Medical Forum / General / Alternative / September 2005
is it safe to rinse your mouth with hydrogen peroxide everyday?
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marcus johannsen - 30 Aug 2005 21:58 GMT rinsing with this solution(half peroxide/half water) controls some of the mucus in my mouth.
the bottle says do not exceed use for 7 days.
is it safe to use this solution for rinsing everyday?
Sbharris[atsign]ix.netcom.com - 30 Aug 2005 22:05 GMT > rinsing with this solution(half peroxide/half water) controls some of > the mucus in my mouth. > > the bottle says do not exceed use for 7 days. > > is it safe to use this solution for rinsing everyday? Yes.
Mr-Natural-Health - 31 Aug 2005 15:30 GMT > > is it safe to use this solution for rinsing everyday? > > Yes. WRONG!
No need to go to medical school. Just learn to read the WARNINGS label on the bottle which clearly warns against using it more than 7 days in a row.
Just thought that physicians might try reading once and a while.
You have my condolences.
Mark & Steven Bornfeld - 31 Aug 2005 15:55 GMT >>>is it safe to use this solution for rinsing everyday? >> [quoted text clipped - 9 lines] > > You have my condolences. Don't believe everything you see and half of what you hear.
Steve
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
Rich - 31 Aug 2005 01:02 GMT > rinsing with this solution(half peroxide/half water) controls some of > the mucus in my mouth. > > the bottle says do not exceed use for 7 days. > > is it safe to use this solution for rinsing everyday? Rinsing with H2O2 before flossing is an excellent way to prevent gum disease. I've been doing it for years with no ill effects.
--Rich
Steven Bornfeld - 31 Aug 2005 02:21 GMT >>rinsing with this solution(half peroxide/half water) controls some of >>the mucus in my mouth. [quoted text clipped - 7 lines] > > --Rich I'd emphasize the flossing, rather than the rinsing.
Steve
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Rich - 31 Aug 2005 02:37 GMT >>>rinsing with this solution(half peroxide/half water) controls some of >>>the mucus in my mouth. [quoted text clipped - 11 lines] > > Steve Agreed. But when I use the peroxide first, the flossing carries the stuff down to where the anaerobes like to hide, and I feel like the flossing is doing more. The peroxide also loosens up the crud that I then scrape off my tongue.
--Rich
Steven Bornfeld - 31 Aug 2005 03:12 GMT > Agreed. But when I use the peroxide first, the flossing carries the stuff > down to where the anaerobes like to hide, and I feel like the flossing is > doing more. The peroxide also loosens up the crud that I then scrape off my > tongue. > > --Rich Nothing wrong with it, but there's no magic either. You don't get enough peroxide down where it needs to be for long enough to really affect the bacterial flora. The flossing will, of course. The peroxide may have some mild detergency to it.
Steve
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Sbharris[atsign]ix.netcom.com - 31 Aug 2005 05:09 GMT > >>>rinsing with this solution(half peroxide/half water) controls some of > >>>the mucus in my mouth. [quoted text clipped - 15 lines] > down to where the anaerobes like to hide, and I feel like the flossing is > doing more. COMMENT:
Funny. I have the impression that flossing gets the crud out so the peroxide can get to the pockets where the bugs like to hide, so IT'S doing more.
Of course, no doubt that flossing is the best of all things you can do, and nothing replaces it.
Peroxide may not affect most normal mouth flora, but the smelly anaerobes just HATE it. For obvious reasons.
SBH
montygram - 31 Aug 2005 06:25 GMT Plain yogurt before you go to bed, then rinse with filtered water. I pick the stuff out of my teeth as well. Using oxidizing agents can lead to oral cancers. It is a really stupid thing to do. Oral surgeons are warning of an "oral cancer epidemic" in a few years due to all the bleaching that's going on. Unfortunately, many doctors and scientists just don't understand how dangerous the oxidative stress that is generated can be.
montygram - 31 Aug 2005 06:59 GMT Instead of worrying about what textbooks say, I read scientific papers such as the following (I posted this one due to the interest in hydrogen peroxide). Most people don't realize how many such papers are completely ignored by the mainstream media, for whatever reason.
Arch Biochem Biophys. 1997 Mar 15;339(2):267-74.
