Yes, but... alcoholic mouthwashes also kill the good bacteria in your mouth, and your digestive system if ingested. So does regular drinking alcohol, for that matter. (In fact, both OTC mouthwashes and high-ABV beverages tend to kill good gut and mucosal flora in preference to the bad ones, because the good flora are highly adapted to the ecological niche that only pertains in the "normal" ecological environment of the body.) But neither alcoholic mouthwashes, nor alcoholic beverages, are prescription-only.
> and if ingested ... which is why the formulation designed for ingestion
There are all sorts of things sold OTC for putting in your mouth or other mucus membranes, that would harm you if you swallowed the active dose. Eye drops, for example. Governments generally trust people to just... not do that. They require that the manufacturer put instructions to not ingest the thing on the label, and that's usually the end of it.
Also, there is a reason that mouthwashes have child-proof caps! They are, in fact, dangerous in general if you don't know what you're doing with them!
But chlorhexidine is no more dangerous than your average mouthwash. And far less dangerous than other things you can get ahold of without a prescription.
(And, given the implication of gingivitis gingipains in Alzheimer's, it might turn out to be a lot more dangerous to not sterilize your gums. Especially if you're old, immunoincompetent, and/or have lost many of your teeth, exposing more of the gum surface to regular microabrasion. Enabling OTC access to chlorhexidine mouthwashes could very well be highly-positive in global QALYs.)
> The floor cleaner version is similar to the ingested version but it is not the same thing
Yes, my point wasn't that you should put floor cleaner in your mouth; my point was that someone can buy things that contain a large amount of chlorhexidine gluconate OTC very easily — sometimes even pure! — and anyone who cares could then just distill the active ingredient out to ensure purity. It's not like these are intentionally denatured; none of the other ingredients have the same molecular weight.
> alcoholic mouthwashes also kill the good bacteria in your mouth
Many (all?) in Canada have reformulated as alcohol-free. Unsure if it’s because water is cheaper than alcohol or to avoid a tobacco-style lawsuit because alcohol is linked to oral cancers.
Maybe because people drink the stuff, but I don’t think the manufacturers really had a problem with that.
> and if ingested ... which is why the formulation designed for ingestion
There are all sorts of things sold OTC for putting in your mouth or other mucus membranes, that would harm you if you swallowed the active dose. Eye drops, for example. Governments generally trust people to just... not do that. They require that the manufacturer put instructions to not ingest the thing on the label, and that's usually the end of it.
Also, there is a reason that mouthwashes have child-proof caps! They are, in fact, dangerous in general if you don't know what you're doing with them!
But chlorhexidine is no more dangerous than your average mouthwash. And far less dangerous than other things you can get ahold of without a prescription.
(And, given the implication of gingivitis gingipains in Alzheimer's, it might turn out to be a lot more dangerous to not sterilize your gums. Especially if you're old, immunoincompetent, and/or have lost many of your teeth, exposing more of the gum surface to regular microabrasion. Enabling OTC access to chlorhexidine mouthwashes could very well be highly-positive in global QALYs.)
> The floor cleaner version is similar to the ingested version but it is not the same thing
Yes, my point wasn't that you should put floor cleaner in your mouth; my point was that someone can buy things that contain a large amount of chlorhexidine gluconate OTC very easily — sometimes even pure! — and anyone who cares could then just distill the active ingredient out to ensure purity. It's not like these are intentionally denatured; none of the other ingredients have the same molecular weight.