Key takeaways:
Magic mouthwash is a mouth-rinse mixture. It’s made of different medications used to relieve pain from mouth and throat sores.
There’s no standard set of ingredients or directions for magic mouthwash. Your healthcare provider will determine which ingredients may work best for you.
There’s limited data on magic mouthwash. And it might not work any better than other mouth rinses for pain from mouth and throat sores.
01:34
Reviewed by Mera Goodman, MD, FAAP
If you or your loved ones have ever received chemotherapy or radiation for cancer, chances are that you’ve heard of the term “magic mouthwash.” That’s because it’s commonly used to help with mouth and throat sores from inflamed tissue in your mouth (called oral mucositis). Oral mucositis is a common side effect of these cancer treatments.
But chemotherapy and radiation aren’t the only causes of mouth and throat sores. Painful sores can also be caused by other conditions, like infections and a weakened immune system. If left untreated, these sores can lead to other problems and affect your quality of life. So, it’s important to find the right treatment.
So, what is magic mouthwash, and is it all that magical? Read on to learn more about magic mouthwash, how it’s used, and if it really works.
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What is magic mouthwash?
Magic mouthwash is a mouth-rinse mixture. It’s usually made from a combination of different liquid medications. Examples of these ingredients include antihistamines, antacids, and numbing medications.
Although some of these ingredients are available over the counter (OTC), your healthcare provider will typically write you a prescription for magic mouthwash. Your pharmacist will be able to make it for you by mixing the medications together (called compounding). Depending on the ingredients, you may be able to have it made at your local retail pharmacy.
What is magic mouthwash used to treat?
The ingredients in magic mouthwash can be used to provide pain relief from mouth and throat sores. Most commonly, it’s used to soothe pain from oral mucositis resulting from certain cancer treatments. It might also be used for sores or inflammation caused by oral viral infections, like cold sores from herpes simplex virus.
Painful sores can make it difficult for you to eat and drink. This can prevent you from getting proper nutrition and hydration. They can also make it challenging for you to floss and brush your teeth. This not only affects your oral health, but also might worsen the sores and make it more difficult for them to heal.
That’s why it’s important to discuss potential treatment options with your provider. They can also provide recommendations for how to take care of your oral health during treatment.
What are the ingredients in magic mouthwash?
There isn’t a standard set of ingredients for magic mouthwash. It's often compounded to meet your individual needs. Providers combine medications with different potential benefits to help provide relief.
Some common medications found in magic mouthwash formulas include:
Diphenhydramine is an antihistamine. Liquid diphenhydramine (Benadryl) is used to lessen swelling.
Antacids are used to help the medications coat your sores to provide relief. An example of an antacid is aluminum hydroxide/magnesium hydroxide/simethicone (Maalox).
Viscous lidocaine is a local anesthetic. It’s used to numb the nerves inside your mouth and make them less sensitive to pain.
Nystatin is an antifungal medication. It’s sometimes added to prevent or stop fungal growth inside your mouth. It’s more commonly used if your sores are caused by oral thrush, a fungal infection.
Other ingredients may include corticosteroids (e.g., hydrocortisone) for swelling and antibiotics (e.g., tetracycline) for infections.
How do I use magic mouthwash?
There also isn’t a standard set of directions for how to use magic mouthwash. That’s why it’s important to follow the instructions your healthcare provider gives you.
An example of instructions might read as follows: “Shake well before using. Swish, gargle, and spit 1 to 2 teaspoons every 4 to 6 hours, as needed for pain.”
Sometimes, your provider might ask you to swallow magic mouthwash if your sores are in your throat. Don’t swallow this medication unless instructed to do so. Swallowing too much medication can put you at risk for certain side effects, such as sleepiness, nausea, and upset stomach. Side effects of magic mouthwash may vary depending on what medications are used in your mixture.
After using this mouthwash, it may be recommended that you wait 30 minutes before you eat or drink. Eating or drinking too soon might wash away the medication and not give it the chance to work.
Can I make my own magic mouthwash at home?
Unless instructed by your healthcare provider, don’t make your own magic mouthwash at home. Magic mouthwash is a prescription medication. Some of the ingredients aren’t available OTC and need a prescription from your provider. A pharmacist will mix the medication according to directions on your prescription.