Prolonged oxidative stress on actin.
Milzani A, DalleDonne I, Colombo R.
Laboratory of Biochemistry and Biophysics of Cytoskeletal Structures, University of Milan, Via Celoria 26, Milan, 20133, Italy.
Hydrogen peroxide, coming from polymorphonuclear leukocytes, causes severe oxidative injury on actin molecules with the disarrangement of cortical actin cytoskeleton followed by plasmalemma blebbing. In this paper we demonstrate that actin oxidation does not simply develop into denaturation, but oxidative injuries on actin are specific and related to the chemical characteristics of the oxidant. Experiments on purified actin in solution have shown that actin behavior to oxidation depends on (i) the amino acidic targets of the oxidant and (ii) on the structural plasticity of the actin molecule, which differently responds to different chemical modifications. Therefore, hydrogen peroxide (that presents a broad oxidative activity) affects actin dynamics by markedly inhibiting the assembly of actin monomers, by forcing the disassembly of actin polymers, and, moreover, by affecting the interaction between oxidant-stressed actin and DNase I. Diamide (a specific thiol oxidant), in contrast, mainly lowers the actin polymerization extent, while it slightly influences the polymerization rate and results uneffective on both F-actin disassembly and actin-related DNase I inhibition. Actin response to oxidative stresses likely depends on the "structural connectivity in actin," the property allowing it to finely modulate the actin filament architecture. The potential cellular relevance of the alterations in the interaction between oxidized actin and DNase I has been briefly discussed.
Barry - 31 Aug 2005 08:40 GMT > Arch Biochem Biophys. 1997 Mar 15;339(2):267-74. > [quoted text clipped - 27 lines] > alterations in the interaction between oxidized actin and DNase I has > been briefly discussed. Is that good or bad?
MMu - 31 Aug 2005 09:16 GMT > Instead of worrying about what textbooks say, I read scientific papers > such as the following (I posted this one due to the interest in [quoted text clipped - 9 lines] > Laboratory of Biochemistry and Biophysics of Cytoskeletal Structures, > University of Milan, Via Celoria 26, Milan, 20133, Italy. This study is completely irrelevant to the topic.
1) the actin in this study was prepared out / isolated. I don't have isolated actin in my mouth (except for that in the meat I chew), only cells with actin.
2) its a pure in-vitro experiment with actin (not cells with actin) but without any antioxidant system. every cell has an antioxidant system do deal with hydroperoxide quite efficiently.
3) incubation time with H2O2 was 24 hours in this study. how long do you use your "filtered water" when washing your teeth?
.. seems like you just randomly picked the first abstract with H2O2 and some negative effect without reading it.
MMu - 31 Aug 2005 11:09 GMT Correction: "hydrogenperoxide", not "hydroperoxide"...
montygram - 31 Aug 2005 21:15 GMT This is a molecular level model of what occurs when you use such products. It explains why oral surgeons are warning about cancer risks for people who bleach their teeth white. It is consistent with basic science. If you want to volunteer your mputh to be bombarded with H2O2 daily, I'd be curious to see what results. If you know of a more on point paper, then cite it. Evidence is hardly ever perfect, but I don't see any reason why one should expect something different to occur in one's mouth. If you have a reason to think otherwise, explain it. Actin is actin, H2O2 is H2O2. What antioxidant system will be at work in your mouth when you bombard it with H2O2 all the time? Your desire to attack is irresponsible, possibly leading people to do horrible damage to themselves. But I guess if people aren't intelligent enough to understand the difference between evidence that is basic and troubling and evidence that is trumped up, they will just have to live (or not) with the consequences.
The media ususally covers the epidemiological garbage instead of good evidence such as the study I presented. For example:
* 02:00 30 August 2005 * NewScientist.com news service * Kurt Kleiner
Most published scientific research papers are wrong, according to a new analysis. Assuming that the new paper is itself correct, problems with experimental and statistical methods mean that there is less than a 50% chance that the results of any randomly chosen scientific paper are true.
John Ioannidis, an epidemiologist at the University of Ioannina School of Medicine in Greece, says that small sample sizes, poor study design, researcher bias, and selective reporting and other problems combine to make most research findings false. But even large, well-designed studies are not always right, meaning that scientists and the public have to be wary of reported findings.
