How ‘Magic Mouthwash’ Can Help Relieve Painful Mouth Sores

When you’re dealing with mouth sores, it can be hard to eat, drink or even swallow without pain. But a prescription-only option called “magic mouthwash” may be able to bring some relief.

Internal medicine doctor Janet Morgan, MD, unlocks the science behind the so-called magic.

What is magic mouthwash?

“Magic mouthwash” is an umbrella term for prescription mouthwash that can help relieve and even prevent mouth sores (oral mucositis).

“Sometimes, the mouthwash itself can be the treatment for whatever is causing mouth sores,” Dr. Morgan says. “But more often, we use it to temporarily relieve pain or swelling while we wait for other treatments to resolve the underlying problem.”

Your doctor may prescribe magic mouthwash if you’re experiencing mouth sores as a side effect of:

• Cancer treatments: Chemotherapy and radiation therapy can affect the cells of your mouth and cause sores or blisters.
• Oral thrush: Sometimes, taking a potent antibiotic can wipe out “good” bacteria and cause an overgrowth of yeast to develop in your mouth. It looks like small white bumps on your tongue and palate.
• Viral infection: Many viruses can cause mouth sores, including the herpes virus and hand, foot and mouth disease (common in young children). HIV can make you more prone to mouth sores, too.
• Bacterial infection: When bacteria infect your throat and tonsils, it can lead to pain in your mouth and throat. The most common example is strep throat.
• Autoimmune diseases: If your immune system attacks tissues or organs, you may experience sores in your mouth, along with changes in your saliva.
• Behçet’s disease: This rare condition causes inflammation in the blood vessels of your mouth, leading to painful sores.

Oral medications, like pills, can interact with other medications you’re taking. But mouthwash is a topical treatment, which means it only targets the area of your body that’s affected — in this case, your mouth.

“For that reason, we prefer to start with a topical option whenever possible,” Dr. Morgan says.

What are the ingredients?

The name “magic mouthwash” sounds casual, like maybe this is something you could whip up at home. But it’s a medication, so you should never try to make it on your own. Leave that to the pharmacist!

Plus, magic mouthwash is custom-made for the person it’s prescribed to, so its ingredients vary.

“Every formula is different and depends on the specific needs of the person it’s made for,” Dr. Morgan explains. “So, what’s in your version of magic mouthwash isn’t necessarily what’s in someone else’s.”

Depending on the cause of your mouth sores, your prescription may contain one or more of these ingredients:

• An antibiotic to kill bacteria
• An antifungal medicine to get yeast back in balance
• A numbing agent, like lidocaine, to soothe the pain from mouth sores
• Corticosteroids to reduce inflammation
• An antihistamine to relieve pain
• An antacid to coat your mouth and offer relief

You might also hear magic mouthwash referred to as miracle mouthwash or mixed medicated mouthwash. And certain formulations go by nicknames of their own, though the formulas may still differ:

• BMX
• Duke’s magic mouthwash
• Mary’s magic mouthwash
• Kaiser’s magic mouthwash
• Pink Lady
• Xyloxadryl

The benefits and risks

There’s one big benefit to using magic mouthwash: It can help relieve the pain of mouth sores. But you may experience some side effects, too, depending on the ingredients in your specific formulation.

Side effects may include:

• Dry mouth
• Mouth numbness, which can make it hard to feel hot or cold foods
• Temporary changes to your sense of taste
• A burning or tingling feeling in your mouth, especially if you have open mouth sores

If your prescription calls for you to swallow magic mouthwash (more on that in a moment), you may experience other side effects, too, like:

• Drowsiness
• Gastrointestinal issues, like constipation or diarrhea
• Nausea

How to use magic mouthwash

Most people are instructed to swish with magic mouthwash and then spit it out — usually every four to six hours as needed for relief from pain and inflammation.

You should always follow guidance from your doctor and the instructions on the packaging of your medication. But it usually goes something like this:

• Shake it first. The ingredients can settle and separate in the bottle between uses, so give it a good shake each time you’re ready to use it.
• Measure it out. Following dosage instructions, carefully measure the required amount of medicated liquid, then put it in your mouth.
• Swish it around. “You want to try to coat all the surfaces of the inside of your mouth,” Dr. Morgan instructs. Your instructions may include a specific amount of time to swish.
• Don’t swallow it. Most magic mouthwash is made to be spit out. But even so, don’t fret if you accidentally ingest a little. “The dose is small, so if it happens once or twice, it won’t harm you,” Dr. Morgan reassures.
• Spit it out. When you’re done, spit magic mouthwash into the sink. You’re all done for now!

“Basically, you use it like you would normal mouthwash,” Dr. Morgan points out.

She notes that there are times when your provider may instruct you to swallow your magic mouthwash instead — particularly if you have sores in your throat. But unless you’ve been specifically advised, stick to swishing and spitting.

A few final tips

Dr. Morgan shares some more suggestions for magic mouthwash success:

• Don’t rinse your mouth out. The mouthwash needs to coat your mouth to do its job. So, in the same vein…
• Wait 30 minutes. To give the mouthwash time to work its magic, avoid eating or drinking anything for the next half hour.
• Avoid hot beverages. If you’re taking a solution with lidocaine numbing, hit pause on the lattes and warming teas. This ingredient numbs your mouth and throat, so hot drinks could burn you without you realizing it.
• Try keeping it cold. Medicated mouthwash has an unpleasant taste, but refrigerating it can help. “That said, it won’t make a big difference if you keep it out instead,” Dr. Morgan notes. So, it’s up to you.
• Throw it out when it’s time. Magic mouthwash usually lasts for at least 12 months, unless the bottle says otherwise. As with other medications, you shouldn’t use it beyond its expiration date.

Oh, and one last thing: In this instance, sharing is not caring.

“Because the formulas differ, never share your magic mouthwash with other people unless you have an explicit go-ahead from your provider,” Dr. Morgan stresses. “Even if two members of your family both have strep throat, talk with your provider before sharing.”