The "best" mouthwash is ultimately based on what you need to use it for. A mouthwash can be used as part of your daily oral hygiene routine or to aid with recovery from a mouth sore or injury. Others can help ease mouth pain, stop bleeding gums, or simply freshen your breath. There are even mouthwashes that can help whiten your teeth.
This article looks at five different categories of mouthwash, including some of the more popular brands you can buy. It also offers you tips on how to choose the right mouthwash and factors that may influence your choice.
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Choosing the Best Mouthwash
Before purchasing a mouthwash, there are four things to consider:
- Purpose of the product: Not all mouthwashes are created equally. Those intended for daily oral hygiene may not be useful if you have an aphthous ulcer or are recovering from mouth surgery.
- Appropriate use of the product: If you need mouthwash to treat a specific condition, like gum disease, consult with your dentist to determine which ones help and which ones don't.
- Safety of the product: Some OTC mouthwashes should not be used if you have mouth sores, a compromised immune system, or are undergoing chemotherapy. Again, check with your dentist.
- How to use the product: Products used for oral hygiene may not be used in the same way as those for pain relief or teeth whitening. Read the product label to use it correctly. Some products are not intended for long-term use and may pose certain risks if overused.
Chlorhexidine Mouthwash
Chlorhexidine is an antibacterial used as an active ingredient in certain mouthwash brands. It is a broad-spectrum antimicrobial that exerts strong action against bacteria that cause periodontitis (gum disease).
Dentists will sometimes prescribe chlorhexidine mouthwash after mouth dental surgery to inhibit the formation of bacteria and plaque and aid with healing.
Chlorhexidine mouthwash is only intended for short-term use as it can cause yellowish or brownish staining of your teeth and tongue if overused. It can also affect your taste after use, particularly with salty foods.
Chlorhexidine isavailable by prescription and marketed under the brand names:
- 3M Peridex
- Colgate Periogard
- GUM Paroex
How to Get Rid of Gingivitis Without a Dentist
Fluoride Mouthwash
Many mouthwashes containfluoridethat help prevent cavities and tooth decay. Fluoride "remineralizes" tooth enamel by bonding to areas of decay and attracting other minerals to fill in any tiny gaps.
Fluoride also has antibacterial properties that not only inhibit the growth of bacteria but prevent them from sticking to your teeth. It can also help reduce bacteria that contribute to halitosis (bad breath).
Fluoride mouthwash is not meant to replace fluoride toothpaste, but it can support a daily dental hygiene routine. Fluoride rinses with 0.05% fluoride are likely the most effective.
Fluoride mouthwashes should not be swallowed as they have a potential for toxicity, particularly in small children. Children under 7 years of age should never use them as they are most likely to swallow.
OTC fluoride mouthwash brands include:
- ACT Alcohol-Free Anticavity Fluoride Rinse
- CloSYS Silver Fluoride Mouthwash
- Crest Pro-Health Densify Fluoride Mouthwash
- Listerine Total Care AnticavityFluoride Mouthwash
- The Natural Dentist Healthy Teeth Fluoride Anticavity Mouth Wash
- Tom's Of Maine Whole Care Natural Fluoride Mouthwash
Hydrogen Peroxide Mouthwash
Hydrogen peroxide is an active ingredient in many household cleaning products. It has antimicrobial and disinfecting properties due to its oxidizing effects.
As hydrogen peroxide comes into contact with bacteria, it releases oxygen molecules that create a foaming action that disrupts the cellular wall, killing the microorganism. The same foaming action has a bleaching effect.
For this reason, mouthwashes with a higher concentration of hydrogen peroxide are commonly used as an antiseptic to treat mouth sores and gingivitis (a form of gum disease). Those with lower concentrations are commonly used as teeth whiteners. Concentrations of between 1% and 3% are considered safe.
Hydrogen peroxide mouthwashes are not intended for daily use. When overused, hydrogen peroxide can penetrate the tooth root and damage the soft interior of the tooth called the dental pulp. This can lead to tooth sensitivity and pain as well as the swelling of the gums.