Let your healthcare provider know if you’re having a hard time finding a pharmacy that can make it or if the medication is too expensive. They can discuss other options with you.
In some cases, your healthcare provider may have you make an OTC version, called “magic mouthwash lite.” It’s a version of the mouth rinse that only includes the OTC ingredients, such as diphenhydramine and antacids.
It’s possible to buy these ingredients at your local pharmacy and make your own rinse at home. But only do so if your provider gives you specific instructions on how to make and take the mouthwash. OTC medications can cause serious side effects if not used according to their directions.
Does magic mouthwash really work?
Is magic mouthwash really a “miracle” medication? It’s hard to say for sure. There’s been some research in people receiving chemotherapy or radiation for cancer with conflicting results. And, magic mouthwash might not be any more effective than other types of rinses used to treat sores.
For example, one study compared the effectiveness of three types of mouth rinses in mucositis. It looked at magic mouthwash, chlorhexidine (Peridex) rinse, and salt and baking soda rinse. This particular magic mouthwash contained lidocaine, diphenhydramine, and an antacid.
Results showed that over 70% of people experienced complete relief within 12 days of treatment. Of the three rinses, no treatment was shown to work more quickly than another. But of these options, the salt and baking soda rinse was the most affordable.
Based on existing studies, it’s difficult for healthcare providers to include magic mouthwash in any official guidelines for mucositis. Besides the limited research that’s available, there’s no standard magic mouthwash formula. This can make it more difficult to study its effectiveness.
That’s why magic mouthwash isn’t part of the official treatment guidelines for mucositis from cancer treatments.
Are there any alternatives to magic mouthwash?
There are alternative ways to ease pain from mouth and throat sores. But treatment can vary depending on what’s causing your sores.
For example, current recommendations for oral mucositis usually depend on the type of cancer treatment you’re receiving. Sucking on ice chips is recommended for people who receive short chemotherapy infusions.
The ice chips narrow the blood vessels in your mouth, which can limit the amount of chemotherapy medication that flows to the area. This can lessen skin damage from chemotherapy and lower the pain from mucositis.
Some experts suggest a baking soda and salt mouth rinse to prevent bacteria build up and to bring comfort for oral mucositis. This mouth rinse can also bring pain relief from canker sores.
Your healthcare provider can give you recommendations for treatment options to help bring you relief and prevent other issues, such as infection.
The bottom line
Magic mouthwash is a mouth-rinse mixture. It’s sometimes used to ease pain from mouth and throat sores. But there isn’t a standard set of ingredients or directions for magic mouthwash. Instead, the ingredients and instructions can be tailored to your individual needs.
Some people can experience pain relief from magic mouthwash. But it might not work any better than other mouth rinses or treatments. Depending on the ingredients, it can also be expensive because it contains several medications. There might be cheaper alternatives that you can try first.
If you’re experiencing pain from mouth and throat sores, ask your provider if magic mouthwash is a possible option for you.
References
Al-Rudayni, A., et al. (2020). Impact of oral mucositis on quality of life in patients undergoing oncological treatment: a systematic review. Translational Cancer Research.
American Academy of Oral Medicine. (2015). Oral mucositis.
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Dodd, M.J., et al. (2000). Randomized clinical trial of the effectiveness of 3 commonly used mouthwashes to treat chemotherapy-induced mucositis. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology.
Elad, S., et al. (2020). MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer.
Kravitz, N.D., et al. (2020). Magic mouthwash demystified. Journal of Clinical Orthodontics.
Kuk, J.S., et al. (2011). A randomized phase III trial of magic mouthwash and sucralfate versus benzydamine hydrochloride for prophylaxis of radiation-induced oral mucositis in head and neck cancer. Journal of Clinical Oncology.
Marchesi, F., et al. (2017). Cryotherapy reduces oral mucositis and febrile episodes in myeloma patients treated with high-dose melphalan and autologous stem cell transplant: a prospective, randomized study. Bone Marrow Transplant.
McBride, D.R. (2000). Management of aphthous ulcers. American Family Physician.
McGuire, D.B., et al. (2013). Systematic review of basic oral care for the management of oral mucositis in cancer patients. Supportive Care in Cancer.
MedlinePlus. (2019). Canker sore.
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Stoopler, E. T., et al. (2013). Topical and systemic therapies for oral and perioral herpes simplex virus infections. California Dental Association Journal.
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