{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:51:10Z","timestamp":1782489070541,"version":"3.54.5"},"reference-count":34,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T00:00:00Z","timestamp":1601337600000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1122514"],"award-info":[{"award-number":["GNT1122514"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,9,4]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the rinsing and gargling mouthwash practices among frequent mouthwash users to determine if there are differences in use between gender, sexual orientation and sex work status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Data obtained from patients attending a sexual health centre located in Melbourne, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>200 frequent mouthwash users (four or more times per week), 50 for each of the following patient groups: men who have sex with men (MSM), female sex workers (FSW), females who are not sex workers and men who have sex with women only (MSW). Participants were observed and audio recorded using mouthwash.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>\n                      Descriptive analyses were conducted to calculate the median age, time rinsing and gargling, amount of mouthwash used and proportion of participants who rinsed, gargled or both, as determined from the audio files. Kruskal-Wallis H test and \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test were used to examine differences between the patient groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median age was 28 years (IQR: 24\u201333). During the study, most (n=127; 63.5%) rinsed and gargled, but 70 (35.0%) rinsed only and three (1.5%) gargled only. Median time rinsing was 13.5\u2009s (IQR: 8.5\u201322.0\u2009s), gargling was 4.0\u2009s (IQR: 2.5\u20136.0\u2009s) and the median total duration was 17.0\u2009s (IQR: 11.5\u201325.8\u2009s). Median duration of mouthwash did not differ significantly between the groups (females not sex workers: 18.8\u2009s (IQR: 12.5\u201324.5\u2009s); FSW: 14.0\u2009s (9.0\u201322.0\u2009s); MSM: 22.3\u2009s (13.0\u201326.5\u2009s); MSW: 15.8\u2009s (12.0\u201325.0\u2009s); p=0.070) but males used mouthwash longer than females (median 20.3\u2009s compared with 15.5\u2009s; p=0.034). The median volume of mouthwash used was 20 mL (IQR: 15\u201327 mL). And most (n=198; 99.0%) did not dilute mouthwash with water.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Over a quarter of frequent users do not gargle mouthwash at all (35%) and used it for a substantially shorter period of time than it was used in the randomised trial (1\u2009min) where it was shown to be effective at inhibiting\n                      <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                      growth. Our findings suggest that many frequent mouthwash users do not follow the manufacturer instructions for using mouthwash and may not use mouthwash in a way that was shown to reduce the growth of oropharyngeal gonorrhoea.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-040754","type":"journal-article","created":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T17:53:52Z","timestamp":1601402032000},"page":"e040754","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Duration of gargling and rinsing among frequent mouthwash users: a cross-sectional study"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6920-7710","authenticated-orcid":false,"given":"Tiffany Renee","family":"Phillips","sequence":"first","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"},{"name":"Central Clinical School, Monash University, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Fairley","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"},{"name":"Central Clinical School, Monash University, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Maddaford","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Trumpour","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Wigan","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"},{"name":"Central Clinical School, Monash University, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane S","family":"Hocking","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1766-0657","authenticated-orcid":false,"given":"Eric P F","family":"Chow","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"},{"name":"Central Clinical School, Monash University, Carlton, Victoria, Australia"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,9,29]]},"reference":[{"key":"2026062608071268000_10.9.e040754.1","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1071\/SH18097","article-title":"Gonorrhoea gone wild: rising incidence of gonorrhoea and associated risk factors among gay and bisexual men attending Australian sexual health clinics","volume":"16","author":"Callander","year":"2019","journal-title":"Sex Health"},{"key":"2026062608071268000_10.9.e040754.2","doi-asserted-by":"crossref","first-page":"e396","DOI":"10.1016\/S2352-3018(19)30043-8","article-title":"Epidemiology and prevention of sexually transmitted infections in men who have sex with men at risk of HIV","volume":"6","author":"Chow","year":"2019","journal-title":"Lancet HIV"},{"key":"2026062608071268000_10.9.e040754.3","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053273"},{"key":"2026062608071268000_10.9.e040754.4","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1056\/NEJMp1812269","article-title":"Neisseria gonorrhoeae - rising infection rates, dwindling treatment options","volume":"379","author":"Blank","year":"2018","journal-title":"N Engl J Med"},{"key":"2026062608071268000_10.9.e040754.5","unstructured":"The Kirby Institute . 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