Something right for me can be wrong for you. The right mouthwash for you depends on your personal needs.
Your oral hygiene routine comprises three essential steps: brushing, flossing, and mouthwashing to keep your teeth, gums, and tongue healthy.
Choosing the right mouthwash out of so many options in the market might appear difficult, so we are here to take you out of this problem.
Simply, a mouthwash in an oral rinse which is available in a liquid formulation that allows you to clean the germs in your oral cavity.
Its antiseptic and antibacterial properties prevent tooth decay and gum problems.
Just like interdental cleaners, mouthwashes are supplemental to essential brushing and flossing as the liquid can reach the areas that are alone and not accessible with a toothbrush.
Mouthwashes can also be given for pain relief during an ongoing infection, and some mouthwashes, like cosmetic mouthwashes, aim to provide temporary benefits only.
Let’s uncover all the details about this essential oral hygiene routine to optimize your oral health to its fullest.
Broadly, Mouthwashes Can Be Classified into 2 Categories
There are two major types of mouthwashes: Therapeutic mouthwashes and Cosmetic Mouthwashes. Let’s find the difference between the two.
| Therapeutic Mouthwashes | Cosmetic Mouthwashes |
| Permenantly control bad breath and leave by decreasing bacterial count | Temporarily controls bad breath (halitosis) |
| Help reduce plaque, gingivitis, and cavities | Do not reduce plaque, gingivitis, and cavities. |
| Your breath will smell fresh because of the decreased bacterial load | Make your teeth white and breath smell fresher |
| Contains fluoride that helps prevent tooth decay | It does not contain fluoride |
| Has up to 27% of alcohol for the carrier of active ingredients | It may or may not contain alcohol. |
| Rarely contain flavoring agents. | Always contain flavoring agents for a pleasant taste. |
Benefits of 5 Different Types of Mouthwash
Antiseptic mouthwash
Antiseptic mouthwash has a crucial ingredient called chlorhexidine that helps prevent bacterial growth in the mouth. It heals mouth sores and ulcers and also provides fresh breath to the patients.
Fluoride mouthwash
Sodium fluoride helps fight tooth decay by strengthening the outer layer of the tooth called enamel. Adding fluoride to your hygiene routine is easier with community water fluoridation and toothpaste formulas. Too much fluoride is also not good for health, and it may lead to fluorosis.
Cosmetic mouthwash
If you’re looking for a mouthwash that strictly gives you a fresher smell, cosmetic mouthwash is all you need. This has to be used after brushing to achieve maximum benefits.
Additionally, these rinses contain zinc chloride that provides a protective layer between your mouth. It also provides a pleasant taste with the addition of flavoring agents.
Natural Mouthwash
Natural mouthwashes don’t contain fluoride and alcohol.
These include essential oil, salts, echinacea, calendula, mint, and aloe vera. As these are made up of organic ingredients, these are the most natural form of mouthwashes.
Prescription Mouthwash
Your dentist or periodontist provides prescription mouthwashes if you have a gum disease.
These mouthwashes contain chlorhexidine in prescription doses to heal inflamed gums and prevent bleeding.
These are only effective for milder gum diseases like gingivitis; however, they would be of no help in advanced gum diseases like periodontitis.
Active Ingredients in Therapeutic Mouthwashes
1. Chlorhexidine
Of so many antimicrobial agents, chlorhexidine is the most used and researched.
Most commonly, chlorhexidine is used in combination with cetylpyridinium chloride and chlorobutanol. It is used to prevent dental plaque and to treat fungal infections in the oral cavity.
It acts against gram-positive bacteria at concentrations ≥ 1 µg/l. Gram-negative bacteria and fungi require significantly higher concentrations of 10 to more than 73 µg / ml.
Chlorhexidine is ineffective against polioviruses and adenoviruses.
2. Cetylpyridinium Chloride
Cetylpyridinium chloride, or CPC, is an antiseptic compound, mainly applied in some mouthwash toothpaste, effectively preventing dental plaque and reducing gum inflammation.
It has been used since 1939 in formulations 0.045-0.075%. It is important to note that 0.045% is the minimum concentration of CPC required for antiplaque and anti-tartar benefits.
3. Essential Oil and Phenols
Phenolic compounds include essential oils such as phenol, thymol, eugenol, eucalyptol, or menthol. They show antibacterial properties and effectively reduce halitosis (bad breath).