OTC mouthwashes containing hydrogen peroxide include:
- Arc Teeth Whitening Rinse
- Bee's Whitening Pre-Brush Oral Rinse
- Colgate Peroxyl Antiseptic Mouth Sore Rinse
- Crest Breath Bacterial Blast Mint Mouthwash
- Crest 3D White Anticavity Fluoride Mouthwash
- Equaline Glowing White Anticavity Mouthwash
- Meijer Sore Mouth Peroxide Rinse
- Orajel Antiseptic Mouth Sore Rinse
Essential Oil Mouthwash
Essential oils extracted from plants are thought by some to have healing properties. Studies have shown that many have antioxidant, antimicrobial, and anti-inflammatory effects that may be beneficial when applied to the skin. However, quality studies are lacking.
On the other hand, several essential oils used in mouthwashes have been shown to exert potent antibacterial effects that may support dental health. These include peppermint oil, spearmint oil, clove oil, tea tree oil, and eucalyptus oil.
You may be surprised to learn that Listerine, one of the oldest and most popular mouthwash brands, contains four essential oils including eucalyptus and peppermint oil.
Other OTC mouthwash brands containing essential oils are often marketed as "natural" mouthwashes, such as:
- BR Organic Brushing Rinse
- Desert Essence Tea Tree Oil Mouthwash
- Lucky Teeth Organic Mouthwash
- Nature's Answer Essential Oil Mouthwash
- Thieves Fresh Essence Mouthwash
Essential oil mouthwashes tend to be more costly other other OTC brands. You can make your own by simply mixing one cup of filtered water with 10 drops of essential oil.
Avoid swallowing mouthwashes made with essential oils. Essential oils are not intended for internal use and can be poisonous if consumed in excess. Even small amounts of clove oil have been known to cause seizures in children.
For safety, do not use essential oil mouthwash in younger kids.
Saltwater Mouthwash
A saltwater rinse is commonly recommended after dental extraction. The antibacterial properties may decrease the risk of infections and gum inflammation, such as can occur with dry socket (a complication of tooth extraction).
Warm saltwater is known to help ease sore throats and alleviate mouth sores or ulcers. As it has a low pH, saltwater may also help to treat bad breath. (Bacteria that cause bad breath require a high pH.)
There are several saltwater mouthwashes sold in stores that are isotonic (meaning that they have the same saline concentration as the body). These include:
- CVS Health Daily Sea Salt Oral Rinse
- Gargle Water Salt Rinse Mouthwash
- H2O Healing Rinse Natural Sea Salt Oral Care
- Tom's of Maine Sea Salt Natural Mouthwash
- Walgreen's Sea Salt Mouth Rinse Spearmint
You can make your own saltwater mouthwash by adding ½ a teaspoon of salt to 1 cup of warm water.
Saltwater mouthwashes are safe for occasional use. Long-term use can potentially damage tooth enamel and irritate the gums, causing easy bleeding.
Other Considerations When Using Mouthwash
When buying mouthwash, there are several factors to consider:
Role in Dental Health
One common misconceptionis that mouthwash can remove plaque from your teeth and gums. Swishing a mouthwash may have antibacterial action that can inhibit plaque, but it doesn't actually remove it. It should never be considered a replacement for daily brushing and flossing.
Alcohol
Alcohol is one of the most common mouthwash ingredients.Many people assume that alcohol kills bacteria, but it isn’t an active ingredient. It simply helps diffuse other active ingredients, like essential oils, and hasn't proven to be against bacteria that cause gum disease or bad breath.
Alcohol mouthwash has drawn concern in recent years because is it linked to oral cancer. Research has shown that alcohol makes the cells in the mouth more vulnerable to cancer-causing agents (carcinogens). Moreover, when alcohol is broken down, it produces a byproduct called acetaldehyde, a known human carcinogen.
As a general rule, opt for mouthwash brands that don't contain alcohol.
Detergents and Preservative
Certain detergents in mouthwash like sodium lauryl sulfate are used to loosen residue that has accumulated on teeth. There may also be preservatives like sodium benzoate that help extend the shelf life of the product.
While both these ingredients are generally considered safe, they have been known to cause gum irritation and allergic contact dermatitis (a condition characterized by itching, swelling, and tiny blisters) in some people.
Summary
Different mouthwashes serve different purposes. Chlorhexidine mouthwashes, available by prescription, are sometimes prescribed to people with periodontitis. Fluoride mouthwashes are commonly used for daily oral hygiene, while hydrogen peroxide mouthwashes may be used for the short-term treatment of mouth sores or teeth whitening.
Mouthwashes with essential oils and saltwater can be made at home as alternatives to commercial mouthwashes. Saltwater is especially useful in preventing infection after tooth extraction or a mouth injury.
