Overview

Chlorine dioxide is a disinfectant that may be added in very small amounts to toothpastes, mouthwashes, and skin care products. When applied to the skin, these small amounts may cause irritation or redness. Larger amounts of chlorine dioxide may cause severe burns. Although oral chlorine dioxide products may be available for purchase online, they are not considered legal in the U.S. These products may be marketed for various uses, but they are unsafe when taken by mouth and can cause serious health problems. Before using products that contain chlorine dioxide, make sure to tell your health care provider about any health conditions you have or medicines you are taking.

Uses

What is chlorine dioxide used for?

Chlorine dioxide is a disinfectant. Small amounts of chlorine dioxide may be added to toothpaste and mouthwash products to help with bad breath or oral infections and to skin care products to help cleanse the skin.

Chlorine dioxide products that are taken by mouth are marketed for a wide range of uses. However, there is no evidence that these products are helpful for any use, and taking chlorine dioxide by mouth can cause serious health problems.

Note: Chlorine dioxide may be added to mouthwashes, toothpastes, or skin care products in small amounts. The FDA has not reviewed chlorine dioxide for any oral use. The FDA also does not consider chlorine dioxide to be a legal dietary ingredient in the U.S.

How does chlorine dioxide work (mechanism of action)?

Chlorine dioxide is a bleach-like disinfectant. Very small amounts of chlorine dioxide are commonly used to disinfect drinking water. It is also an ingredient in some mouthwashes, toothpastes, and skin care products. Large amounts of chlorine dioxide can cause serious health problems when taken by mouth or applied to the skin.

Small amounts of chlorine dioxide may be added to toothpaste or mouthwash products. As a disinfectant, chlorine dioxide can help kill the bacteria and fungi in the mouth that cause bad breath and increase the risk of certain oral infections, such as thrush. These products should be spit out after use and are not meant to be swallowed.

Chlorine dioxide may also be added to skin care products in small amounts. These products may be marketed for general skin care, for cleansing the skin, or for specific skin and nail problems. Chlorine dioxide is an effective disinfectant that can help clean the skin. But it is not clear if it helps with specific skin problems, such as warts, nail fungus, or acne. The benefits of using skin products that contain chlorine dioxide for these purposes is unclear.

Oral chlorine dioxide products are not considered legal in the U.S. Many of these products claim to treat, prevent, or cure a wide range of health problems. But chlorine dioxide has not been studied for any use and is unsafe at the doses found in these products. When taken by mouth, chlorine dioxide can cause severe nausea and vomiting and can also burn the mouth, throat, and stomach. See the Side Effects section for more information.

Some oral chlorine dioxide products are sold under the name Miracle Mineral Solution (MMS). These products contain sodium chlorite, a form of bleach that turns into chlorine dioxide when mixed with acid. MMS products contain instructions for making chlorine dioxide that involve mixing the product with citrus juice, which contains acid. Both sodium chlorite and chlorine dioxide can cause serious health problems when taken at the doses found in these products.

How should I store chlorine dioxide?

You should store chlorine dioxide according to the product label. Most dietary supplements should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.

Side Effects

What are the most common side effects of chlorine dioxide?

At the very small amounts found in drinking water, mouthwash, and toothpaste, chlorine dioxide seems to be well tolerated. The most common side effects of larger amounts of chlorine dioxide are listed below. These side effects may vary depending on how you are using it, the dose you are taking, or the specific product you are using. Tell your health care provider if you have any of these side effects that bother you.

• Burning in the mouth, throat, or stomach (when taken by mouth)
• Nausea or vomiting (when taken by mouth)
• Itching, redness, or irritation (when applied to the skin)

There may be other side effects of chlorine dioxide that are not listed here. Contact your health care provider if you think you are having a side effect of a supplement. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of chlorine dioxide?

While less common, the most serious side effects of chlorine dioxide are described below, along with what to do if they happen.

Severe Allergic Reactions. Chlorine dioxide may cause allergic reactions, which can be serious. Stop using chlorine dioxide and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching or skin rash
• Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Skin Burns.Applying large amounts of chlorine dioxide directly to the skin can cause serious burns, including second- or third-degree burns. Do not apply concentrated chlorine dioxide to your skin. If you accidentally get concentrated chlorine dioxide on your skin, wash it right away with water and soap. Skin care products that contain very small amounts of chlorine dioxide are not expected to burn the skin as long as they are used as directed on the label.

