While that minty burn sure seems like it's working, oral hygiene experts explain why that's not what you want in your rinse.
Highlights
|
Lately, good oral hygiene has been linked with benefits like pancreatic cancer prevention and living to 100. If mouthwash is part of your routine, experts say it may be a good moment to take inventory of your practice. Between long-known brands and newer, more holistic formulas, there are products available for a range of needs—but some are safer and more effective than others.
We asked four dentists for their advice. All of them agreed on one thing that’s most important when you’re contemplating mouthwash.
About the experts
|
A quick guide to mouthwash types
Antiseptic mouthwashes
These are the heavy hitters with ingredients like chlorhexidine gluconate. They demolish bacteria—which means they may also “disturb the balance of your oral microbiome,” says Fatima Khan, DDS, dentist and co-founder of Riven Oral Care.
Additionally, these types of mouthwash can stain your teeth with long-term use. They’re often prescription-only for reasons such as these.
Natural mouthwashes
These generally come with essential oils, herbs, or aloe vera, all of which sound gentle. Dr. Khan notes the caveat that “natural mouthwashes … can be quite acidic.” Routine use can be tough on tooth enamel.
Whitening mouthwashes
These contain hydrogen peroxide or carbamide peroxide to tackle surface stains. They work, but slowly, and “prolonged use of whitening mouthwash may lead to tooth sensitivity,” Dr. Khan says. So use with caution—especially if you’re using other whitening products at the same time.
If you “feel the burn,” that might be problematic
All four dentists agreed: skip the alcohol when choosing your mouthwash. If you’ve ever thought that intense burning sensation meant the mouthwash was really working, unfortunately, that’s just pain.
“I always start with alcohol-free,” says Jeremy S. Manuele, DMD, a board-certified orthodontist based in Las Vegas. “Alcohol in mouthwash tends to dry out the mouth, which actually makes breath worse over time and can irritate the tissues.”
Some mouthwash makes bad breath worse? It’s true, confirms Sandip Sachar, DDS, founder and owner of Sachar Dental NYC—and the reason is fascinating.
As Dr. Khan explains, antiseptic mouthwashes with alcohol destroy nitric oxide-producing bacteria in your mouth. “The bacteria that converts nitrates to nitric oxide is so important because it aids in regulating blood pressure and improving circulation, which in turn can boost both heart health and athletic performance,” she says. Basically, that “fresh” burning feeling could have some impact on your cardiovascular health.
According to the American Dental Association, alcohol-based mouthwashes mess with your mouth’s delicate natural balance. That “minty fresh” feeling isn’t a selling point; it’s a warning. “That burning feeling from the alcohol isn’t actually doing anything for our mouths,” Dr. Manuele explains. Research shows alcohol doesn’t even kill bacteria better than alcohol-free options. It’s all pain with no gain.
Not all bacteria are the enemy
Just as the cultural understanding is growing that our gut needs “good” microbes, the mouth’s microbiome does, too. Dr. Khan says, “Traditional mouthwash has been marketed with the message that ‘Bacteria is bad’ and needs to be eliminated. But based on leading research, we now know that the opposite is true: nurturing the right bacteria is crucial for a cleaner and healthier mouth.”
According to Harvard Health, certain bacteria live on your tongue and convert nitrates from the food we eat into nitric oxide—a molecule that helps regulate your blood pressure and improve circulation. Research published in the American Journal of Hypertension showed that people with normal blood pressure had significantly higher levels of these helpful bacteria, while people using antibacterial mouthwash for just seven days reduced oral nitrate production by up to 90%—in turn increasing blood pressure. That’s a pretty big deal when you consider that half of Americans have hypertension.
Beyond cardiovascular benefits, beneficial bacteria also fight the germs that cause bad breath, produce natural antimicrobials that keep harmful bacteria in check, and help maintain the right pH balance in your mouth to prevent cavities. “Overuse of alcohol containing mouthwash can lead to dry mouth and bacterial imbalance,” Dr. Khan says. “The bacterial imbalance can further exacerbate dental issues.”
Harsh mouthwash is like using a flamethrower when you need a broom—they wipe out the good and bad.
Do you really need mouthwash?
“Most people don’t actually need mouthwash,” Dr. Manuele says. “But it can be very helpful when used for the right reasons.”
Adam Patel, DDS, owner of XO Dental Clinic in the United Kingdom, clarifies: “I do usually advise mouthwash as part of a full oral health regimen, but not on its own in place of brushing and flossing.” Proper brushing and flossing still do the heavy lifting.
So when should you use mouthwash? Dr. Manuele suggests it comes down to three main reasons: cavity prevention, gum health (especially if you’re dealing with periodontal issues), and freshening breath. (There’s also a fourth: post-surgical or wound care, where a gentle rinse helps with healing.)
The best mouthwash for your needs
All four dentists said you can forget the “best overall.” Which type of mouthwash you need depends on what oral situation you’re trying to address. Here are a few common oral health problems, along with the doctors’ recommendations for the mouthwash to help.
Bad breath
“Bad breath” has been stated as the top reason most people cite for wanting to use mouthwash. For breath freshening, Dr. Manuele recommends Oxyfresh, which neutralizes the bacteria causing bad breath instead of just covering up the smell with mint.