"We should accept that most research findings will be refuted. Some will be replicated and validated. The replication process is more important than the first discovery," Ioannidis says.
In the paper, Ioannidis does not show that any particular findings are false. Instead, he shows statistically how the many obstacles to getting research findings right combine to make most published research wrong. Massaged conclusions
Traditionally a study is said to be "statistically significant" if the odds are only 1 in 20 that the result could be pure chance. But in a complicated field where there are many potential hypotheses to sift through - such as whether a particular gene influences a particular disease - it is easy to reach false conclusions using this standard. If you test 20 false hypotheses, one of them is likely to show up as true, on average.
Odds get even worse for studies that are too small, studies that find small effects (for example, a drug that works for only 10% of patients), or studies where the protocol and endpoints are poorly defined, allowing researchers to massage their conclusions after the fact.
Surprisingly, Ioannidis says another predictor of false findings is if a field is "hot", with many teams feeling pressure to beat the others to statistically significant findings.
But Solomon Snyder, senior editor at the Proceedings of the National Academy of Sciences, and a neuroscientist at Johns Hopkins Medical School in Baltimore, US, says most working scientists understand the limitations of published research.
"When I read the literature, I'm not reading it to find proof like a textbook. I'm reading to get ideas. So even if something is wrong with the paper, if they have the kernel of a novel idea, that's something to think about," he says.
Mark & Steven Bornfeld - 31 Aug 2005 21:43 GMT > This is a molecular level model of what occurs when you use such > products. It explains why oral surgeons are warning about cancer risks > for people who bleach their teeth white. I'm sure there are one or two oral surgeons waving the flag, but none I know. The risks for primary oral cancer are very well known--tobacco and alcohol. I have never seen a PRIMARY oral squamous cell carcinoma in patients who are not heavy tobacco users. The overwhelming majority are heavy drinkers as well. (I have seen primary cancers of the salivary glands, and occasionally--ONLY occasionally I've seen reports of these in non-smokers/non drinkers). BTW, I've had plenty of patients who in fact rinse their mouths with peroxide daily. As I said, I don't advocate this. But I haven't seen any cancers--in fact no dysplastic lesions--in any of them.
YMMV, Steve
It is consistent with basic
> science. If you want to volunteer your mputh to be bombarded with H2O2 > daily, I'd be curious to see what results. If you know of a more on [quoted text clipped - 66 lines] > the paper, if they have the kernel of a novel idea, that's something to > think about," he says.
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
MMu - 01 Sep 2005 10:28 GMT > This is a molecular level model of what occurs when you use such > products. It explains why oral surgeons are warning about cancer risks > for people who bleach their teeth white. No; your article doesn't even mention oral cancer.
>It is consistent with basic > science. If you want to volunteer your mputh to be bombarded with H2O2 > daily, I'd be curious to see what results. Many people do that already.
> If you know of a more on point paper, then cite it. I am not supporting the same viewpoint.
Even though I do think that oral H2O2 treatment 1) isn't necessary and 2) isn't actually very beneficial in most of the cases (for healthy people),
I do not believe that it has much of a negative effect because of the very short time of exposure and the low concentration.
> Evidence is hardly ever perfect, but I > don't see any reason why one should expect something different to occur > in one's mouth. If you have a reason to think otherwise, explain it. > Actin is actin, H2O2 is H2O2. you are applying a in vitro result obtained with isolated actin to an in vivo environment without even considering that there is a difference? just adding peroxidase to that in-vitro system of H2O2 and actin will change the result already.
a cell is a lot more complex than just 2 chemicals in a glass tube.
>What antioxidant system will be at work > in your mouth when you bombard it with H2O2 all the time? Glutathione-Peroxidase (GSH-Px) for instance?
> Your desire > to attack is irresponsible, possibly leading people to do horrible > damage to themselves. But I guess if people aren't intelligent enough > to understand the difference between evidence that is basic and > troubling and evidence that is trumped up, they will just have to live > (or not) with the consequences. polemics. you are trying to proove a point with a study that does not support it. I believe in evidence based science.. do you?
