Are Mouthwashes healthy? What does a dentist say?

The biggest enemy of a healthy mouth is dental plaque. Dental plaque builds up on the teeth very quickly. Plaque is made of bacterial colonies on your teeth mixed with food debris.Mouthrinse

The dental plaque is part of a bigger problem that faces your mouth and teeth: tooth decay, gum disease, bad breath and other issues.

The unfortunate reality is that plaque build-up is happening continuously. We can never have an antiseptic mouth, free of bacteria, because bacteria is present in large amounts in the mouth; and is waiting for reasons to flourish and grow.

[That’s why, when you have surgery inside your mouth, the surgeon doesn’t even attempt to sterilise the operation site, because that is almost impossible. Believe me, I have worked in operating theatres and I have observed this first hand.]

The most important method for removing dental plaque will continue to be the mechanical removal of the dental plaque carried out by the toothbrush. This is further supported with interdental flossing in the form of flossing or interdental brushes.

Maintaining healthy dental habits can help keep symptoms at bay and prevent dental conditions from starting or worsening.

In addition to the oral hygiene steps mentioned above, one can add a mouthwash to the process.

Functions of Mouthwash

Amongst others, mouthwashes have a number of functions:

a) freshen the mouth

b) deliver chemicals to help strengthen teeth

c) help with large scale removal of plaque deposits (for those who are really lacking in Oral Hygiene)

d) neutralise the acid environment

e) deliver chemicals which kill bacteria

f) deliver chemicals that help to inhibit or delay plaque formation

So, as you can see mouthwashes can do a lot. It might be difficult to find a single mouthwash that does all the above. However, one may also be alarmed to see that there is a big role for chemicals to play in mouthwashes. These mouthwashes can be an important part of a health mouth.

For plaque to do damage, bacteria have to be well colonised to cause gingivitis, tooth decay and bad breath. Mouthwashes work in many ways to fight bacteria that does this, by either strengthening your natural defences or by disrupting the bacteria – chemically and – to a lesser degree – mechanically.

 

Mouthwash as a second line of defence

As I stated above, the most important part of dental hygiene is the mechanical removal: this is the first line of defence against dental plaque. Mouthwashes – however – can act as a second line of defence in oral hygiene.

Used correctly, they can be a helpful adjunct to the hygiene of our oral tissues.

Mouthwash should be considered as one of the weapons that you have in your artillery in your battle against dental plaque.

 

The concept of Chemicals

Many people will hear the word “chemicals” and be alarmed. There has been a negative association between the word “chemical” and health. Generally, we have been programmed to think that all “chemicals” are bad and that life would be better without them.

I want to spend a moment or two, to remove the myth around chemicals.

Chemicals are a part and parcel of our existence. Our bodies are made of billions of chemicals. Our food is a complex makeup of chemicals. Simple ingredients are chemicals. Take your ordinary average table salt: that is a chemical named Sodium Chloride (NaCl). Water is a chemical (H20); and so on.

We have to therefore understand that the building blocks of life are all chemicals.

There are good chemicals as well as “bad” chemicals. There are useful chemicals and there are dangerous ones.

It is true that chemicals come in all forms, shapes and sizes. Some are dangerous and even lethal. Whilst others are healthy and vital. We have to learn how to differentiate between the two.

Which chemicals should I avoid?

It is difficult to discuss all the different aspects of a mouthwash, and we will come back to this in a future article.

One chemical that is good to avoid in mouthwashes is alcohol. For many decades, manufacturers have been adding alcohol to mouthwashes for some benefits that are thought to be produced by the alcohol, namely the bactericidal effect it has, and because alcohol is a good solvent for other chemicals.

With an increase in the awareness of how this chemical may be detrimental to oral health, there has been a substantial move to produce alcohol free mouthwashes.

A recent review[1] into the effect of alcohol mouthwashes concluded that alcohol-based mouthwash consumption significantly increases acetaldehyde levels in the first few minutes, but no evidence exists if long-term salivary acetaldehyde levels may increase with a high frequency of mouthwash use. The review went to state “There is still insufficient evidence of whether the use of alcohol-based mouthwash is an independent risk factor for oral or oropharynx cancer. Nonetheless, it does increase the risk when it occurs concomitantly with other risk factors such as smoking or alcohol.”

