Does Mouthwash Protect Oral Health?

Millions of people use mouthwash as a part of their morning routine. After scrubbing their teeth clean with a toothbrush, they brush their breath with mouthwash. Ads tout mouthwash as both refreshing and good for teeth and gums.

But can taking a swig of breath-freshening mouthwash really rinse away oral health problems? Experts say the answer depends.

There are two major types of mouthwashes available over the counter at pharmacies and other stores: cosmetic mouthwash and therapeutic mouthwash. Each type of rinse offers its own benefits:

Cosmetic mouthwashes are intended to mask bad breath (medically known as halitosis) and remove debris from your teeth and gums. Some mouthwashes contain whiteners to help whiten the teeth. Whitening teeth improves their appearance, but it is purely cosmetic and does not provide added protection against tooth decay.
Therapeutic mouthwashes include any rinse formulated to help prevent or treat an oral health problem. For example, anti-plaque rinses are designed to treat and prevent excessive buildup of dental plaque while anti-gingivitis rinses are intended to help prevent gum disease. Fluoride rinses also are available to help strengthen teeth and protect them from decay. Cosmetic mouthwashes that contain these ingredients designed to treat such oral health conditions also double as therapeutic rinses.

What the experts say

Experts continue to debate questions about the effectiveness of mouthwash use in boosting oral health. Organizations such as the American Dental Association (ADA) and the Academy of General Dentistry (AGD) agree that the benefits of mouthwash depend on the type of rinse that is used.

For example, both the ADA and AGD agree that mouthwashes that contain fluoride may reduce bacteria that cause cavities. These organizations also state that using a cosmetic mouthwash can freshen breath for several hours.

However, studies have shown that rinsing with water is nearly as effective in reducing plaque and the risk of periodontal disease as using anti-plaque and anti-gingivitis rinses, according to the AGD. In addition, the ADA emphasizes that cosmetic mouthwash only masks bad breath for a few hours (rather than eliminating it). The AGD does not specifically advocate using mouthwash as part of its suggested routine for maintaining good oral hygiene.

Despite such statements, many individual dentists recommend that their patients use mouthwash on a regular basis. These dentists maintain that using mouthwash, along with flossing and brushing, may further improve the health of your teeth and gums.

Using your rinse safely

If you do use mouthwash, there are several factors to keep in mind. Many over-the-counter mouthwashes contain levels of alcohol ranging from 18 percent to 26 percent, which is a higher percentage than found in some alcoholic drinks. If you use too much of this type of solution, you may develop an unpleasant burning sensation in your cheeks, teeth and gums.

If you have children, keep them away from any over-the-counter mouthwash until they are at least 13 years old. Children are more likely than adults to accidentally (or even purposely) swallow mouthwash, which can lead to alcohol poisoning or fluoride overdose. Both conditions may require immediate medical attention.

If you do use a mouthwash, make sure you do it right. Swish for about 30 seconds before spitting out the mouthwash. Do not swallow the rinse, and immediately report any side effects to your dentist. Depending on the type of rinse, you should avoid eating, drinking or rinsing of the mouth for up to several hours after using mouthwash.

In addition, it is crucial to remember that mouthwash should not be viewed as a substitute for daily brushing and flossing. You also should see your dentist as recommended, usually at least twice yearly.