What to Know About Magic Mouthwash

Medically Reviewed by Dany Paul Baby, MD on February 15, 2023
5 min read

Doctors prescribe magic mouthwash (also called miracle mouthwash) to prevent or treat mouth sores. It's different from over-the-counter mouthwash because it's used for mouth sores caused by autoimmune diseases, viral infections, and cancer treatment. That said, there are some over-the-counter products that have the title "miracle mouthwash," so it's important to understand what type of product you need. You should also know how to use the mouthwash correctly, and for how long to use it. 

Magic mouthwash is a prescription mouthwash that's made from a variety of medications. 

You may use magic mouthwash (sometimes sold as Mary’s magic mouthwash or Duke’s magic mouthwash), to ease symptoms of oral mucositis. Oral mucositis is caused by radiation therapy and chemotherapy. ‌‌ This painful condition can make it hard to eat properly and maintain good oral hygiene. 

You can also use magic mouthwash for mouth sores caused by viral infections, autoimmune diseases, Behcet’s disease, oral thrush, and bacterial infections.

There are compounded and premade prescription magic mouthwashes. Some people make their own varieties by mixing over-the-counter medications. Ask your doctor which type is best for you.

What's In Magic Mouthwash?

A bunch of different ingredients that are mixed together – or compounded – by a pharmacist. (You may need a prescription for other premade varieties, which aren't compounded by a pharmacist.) 

Magic mouthwash usually contains:

  • An antibiotic to kill bacteria around mouth sores
  • An antifungal to stop fungal growth
  • An anticholinergic or antihistamine to ease pain
  • A local anesthetic to relieve pain
  • An antacid that spreads the other ingredients inside your mouth‌

Your doctor may recommend a DIY magic mouthwash recipe. You may have to mix over-the-counter medicines together to create your own formulation.

 

How you should use mouthwash can vary based on the mixture and your doctor's orders. 

Most people use miracle mouthwash every 4 to 6 hours. How much you should use depends on the specific mouthwash type and on your condition. The doctor should let you know a specific dose. A typical dose might be 10 milliliters (about 2 teaspoons) every 3 hours, up to six times a day.‌

Shake it well before using it. In general, keep the mouthwash in your mouth for 1  to 2 minutes. Then spit it out. Avoid eating or drinking for at least half an hour afterward to let the medicine take effect. (Ask your doctor or pharmacist for specific guidelines based on the prescription.)

‌Ask your pharmacist or doctor if refrigerating the mouthwash may make using it more pleasant. It works just as well at room temperature, unless they say otherwise. 

Be sure to ask how long to use the mouthwash, as the doctor may only want you to use it for a brief amount of time. Or they may tell you to use it whenever you feel the need.

 

Magic mouthwash usually costs $34 to $50 for 8 ounces. Since most people use it several times a day, 8 ounces may not last a whole week, depending on your dosage. ‌The bottle can last for about a year, but check the package for specifics.

Check with your insurance provider to see if they cover magic mouthwash. Some coverage can make your out-of-pocket costs cheaper. Some insurance companies don’t cover it at all.

Although some research has shown that magic mouthwash can provide relief for mouth sores, studies have mixed results. Some have found magic mouthwash has no benefits. 

But in another, a group of people who’d had head and neck radiation treatments found that magic mouthwash gave them better pain relief than a flavored water mouthwash.‌‌

Another study compared magic mouthwash with benzydamine hydrochloride, a drug that decreases swelling, pain, and inflammation. The results suggested that magic mouthwash that contained an antacid was no more effective for oral mucositis symptoms than benzydamine hydrochloride alone.

It’s hard to say how effective magic mouthwash is because formulas can vary so much. Some types are made to order by a pharmacist. Others come in pre-measured kits that a pharmacist mixes together.

Magic mouthwash is different from regular mouthwash for one main reason: You need a prescription to get it. It may also contain antibacterial, anesthetic, or antifungal ingredients, to name a few, and those aren't in your typical over-the-counter mouthwashes that are used to freshen breath. There are over-the-counter mouthwashes that can ease pain, and they may be cheaper than having your own custom mouthwash made. Ask your doctor what's right for you.

If you're hoping to see relief with an over-the-counter mouthwash, beware of ingredients that may be in them that may irritate your mouth. Regular mouthwashes may contain alcohol. That may make the pain worse. Some people may be sensitive to sodium lauryl sulfate, which has been linked to canker sores. 

Miracle mouthwashes may differ from over-the-counter varieties in terms of how long you use the mouthwash. For example, you may swish the magic mouthwash for a longer amount of time, compared to a regular solution. Or you may not be able to eat for a certain amount of time after you rinse your mouth with a magic mouthwash. Ask your doctor for specifics.

‌Magic mouthwash can have some side effects, including:

  • Diarrhea
  • Nausea
  • Drowsiness
  • Constipation
  • Problems with taste
  • A tingling or burning sensation in your mouth

Magic mouthwash isn’t the only way to prevent or manage mouth sores. 

Oral cryotherapy, for example, may work better for some people. It has very low rates of side effects, and they’re minor ones like chills, headaches, and tooth pain. Cryotherapy uses extreme cold to freeze your mouth sores in your mouth. It can help even with serious mucositis.

Gargling with a homemade rinse made with water and salt or baking soda can also help ease the pain of mouth sores. These solutions are a much less expensive solution than magic mouthwash. They also have few risks of side effects since they don’t contain irritants like alcohol.

You may be able to find over-the-counter mouthwashes that can ease pain. They won't contain the medicines you'll find in a miracle mouthwash, but they may be able to help with some symptoms. It depends on your condition and what you need.

For serious oral mucositis, mouthwash that contains a morphine solution may be an option. In a study of 28 people with oral mucositis, those who used morphine mouthwash had better results than those who used magic mouthwash. 

Ask your doctor if you need a compounded magic mouthwash or if a premade magic mouthwash solution can help. You can also ask if there are alternate magic mouthwash recipes you can try, or if a regular mouthwash can work.