Best Mouthwash Myths Busted for 2020

Dr. Reza Written by Dr. Reza Khazaie

mouthwash for dry mouth Is rinsing your mouth with harsh chemicals a good idea? Does mouthwash actually work? Well, it depends.

Does The Best Mouthwash Really Make A Difference?

Brush and floss your teeth every day.”

Brushing and flossing is the golden rule of oral hygiene. Everyone knows that the foundation of a healthy mouth is brushing at least twice a day with a fluoridated toothpaste followed by flossing at least once a day. Throw in a visit to Willow Pass Dental Care every six months to one year and, with the right set of genes, your natural teeth may last you a lifetime.

However, many patients who value their long-term dental health may also opt to use mouthwash in their daily routines as a means of ensuring that their teeth will stay strong, stay white, and stay in their mouths in their old age. It stands to reason that if bacteria is the enemy of healthy teeth, then anything that helps to kill or control that bacteria can only be good for your oral health – right?


5 Myths About Mouthwash

#1: Killing or eliminating all bacteria is the solution

Best Mouthwash - Microbes: Good and Bad - Concord Dentist

The idea of killing or eliminating all bacteria within the oral cavity is simply preposterous. In fact, even mouthwashes that advertise their antimicrobial capabilities never claim to be able to completely annihilate all microscopic life from a person’s mouth. Even oral washes that claim to kill 99 percent of germs should be viewed with some skepticism.

Furthermore, it isn’t clear that killing all microbes is even a good idea. On the contrary, there is ample evidence to suggest that nuking your mouth with harsh chemicals might actually make your oral health worse.

Mouthwashes, particularly anti-microbial varieties, do not distinguish between bad Streptococcus mutans, which is known for their enamel-destroying tendencies, and probiotic Lactobacillus paracasei, which is known to antagonize harmful bacteria. Chemically wiping the slate clean every day with mouthwash may actually clear the board for Streptococcus mutans and other harmful strains to flourish unopposed by other types of oral bacteria.

#2: Using more mouthwash will be better for your teeth

Bacteria and Saliva producition - Dentist Concord

Many consumers fall into the trap of assuming that more of a good thing can only be even better.

When it comes to mouthwash, it can be natural to assume that using more mouthwash more often will be better for your teeth since mouthwash kills and controls bacteria. This is patently false. Not only will you never eliminate 100 percent of all the microbes in your mouth, as explained above in Misconception #1: Killing or Eliminating All Bacteria is the Solution, killing all microbes isn’t the best idea.

Overusing mouthwashes can have several destructive effects. First and foremost, mouthwashes containing alcohol (which most commercial varieties do) dry out the mouth leading to even higher bacterial growth. Saliva plays a crucial role in controlling microbial populations in the mouth and on the teeth. Alcohol, however, suppresses saliva production, which reduces the protective effects of saliva on the mouth and teeth.

#3: Alcohol is the primary active ingredient

Menthol - Mint Leaf - Concord Dentist

Many people mistakenly assume that due to the sharp bite presented by many types of mouthwash that alcohol is the primary active antibacterial ingredient in most mouthwashes.

This is actually not the case.

Alcohol is actually used as a carrier agent for other essential active ingredients such as menthol, eucalyptol, and thymol. Alcohol is also often included in order to give consumers a noticeable “bite” giving them the impression that the product is more potent or “working” effectively.

#4: It can replace brushing and flossing

What Causes Cavities?

Some consumers erroneously believe that because mouthwash kills bacteria and mouthwash is able to reach areas of the mouth and teeth that are difficult to clean mechanically with a brush head or with a string of floss, that therefore mouthwash can actually replace both brushing and flossing. This is decidedly wrong. The two key mechanisms behind why brushing and flossing are so effective for controlling bacteria and promoting healthy teeth is the physical removal of plaque and debris, and direct exposure of dental surfaces to fluoride.

Mouthwash does neither of these as it relies on much weaker swishing forces to remove debris and does not come into contact with dental surfaces long enough to meaningfully expose teeth to therapeutic levels of fluoride.

#5: Mouthwash is safe & there are no potential health concerns

Mouthwash concerns - Dentist Concord, CA

While the majority of commercial and so-called natural alternative mouthwashes are safe, they should still be used in moderation and with some caution. Children, for example, should be taught to avoid swallowing mouth washing liquids. Adults and children alike should avoid drinking water or other beverages at least 30 minutes after using mouthwash.

In addition, there are some concerns about the chemical ingredients found in many commercially available and mainstream mouthwash varieties. It has been suggested, for example, that the alcohol found in many types of mouthwash may be carcinogenic, although there is no scientific consensus on the matter. Prolonged use of mouthwashes that contain hydrogen peroxide, a potent antimicrobial, can result in hypertrophy of the lingual papillae. Even natural mouthwash solutions, such as oil pulling, has its dangers. There have been reports of lipid pneumonia caused by accidental inhalation of the oil during oil pulling.

So, Does Mouthwash Actually Work?

With these five common and widespread misconceptions out of the way, we can finally get to answering our original premise: Does mouthwash actually work? Or, to put it another way, will using mouthwash regularly provide tangible oral and dental health benefits that justify its use? The answer is “yes”, with one huge caveat. Mouthwash is indeed useful and effective for aiding in the maintenance of a healthy mouth and strong teeth.

However, it is only useful and effective if used correctly, in moderation, and in addition to essential brushing, flossing, and visits to the dentist.

Mouthwash can never be used as a replacement for brushing and flossing no matter how many people wish they would just rinse, swish, and spit their way to better oral health.

Mouthwash should only be used in moderation. The keystone of a healthy mouth is a healthy oral microbiome wherein bad bacteria are kept in check by the flourishing of harmless indigenous microbes that compete with harmful species.

There is also evidence to suggest that overuse of mouthwash, particularly conventional varieties containing alcohol, can actually dry out the mouth leading to explosive bacterial growth. Saliva, and it’s content bathing action on the gums and teeth play a key role in controlling bacteria populations and remineralizing teeth. Mouthwash overuse may actually lead to even more bacterial growth and even worse halitosis, or bad breath.

In summary, mouthwash can work to improve oral health if:

  1. The mouthwash contains therapeutic antibacterial ingredients, not just cosmetic breath fresheners.
  2. It is used in moderation and at least 15 minutes after brushing.
  3. If it is used in addition to regular brushing, flossing, and visits to the dentist.
  4. If it contains ingredients designed to increase saliva production or balance oral PH, such as Xylitol.
  5. If it has been prescribed for a specific oral condition, such as Alveolar Osteitis (Dry Socket), by a dentist aware of the patient’s treatment.