> The media ususally covers the epidemiological garbage instead of good > evidence such as the study I presented. For example: I don't disagree to that- I prefer experimental studies as well, but this does not change the fact that you have to still consider the rest of the cell when thinking of an experiment. Simple experiments are nice, but you never actually know what happens down the line if you don't do in vivo studies.
> * 02:00 30 August 2005 > * NewScientist.com news service [quoted text clipped - 50 lines] > the paper, if they have the kernel of a novel idea, that's something to > think about," he says. Steven Bornfeld - 31 Aug 2005 14:16 GMT > Instead of worrying about what textbooks say, I read scientific papers > such as the following (I posted this one due to the interest in > hydrogen peroxide). Most people don't realize how many such papers are > completely ignored by the mainstream media, for whatever reason. Seems silly to obscess on one in vitro study when there is long in vivo experience in clinical use.
Steve
> Arch Biochem Biophys. 1997 Mar 15;339(2):267-74. > [quoted text clipped - 27 lines] > alterations in the interaction between oxidized actin and DNase I has > been briefly discussed.
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Steven Bornfeld - 31 Aug 2005 14:14 GMT > Plain yogurt before you go to bed, then rinse with filtered water. I > pick the stuff out of my teeth as well. Using oxidizing agents can [quoted text clipped - 3 lines] > scientists just don't understand how dangerous the oxidative stress > that is generated can be. I'm unaware of any documented serious cancer risks from peroxide exposure as done in bleaching. 20 years ago there were some anecdotal reports of a risk, and based on that I held off bleaching literally for years; but as continued use of bleaches showed no evidence of this, I think it's pretty safe to conclude that the cancer risk is insignificant.
Steve
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Mr-Natural-Health - 31 Aug 2005 04:05 GMT > rinsing with this solution(half peroxide/half water) controls some of > the mucus in my mouth. > > the bottle says do not exceed use for 7 days. > > is it safe to use this solution for rinsing everyday? No!
Why would you want to control the mucus in your mouth?
Chronic use of half peroxide/half water will alter the natural bacterial balance in your mouth.
Steven Bornfeld - 31 Aug 2005 14:11 GMT >>rinsing with this solution(half peroxide/half water) controls some of >>the mucus in my mouth. [quoted text clipped - 9 lines] > Chronic use of half peroxide/half water will alter the natural > bacterial balance in your mouth. Nah, not hardly. It will give your tongue a funny whitish appearance though.
Steve
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bae@cs.toronto.no-uce.edu - 31 Aug 2005 14:34 GMT Dr. Bornfeld: Is it better to rinse with H2O2 after flossing than before? I'd think there'd be better contact of disinfectant with bacteria afterwards. Is it a good idea to use diluted H2O2 as a mouthwash if your gums are in good shape already? I use it only occasionally, and my dental hygienist approves my mouth since I started flossing more regularly (using the handy tip below).
Handy dental health tip: keep a packet of dental floss beside your computer and floss while reading net news.
Smartass remark: Too bad there isn't mental floss.
Mark & Steven Bornfeld - 31 Aug 2005 15:06 GMT > Dr. Bornfeld: Is it better to rinse with H2O2 after flossing than > before? I'd think there'd be better contact of disinfectant with [quoted text clipped - 7 lines] > > Smartass remark: Too bad there isn't mental floss. While I don't think there is much risk ordinarily, I don't advocate routine rinsing with peroxide. It does sometimes change the color of oral mucosae. It's also not a very good antiseptic. As a general rule, oral antiseptic rinses should not be necessary, esp. if your gingival health is good. Some patients in periodontal therapy are given chlorhexidene gluconate rinses perioperatively, which will keep down bacterial growth and speed healing. Some dentists will give patients these rinses when extensive restorative dentistry is done as well, for the same reason. However, even the manufacturers are circumspect about using these rinses long-term. The primary problems are change in taste sensation and also (perhaps paradoxically) increased staining of the teeth. I don't floss at the computer; I don't like Windexing my flat panel screen.
Steve
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
Sbharris[atsign]ix.netcom.com - 31 Aug 2005 21:05 GMT > Nah, not hardly. It will give your tongue a funny whitish appearance > though. COMMENT: For about 5 minutes. But that's not discoloration of tissue, it's just a zillion little oxygen bubbles, which are white. Once the reaction ceases, the tissue goes back to normal color.
As somebody has pointed out, every cell in your body has catalase for dealing with hydrogen peroxide. Catalase, in fact, is the fastest enzyme yet to be found.
Food Chem Toxicol. 2000 Nov;38(11):1021-41.
Assessment of the carcinogenicity associated with oral exposures to hydrogen peroxide.
DeSesso JM, Lavin AL, Hsia SM, Mavis RD.
Mitretek Systems, McLean, Virginia, USA. jdesesso@mitretek.org
Concern regarding hydrogen peroxide (H(2)O(2)) carcinogenicity arises from its ability to act as a strong oxidizing agent. In short-term genotoxicity tests, H(2)O(2) has given predominantly positive results; however, these assays have been performed using either bacterial strains engineered to be exquisitely sensitive to oxidant damage, or mammalian cells deficient in antioxidant enzymes. Significantly, the addition of antioxidant protective measures (normally present in vivo) to these assay systems protects against H(2)O(2) genotoxicity. In most whole animal studies, H(2)O(2) exposure neither initiates nor promotes tumors. In mice, however, 0.4% H(2)O(2) in drinking water was reported to induce hyperplastic lesions of the duodenum and to erode areas in the glandular stomach epithelium. Owing to the chemistry of dilute H(2)O(2) solutions and the anatomy/physiology of the gastrointestinal tract, it is unlikely that orally ingested H(2)O(2) reaches the duodenum. Instead, greatly decreased water consumption and the resultant abrasion of the luminal lining on ingestion of pelleted dry rodent chow is the most likely cause of the observed gastric and duodenal lesions following H(2)O(2) administration in drinking water. Significantly, when hamsters received high doses of H(2)O(2) by gastric intubation (and water intake was not affected), the gastric and duodenal epithelia appeared normal. In-depth analysis of the available data supports the conclusion that oral ingestion of H(2)O(2) should not be considered a carcinogenic threat.
Publication Types: Review Review, Tutorial
PMID: 11038240 [PubMed - indexed for MEDLINE]
Mark & Steven Bornfeld - 31 Aug 2005 21:37 GMT >> Nah, not hardly. It will give your tongue a funny whitish appearance >>though. [quoted text clipped - 3 lines] > a zillion little oxygen bubbles, which are white. Once the reaction > ceases, the tissue goes back to normal color. We've occasionally seen hyperplasia of the filliform papillae. In any case, only a very minor cosmetic concern.
Steve
> As somebody has pointed out, every cell in your body has catalase for > dealing with hydrogen peroxide. Catalase, in fact, is the fastest [quoted text clipped - 39 lines] > > PMID: 11038240 [PubMed - indexed for MEDLINE]
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
Barry - 31 Aug 2005 05:02 GMT I also read some stuff about peroxide helping cancer grow. I'd obey the label.
The only mouthwash I use is Biotene, but you'd probably need one with alcohol, which might also cause cancer, but at least there's no warning about it on the bottles.
Anyway, mucus doesn't come from your mouth. It might end up there, but I think you should try to stop excess mucus at the source.
Steven Bornfeld - 31 Aug 2005 14:12 GMT > I also read some stuff about peroxide helping cancer grow. I'd obey the > label. [quoted text clipped - 5 lines] > Anyway, mucus doesn't come from your mouth. It might end up there, but > I think you should try to stop excess mucus at the source. There are plenty of mucous glands in the mouth, esp. the roof of the mouth and lining the lips.
Steve
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Barry - 31 Aug 2005 14:27 GMT > There are plenty of mucous glands in the mouth, esp. the roof of the > mouth and lining the lips. Well, at least there's no saliva up my nose. I'd still work on reducing the mucus, not just removing it when it's there.
Jim - 31 Aug 2005 14:59 GMT I have read some sources that say you shouldn't use peroxide if you have metal fillings, due to the reaction that occurs.
Mark & Steven Bornfeld - 31 Aug 2005 15:57 GMT > I have read some sources that say you shouldn't use peroxide if you have > metal fillings, due to the reaction that occurs. What reaction is that? Other than potential oxidation of any zinc in the alloy, I can't think of any activity. Probably most amalgam alloys at this point are zinc-free.
