Wednesday, April 1, 2015

Is mouthwash effective; how choose a rinse?

children kids fluoride rinse
Mouthwash, is it effective?

I have noticed quite a few people use mouthwash as part of their daily oral health care routine.  Mouthwashes can be a good addition, but it's important to know what the mouthwash does and doesn't do.  Some mouthwashes only freshens breath temporarily, while others may contain antibacterial ingredients to help prevent plaque buildup, and some contain fluoride that offers anti cavity benefits.

There are myriad mouthwash to clean debris (ie. Listerine, ACT, Crest ProHealth, and the "right" choice is one that best meets your dental health needs.

Below are some types of mouthwashes one can consider when choosing a mouthwash:
  • Plaque control - These mouthwashes contain ingredients that help decrease plaque and bacterial levels and help decrease gingivitis.  Such bacteria can create toxins that cause gingivitis, and if not treated, can progress to periodontitis (bone disease that can affect tooth stability).  This mouthwash can also help control halitosis (bad breath).
  • Fluoride - With the proper amount of fluoride this can help decrease small cavity lesions on the tooth's enamel, and also help decrease risk of tooth decay.
  • Cosmetic mouthwashes - This category of mouthwashes may contain astringent salts or an odor neutralizer that may help temporarily reduce bad breath / halitosis, however the main cause is not addressed.  Some mouthwashes may even claim to whiten your teeth, but such gains are likely nonexistent at best and not substantiated with controlled studies.
 When choosing that right rinse, please also keep the following in mind:
  • Alcohol -  Some mouthwashes and rinses can contain a significant amount of alcohol, which in my opinion, may cause more harm than good.  Alcohol can significantly dry out one's gingival tissues and teeth, which may also cause dry mouth and increase risk of tooth decay.  Some rinses contain such a high level of alcohol it may be a source of alcohol abuse.  With so many choices out there, it is my personal recommendation to choose a mouthwash that does NOT have alcohol.  Examine the active and inactive ingredients carefully, as alcohol may not be visibly listed or advertised.
  • Sensitivity -  In certain individuals, mouthwash ingredients may irritate the gums and/or cause the inner cheek lining to be ulcerated.  Alcohol is a common gingival irritant.  If you find your mouth is sensitive to mouthwashes, either discontinue use of the rinse or choose one that is more "natural" that contains aloe vera and chamomile.  
Be advised though, mouthwash is not a substitute for regular flossing and brushing.  If you have any questions about which mouthwash or rinse would best meet your oral health
needs, be sure to ask your dentist or dental hygienist for recommendations.

Warm Regards,

Peter Chien, DMD, MPH