Meanwhile, Dr. Patel is team TheraBreath Fresh Breath Oral Rinse, calling it “the best choice for people with persistent bad breath or dry mouth—gentle yet highly effective.”
Dr. Khan adds that you still need to address the underlying causes, however. “Cosmetic mouthwashes do not target the root cause of bad breath, which is often linked to bacteria build-up or underlying oral health problems,” she says. So if you’re constantly battling bad breath, book an appointment with the dentist to further diagnose the problem.
Your oral microbiome
Having a healthy microbiome is a hot topic. This is Dr. Khan’s speciality, and she recommends a probiotic-based mouthwash, which is basically the opposite approach from traditional rinses. “Probiotic mouthwash contains live strains of bacteria that help to maintain a healthy balance of bacteria in our mouth,” she says. “It is designed to promote the growth of ‘good’ bacteria while inhibiting the growth of ‘bad’ bacteria.”
She developed a probiotic mouthwash, called Riven, to address these issues. She adds that Supermouth is a great option, too.
Your gums
Gum care is a much-overlooked part of oral hygiene, but is critical. Three of our dentists gave Listerine Total Care Zero an alcohol-free thumbs up when it comes to good gum care. “It’s a good alcohol-free rinse that helps reduce bacteria and supports tissue healing,” says Dr. Manuele. Dr. Patel agrees it’s solid for “gum health, fresh breath, and cavity prevention.”
Dr. Sachar goes for CloSYS Sensitive Mouthwash because of its balanced pH and how well it targets gum inflammation.
You’re worried about cavities
When you want to armor up against tooth decay, fluoride is your friend. Dr. Manuele and Dr. Sachar both recommend ACT Anticavity Mouthwash. “It provides a steady and reliable source of fluoride to protect enamel,” Dr. Manuele explains.
Dr. Patel suggests Crest Pro-Health Advanced Rinse if you want fluoride, plus help with plaque and gingivitis—all without the alcohol burn.
A note from Dr. Khan: “It is critical to maintain balance in fluoride usage. Overexposure to fluoride can increase the risk of dental and skeletal fluorosis.” That can mean white or brown spots on your teeth, or in severe cases, weakened bones. More isn’t always better.
What to look for on the label
Once you’ve figured out what you need, here’s what to check. Dr. Sachar looks for “fluoride content to aid enamel strengthening, antibacterial agents for gum health, and an alcohol-free, pH-balanced formulation to avoid dryness or irritation.”
Dr. Patel adds that you should always check for that ADA (American Dental Association) seal of approval. It’s “a trustworthy indicator that the product has undergone clinical testing for safety and efficacy,” he says.
Mouthwash mistakes
In most cases, using mouthwash is harmless. But use the wrong one or overdo it, and you might run into trouble.
Common side effects include dry mouth, irritation, or mouth sores—”especially with rinses containing alcohol or strong essential oils,” Dr. Manuele warns. Some antibacterial rinses can stain your teeth if you go overboard. “Overuse can sometimes disrupt the natural balance of oral bacteria, potentially leading to sensitivity or changes in taste,” he adds.
Dr. Khan adds that allergic reactions are rare but possible, usually from “flavoring agents or essential oils within the mouthwash.” Also, the low pH of alcohol-based mouthwash isn’t great for your enamel—the protective coating we want to keep.
If you experience burning, swelling, or other noticeable symptoms in your mouth after using mouthwash, it’s wise to pause on use and call your dentist to discuss.
How to properly use mouthwash
You’d think swishing liquid around your mouth would be foolproof, but there’s actually a right way to do this:
Identify why you’re using it. Dr. Manuele is blunt, saying, “Don’t just rinse because it feels like a good idea. Pick a product that targets your actual needs.” No need to use fluoride mouthwash if what you need is something for bad breath.
Timing is everything. Use mouthwash after brushing and flossing, not before. Dr. Sachar suggests using it at a different time of day from brushing to maximize the fluoride benefit. And if you’re using fluoride mouthwash, wait at least 30 minutes before eating or drinking. Let it work.
Measure it out. Around 20 milliliters (about four teaspoons) is the sweet spot. Swish it in your mouth for 30 to 60 seconds.
Don’t rinse after. Dr. Sachar advises “avoiding rinsing with water right after using mouthwash to let the ingredients work.” Resist the urge.
Don’t swallow it. “Patients should not swallow any mouthwash,” Dr. Khan reminds us.
Easy does it. “Once a day is really enough,” Dr. Manuele says. “Using it more often doesn’t mean better results.”
The most affordable—and effective—option
After all this talk about specialized formulas and ingredients, Dr. Manuele makes it simple. “Let’s not forget good old salt water,” he says. “It remains one of the best natural oral rinses available.” Salt water is a health staple: especially when virus season is high, recent research suggested salt water can also help stave off severe respiratory infections, such as with Covid.
So the next time you find yourself bewildered and overwhelmed in the mouthwash aisle, remember that the best mouthwash isn’t about the fanciest bottle or the most intense burn. Talk to your dentist about one that’s right for you.
For daily wellness updates, subscribe to The Healthy by Reader’s Digest newsletter and follow The Healthy on Facebook and Instagram. Keep reading:
