Chlorine Dioxide and Sodium Chlorite Oral Rinse

The Full Story

It is common for adults and children to unintentionally swallow a small amount of mouthwash or oral rinse solution while rinsing their mouths. Sometimes a person forgets the “spit” part of “swish and spit” and they swallow them instead. The most common types of mouthwash contains alcohol or fluoride as well as breath-refreshing ingredients. Alcohol is an antiseptic, which kills bacteria and helps keep the teeth and gums healthy. There are types of mouth rinses that contain another ingredient—chlorine dioxide. Chlorine dioxide is also an antiseptic, but it does not cause a burning sensation in the mouth like alcohol. Chlorine dioxide-containing mouth rinses are often marketed for people who have sensitive mouths.

So, what is chlorine dioxide? How does it work? And how concerned should you be if it’s swallowed?

What is chlorine dioxide?

Chlorine dioxide is a gas that dissolves easily in water. It’s created by adding an acid to sodium chlorite. Both chlorine dioxide and sodium chlorite are industrial bleaching agents. They are also used as antimicrobials in some public water treatment facilities to make drinking water clear of harmful microorganisms and safe to drink. The EPA sets the maximum allowable concentration of both chlorine dioxide and its biproduct, chlorite, in drinking water. The concentration of chlorine dioxide/sodium chlorite in oral rinses is very low, usually less than 1%. This makes it a dilute solution.

How does it work?

Both chlorine dioxide and sodium chlorite are highly reactive. In scientific lingo, they are oxidizing agents. This reactivity is what makes them effective disinfectants. They react with the molecules that make up microorganisms like bacteria, viruses, and fungi and kill them.

What happens if chlorine dioxide is swallowed?

This is where the old, tried and true toxicology adage of “the dose makes the poison” comes in. Because chlorine dioxide- and sodium chlorite-containing mouth rise products are quite dilute (very low concentration), an accidental ingestion of a sip or a swallow is unlikely to cause anything beyond mild irritation. In such cases, there could be mild nausea and short-term vomiting.

The same way chlorine dioxide and sodium chlorite react with and oxidize harmful microorganisms can happen in our bodies if a large amount or high concentration product is swallowed. This was the case with products like Miracle Mineral Solution, an industrial bleaching agent that people were drinking to try to treat COVID-19. These products can oxidize red blood cells, making them incapable of carrying oxygen. This leads to two serious conditions–hemolysis and methemoglobinemia. These conditions can have dire ripple effects on other organ systems of the body.

If someone has swallowed an oral rinse product, check the webPOISONCONTROL online tool or call Poison Control at 1-800-222-1222 for guidance.

Serkalem Mekonnen, RN, BSN, MPH
Certified Specialist in Poison Information