ideally, you should do all of these steps after you finish brushing and flossing your teeth.


Examples of peroxide based products

We wish to emphasize that most oral care products whilst carrying the whitening label, do not contain any peroxide. These whitening products will whiten based upon mechanical removal of stains via abrasion.


However, whitening products with an addition of hydrogen peroxide within them will possess an additional bleaching ability. The peroxide can chemically oxidize and bleach away discolored stains, which makes it more effective than products without peroxide.


Peroxide based toothpastes:

  • Colgate pro series

  • Optic white advanced whitening

  • Optic white renewal

  • Arm & Hammer peroxicare


Peroxide based mouthwashes:

  • Optic white advanced whitening mouthwash

  • Hydrogen peroxide in brown bottle


Therefore, please specifically seek out toothpastes and mouthwashes with peroxide for maximum efficacy. Yes, the bottles of 3% hydrogen peroxide that you find at pharmacies can be used as mouth rinses and they do whiten. Although if you wanted brand name, most of the optic white line products from Colgate will also contain it.


Does chlorhexidine really stain the tongue?

Yes, chlorhexidine mouth rinse can cause a brownish tongue stain when used for an extended period of time such as more than 2 weeks. The longer that you use this prescription rinse, the worse the stains can get. It can turn from a light brown stain to a darker brown or even a black color.


What it looks like:

  • Brown to black colored stain on dorsum of tongue.

  • Appearance is similar to hairy tongue.


In case you wanted further evidence, the label on all bottles of chlorhexidine gluconate 0.12% oral rinses specifically warn of staining. The discoloration is a known side effect.


Chlorhexidine label - adverse reactions
Adverse reactions label

How it causes staining

Despite chlorhexidine (CHX) being a blue liquid (or pink), it can cause your tongue and teeth to be stained a brown color. That is because the way it causes staining is not because of the medicated rinse directly but rather it has a strong attraction to stains.


chlorhexidine rinse - blue colored liquid poured into cap
Chlorhexidine - Blue colored liquid

How it causes staining:

  • Chlorhexidine forms a positively charged coating over the teeth.

  • This coating strongly attracts the negatively charged staining chromogens.


This was validated in a study that found strong evidence of interactions between dietary chromogens and locally adsorbed chlorhexidine on teeth. It turns out the discoloration was due to staining chromogens that were interacting with the CHX that were coating it.


In summary, this medicated mouth rinse is like a super charged magnate that attracts stains to your teeth. In other words, if you eat or drink a lot of staining beverages


What else it can stain

Aside from causing discolorations with your tongue, chlorhexidine can also stain your teeth and dental restorations. Essentially anything that this liquid touches can potentially be stained. However, the way to remove these stains still use a similar method, good oral hygiene.


It is quite potent in that department... We would say that it is more effective at yellowing your teeth than the trifecta of teeth staining beverages (coffee, tea, and red wine).


How to prevent it

According to the label on what to expect while using this rinse, it says that you can minimize the discoloration by just brushing and flossing. That's right, you don't actually need any whitening products at all if you wanted to prevent it.


Chlorhexidine label - what to expect
Label - What to expect

How to prevent staining:

  • Brush and floss your teeth/tongue after each meal.

  • Using a peroxide based toothpaste.

  • Regular dental visits for professional cleanings.

  • Minimize consumption of staining foods while using this rinse.


Of course if you're able to prevent these stains from happening, you wouldn't need to think of ways on how to remove them. Therefore, we highly recommend being as diligent as possible with your oral hygiene.


Minimizing staining foods

In our opinion, one of the best ways to prevent the tongue discoloration is if you can minimize the amount of staining foods you consume while you use this rinse.


Don't forget that the rinse itself does not produce stains, it merely attracts stains more readily to your enamel. However, if you don't consume a lot of colored foods or beverages while you're on this treatment, most of the discoloration can be avoided.


Types of foods to avoid:

  • Beverages - coffee, tea, red wine, etc.

  • Turmeric.

  • Smoking and tobacco product use.

  • Any colored foods that will stain your white t-shirt will stain your teeth.


If you're able to stick to drinking plain water while you're using CHX, that would be for the best. Most dentists only have you use this rinse for about 2 weeks at most because they are aware of this commonly known side effect. You can resume your normal diet after you finish your treatment.


Takeaway

Tongue staining from chlorhexidine gluconate rinse is not permanent because it can be removed with adequate oral hygiene. Using a whitening toothpaste and whitening mouthwash can help get rid of the discoloration.


If the discoloration becomes very severe you should consult with your dentist. You may need to discontinue using this prescription rinse and perhaps seek an alternative form of treatment. If you're in the area, you can schedule a consultation with one of our long island city dentists.

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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