This review may not clearly state that alcohol based mouthwashes are detrimental to oral health, but as is the nature of scientific reviews they look at what can be termed “evidence”; and that doesn’t mean that the lack of evidence means there is no evidence.

As we now, have more and more options with alcohol free mouthwashes: then the wise choice would be to opt for these.

[1] Ustrell-Borràs M, Traboulsi-Garet B, Gay-Escoda C. Alcohol-based mouthwash as a risk factor of oral cancer: A systematic review. Med Oral Patol Oral Cir Bucal. 2020;25(1):e1‐e12. Published 2020 Jan 1. doi:10.4317/medoral.23085

Join the conversation

12 Comments

  1. Hello,
    I thank you for writing Are Mouthwashes Health, and you have covered this subject extremely well so I only have one question. I am highly sensitive to chemicals in the products today, so I need natural products and I was wondering can you recommend any natural mouthwash products for me.

    Thank you
    Jeff

    1. Hello Jeff,
      Thanks for your comment.
      There are many natural ingredients that are being added to natural mouthwashes. These ingredients include cinnamon, clove, tea tree, aniseed and others.
      A mouthwash that I recommend is JASON Healthy Mouth Tartar Control Mouthwash, which is available on amazon amongst other places.
      However, you may want to try making your own natural mouthwash. [Watch out for my upcoming articles on natural ingredients in mouthrinses].

  2. Thanks for this really informative, and as someone who can’t use mouthwash with alcohol it really is close to my every day life so thankyou. I don’t find much about the subject written online so this is a welcome addition.

    1. Thanks Phil.
      I am glad you liked the article.
      It’s amazing how in the past, alcohol was added without due attention.
      Obviously, we have more science to show us that alcohol is not a good idea; and hence manufacturers are responding by producing alcohol-free alternatives.

  3. Hey,
    Well put together and explained, a lot of great stuff here i have health problems getting my teeth cleaned every 6 months-yes i do avoid mouthwashes with alcohol.
    long term natural is a good way i think.
    What’s a good natural way.
    Thank’s
    Tommy

    1. Hey Tommy.
      Thanks for your positive comment. Definitely, alcohol based mouthwashes may be an irritant: so avoiding them is a good idea.
      There are many natural ingredients that are being added to natural mouthwashes. These ingredients include cinnamon, clove, tea tree, aniseed and others.
      A mouthwash that I recommend is JASON Healthy Mouth Tartar Control Mouthwash, which is available on amazon amongst other places.
      However, you may want to try making your own natural mouthwash. If you get a chance, check my article on cinnamon as a mouthwash.

  4. You make a really good point here. Chemicals are not all bad. Everything is comprised of them We must make the determination as to whether they are good or bad. Yes, excellent! I can hardly even keep alcohol infused mouthwash in my mouth for more than a few seconds before it starts burning. So I have really always chose those without alcohol.
    Great article, thank you!

    1. Thanks Teresa. I am glad that you agree with the concept.
      The burning sensation can’t be a good thing; yet many people carry on thinking that if it is burning, then it must be good.
      Take care.

  5. Hi,
    I’ve always been sceptical about the mouthwashes due to their extensive ingredients. Would you recommend one with more natural and eco-friendly ingredients?
    Your post reconfirmed my doubts that there is still plenty of research needs to be done to confirm its effectiveness.
    Thanks for this review.
    Habib

  6. I really enjoyed your post about mouthwashes and how they can help. I personally recommend corsodyl. This helps fight all the issues plaque can cause.

    1. Hello Ruas. I am glad you enjoyed the post on mouthwashes.
      Corsodyl is an antibacterial mouthwash which contains chlorhexidine as its main ingredient.
      So, it definitely has the potential to kill bacteria; however it does come with side effects, like it can stain teeth.
      Also, if you use it for a long term: you can get altered taste.

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