Damage to the Mouth, Throat, and Stomach.Taking chlorine dioxide by mouth can cause serious burns in the mouth, throat, and stomach. In some cases, this may require treatment in a hospital. You should not take chlorine dioxide by mouth. If you or your child accidentally takes chlorine dioxide by mouth, get medical care right away. These concerns do not apply to the very small amounts of chlorine dioxide that are used to disinfect the water supply or that are in mouthwashes or toothpastes. These products should be spit out after use and are not meant to be swallowed.

Dehydration.Taking chlorine dioxide by mouth may cause severe nausea and vomiting, which can lead to dehydration. Dehydration may cause low blood pressure, especially when you stand up (orthostatic hypotension), or kidney damage. This is not a concern with the very small amounts of chlorine dioxide that are used to disinfect the water supply. Call your health care provider right away or get emergency help if you have any of the following symptoms of dehydration, low blood pressure, or kidney damage.

• Dizziness or lightheadedness
• Weakness or unusual tiredness
• Confusion
• Unsteadiness
• Peeing less than normal
• Swelling in your legs, ankles, and feet
• Loss of appetite or nausea
• Trouble catching your breath or chest pain or pressure
• Seizures
• Extreme thirst

Precautions

Who should not use chlorine dioxide?

Allergies to Ingredients. People who are allergic to any of the following should not use chlorine dioxide.

• Chlorine dioxide (ClO2)
• Cloralstan
• DioxiCare
• Miracle Mineral Solution (MMS)
• Any of the ingredients in the specific product

Your pharmacist can tell you all of the ingredients in the specific chlorine dioxide products they stock.

What should I know about chlorine dioxide before using it?

Chlorine dioxide may be added to mouthwashes, toothpastes, and skin care products in very small amounts. When using these products, read the product label carefully, and only use the smallest amount needed to achieve the desired effect. These products should not be swallowed.

The FDA does not consider chlorine dioxide to be a legal ingredient in products that are taken by mouth. However, these products may be available for purchase online. Chlorine dioxide may also be made from products that contain sodium chlorite, which is often marketed as Miracle Mineral Solution. Both sodium chlorite and chlorine dioxide can cause serious health problems when taken at the doses found in these products.

Chlorine dioxide may be available in topical products that are marketed for specific skin and nail problems. The amount of chlorine dioxide in these products may vary. Large amounts of chlorine dioxide can irritate the skin and may even cause severe burns. Follow the instructions on the product you are using and only apply the smallest amount of chlorine dioxide needed to achieve the desired effect.

Keep chlorine dioxide and sodium chlorite out of the reach of children.

What should I tell my health care provider before using chlorine dioxide?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if chlorine dioxide is right for you.

In particular, make sure that you discuss any of the following.

Serious Infections.Ask your health care provider before using chlorine dioxide for a serious mouth or skin infection. Some mouth and skin infections may need other forms of treatment.

Pregnancy. It is not known if or how chlorine dioxide could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if chlorine dioxide passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does chlorine dioxide interact with foods or drinks?

There is not enough research to know if chlorine dioxide interacts with foods or drinks, including alcohol. Taking chlorine dioxide by mouth may be unsafe and can lead to serious health problems.

Does chlorine dioxide interact with medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

The interactions between chlorine dioxide and medicines are not fully understood. As with most dietary supplements, the research on drug interactions with chlorine dioxide is incomplete. Always check with your health care provider before taking chlorine dioxide with any medicines.

Dosing

What should I do if I accidentally use too much chlorine dioxide?

If you or someone else has used too much chlorine dioxide, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

Small amounts of chlorine dioxide may be added to a wide range of products, including skin care, toothpaste, and mouthwash products. Read the product label closely, and speak with a health care provider about how to use these products safely. Do not use more than recommended.

In the U.S., chlorine dioxide is not considered a legal ingredient in products that are taken by mouth. Taking chlorine dioxide by mouth has been associated with serious health problems. It is best to avoid the use of these products entirely.