Steve
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
MMu - 01 Sep 2005 15:10 GMT >> I have read some sources that say you shouldn't use peroxide if you have >> metal fillings, due to the reaction that occurs. > > What reaction is that? > Other than potential oxidation of any zinc in the alloy, I can't think of > any activity. Probably most amalgam alloys at this point are zinc-free. just guessing, but maybe because an electron transport could be possible if the metal in question has a redox potential (which could form a hydroxyl-radical or superoxide out of H2O2).
Mark & Steven Bornfeld - 31 Aug 2005 15:01 GMT >> There are plenty of mucous glands in the mouth, esp. the roof of the >>mouth and lining the lips. > > Well, at least there's no saliva up my nose. I'd still work on reducing > the mucus, not just removing it when it's there. Seriously, oral mucus is rarely a problem. The only time I think most people would be aware of it is when there's a deficiency of serous saliva, mostly from the parotid glands. The submandibular glands (under the tongue) have some serous secretion, but are mostly mucous. Someone mentioned Biotene, which is probably the best generally available rinse for dry mouth.
Steve
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
Barry - 01 Sep 2005 01:23 GMT > Someone mentioned Biotene, which is probably the best generally > available rinse for dry mouth. That was me. Plax mouthwash, with only 8.8% alcohol, burned my tongue the last time I tried it, so sometimes I use Biotene (alcohol free) in the morning before breakfast, even though I don't have dry mouth. On the other hand, I eat a little more meat these days, which might be protecting my tongue because mint toothpaste, except for baking soda toothpaste, used to burn my tongue too, but the burning is very minor now. But there's no way I'll go back to Listerine, which I originally tried.
Into the living sea of waking dreams - 31 Aug 2005 15:33 GMT > rinsing with this solution(half peroxide/half water) controls some of > the mucus in my mouth. > > the bottle says do not exceed use for 7 days. > > is it safe to use this solution for rinsing everyday? I had a serious infection of cold sores inside my mouth. Tried everything available, this in the early 1980's, to no avail.
This is when the bleaching started being advertised by dentists, so I thought, why not rinse with hydrogen peroxide, and see if my teeth get whiter.
The cold sores disappeared.
I have been rinsing with 3 % h202 everyday since then cold sores are very rare now.
Just my anectodotal experience.
But, I notice that hydrogen peroxide states that it can be used for oral debridement now.
j.
So, based upon my 20 plus years, with fillings BTW, I can state that I have had only beneficial results.
j.
Susan - 31 Aug 2005 15:57 GMT >> rinsing with this solution(half peroxide/half water) controls some of >> the mucus in my mouth. [quoted text clipped - 26 lines] > > j. I've used a small amount in my sinus irrigator with saline solution to cure and control chronic sinusitis where antibiotics have been failing.
Susan
Mr-Natural-Health - 31 Aug 2005 16:50 GMT > > is it safe to use this solution for rinsing everyday? > > The cold sores disappeared. > > I have been rinsing with 3 % h202 everyday since then cold sores are > very rare now. H2O2 gets rid of mucous, cold sores, and keeps flossed teeth from getting infected, but is clearly not strong enough to affect the natural balance of bacteria in your mouth.
Yeah, ... right, sure ... tell me another tall tale. Just my brain talking. You should try using yours once in a while.
Into the living sea of waking dreams - 31 Aug 2005 20:37 GMT >>>is it safe to use this solution for rinsing everyday? >> [quoted text clipped - 10 lines] > > Just my brain talking. You should try using yours once in a while. brain-fart?
j.
oh, btw, eat sh.t and die.
C.Health - 03 Sep 2005 06:24 GMT > rinsing with this solution(half peroxide/half water) controls some of > the mucus in my mouth. > > the bottle says do not exceed use for 7 days. > > is it safe to use this solution for rinsing everyday? There is a difference between 3% Hydrogen Peroxide (Drug/Grocery Store Variety) and 35% Food Grade Hydrogen Peroxide (Also 50% Food Grade H2O2) It is safer to use the food grade in your mouth and less expensive to use the 3% on your skin for a wound.
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