substitute for regular toothbrushing and flossing. Instead, chlorhexidine mouthwash is more effective when used as an adjunctive treatment with toothbrushing and flossing. In the short term, if toothbrushing is impossible due to pain, as may occur in primary herpetic gingivostomatitis, chlorhexidine mouthwash is used as a temporary substitute for other oral hygiene measures. It is not suited for use in acute necrotizing ulcerative gingivitis, however. Rinsing with chlorhexidine mouthwash before and after a tooth extraction may reduce the risk of a dry socket. Other uses of chlorhexidine mouthwash include prevention of oral candidiasis in immunocompromised persons, treatment of denture-related stomatitis, mucosal ulceration/erosions and oral mucosal lesions, general burning sensation and many other uses. Chlorhexidine mouthwash is known to have minor adverse effects. Chlorhexidine binds to tannins, meaning that prolonged use in persons who consume coffee, tea or red wine is associated with extrinsic staining (i.e. removable staining) of teeth. A systematic review of commercial chlorhexidine products with anti-discoloration systems (ADSs) found that the ADSs were able to reduce tooth staining without affecting the beneficial effects of chlorhexidine. Chlorhexidine mouthwash can also cause taste disturbance or alteration. Chlorhexidine is rarely associated with other issues like overgrowth of enterobacteria in persons with leukemia, desquamation, irritation, and stomatitis of oral mucosa, salivary gland pain and swelling, and hypersensitivity reactions including anaphylaxis. Hexetidine also has anti-plaque, analgesic, astringent and anti-malodor properties, but is considered an inferior alternative to chlorhexidine. Edible oils In traditional Ayurvedic medicine, the use of oil mouthwashes is called "Kavala" ("oil swishing") or "Gandusha", and this practice has more recently been re-marketed by the complementary and alternative medicine industry as "oil pulling". Its promoters claim it works by "pulling out" "toxins", which are known as ama in Ayurvedic medicine, and thereby reducing inflammation. Ayurvedic literature claims that oil pulling is capable of improving oral and systemic health, including a benefit in conditions such as headaches, migraines, diabetes mellitus, asthma, and acne, as well as whitening teeth. Oil pulling has received little study and there is little evidence to support claims made by the technique's advocates. When compared with chlorhexidine in one small study, it was found to be less effective at reducing oral bacterial load, and the other health claims of oil pulling have failed scientific verification or have not been investigated. There is a report of lipid pneumonia caused by accidental inhalation of the oil during oil pulling. The mouth