4. Propolis
Propolis is used in mouthwashes and toothpaste to prevent caries and to treat gingivitis and stomatitis. Due to its antioxidant properties, it is widely used in the medical and dental industries.
5. Benzydamine hydrochloride
It is a locally acting anti-inflammatory drug, and its action is to relieve pain and inflammation in the mouth.
It shows antibacterial activity against the antibiotic-resistant strains of Staphylococcus aureus – the main bacteria in the mouth that causes cavities.
6. Fluoride
Flouride is a mineral used to prevent caries, and this ingredient helps prevent caries in individuals and is suitable for patients suffering from Xerostomia (less salivary flow).
7. Hydrogen peroxide
Hydrogen peroxide has a bactericidal effect on anaerobic bacteria and also has a mechanical cleaning action.
What should you consider before buying a mouthwash?
Before spending on mouthwash, you must consider a few things:
Purpose of the product:
Not all mouthwashes are the same. You should choose the one that specifically meets your needs and oral requirements. Those mouth ulcers you use daily won’t be suitable for you to recover from ulcers or gum surgery. You’d need prescription mouth rinses in that case.
Appropriate use of the product:
If you aim to achieve therapeutic benefits the mouthwash, you must choose therapeutic mouthwashes; however, if you intend to achieve fresh breath and teeth-whitening effects, then you must go for cosmetic mouthwashes.
Safety of the Product:
Some mouth rinses have ingredients that are contraindicated to be used by patients undergoing chemotherapy or a compromised immune system.
Know well how to use the product:
You must read the product label before using it. You may also ask your dentist if it’s right to use a particular product in the long run
6 Tips That Can Help You Choose The Best Mouthwash For Yourself
If your dentist has just asked you to start using mouthwash along with your brushing and flossing routine, you must be confused about which one is made for you.
A mouthwash that suits you might not suit your friend because everyone has different needs and requirements.
When you reach the mouthwash aisle, we can understand how confusing it is to pick the right mouthwash from so many colored bottles arranged in a row.
Initially, they all might appear the same to you, and you may select them based on your favorite flavor, peppermint,t, or cinnamon.
Here’s the key: A mouth rinse will only benefit you if chosen based on your needs. Your dentist may prescribe you a prescription mouthwash if there’s a need; however, here’s how you can select on your own
1. You’ve got a dry mouth already: Choose an alcohol-free mouthwash
You may be suffering from a dry mouth due to ongoing cancer therapy or due to Sjogren syndrome or diabetes commonly seen in the US population.
Alcohol-based mouthwashes super dry your mouth and may irritate the tissues in the oral cavity. Also, alcohol kills harmful bacteria as well as good bacteria, making you more prone to caries.
Some over-the-counter alcohol-free mouthwashes are:
- Listerine alcohol-free mouthwash
- Crest pro-health advanced
- Colgate total alcohol-free
- ACT alcohol-free anticavity fluoride rinses
- TheraBreath fresh breath oral rinse
2. You want to control plaque buildup – Choose therapeutic mouthwashes
Therapeutic mouthwashes outweigh the benefits when compared to cosmetic ones.
These are known to prevent cavities and gum disease like gingivitis. Cosmetic mouthwashes, on the other hand, have flavored sweeteners that can harm your teeth in the long run.
You must opt for antiseptic, antimicrobial, and fluoride-containing mouthwashes for plaque control. Ingredients like cetyl pyridinium and chlorhexidine are known to prevent plaque build along the gum lines.
Chlorhexidine mouthwashes are broad-spectrum that act on both gram-positive and gram-negative harmful bacteria in your mouth that cause cavities and gum diseases.
This one is only intended for short-term use, as long-term use can cause tooth staining.
These mouthwashes are available in prescription form under the brand names
- 3M Peridex
- Colgate Periogard
- GUM Paroex
3. Prone to Cavities – Choose Flouride Containing Mouthwashes
If you are at a higher risk of caries and have a sweet tooth, you must look for mouthwashes that strengthen the outer layer of your tooth, called enamel. Flouride-containing mouthwashes prevent tooth decay by forming tooth complexes with calcium and hydroxide ions in the tooth.
Flouride also exhibits antibacterial properties that prevent bacterial sticking on your teeth. It will also avoid halitosis in the long run.
Flouride mouthwashes don’t replace fluoride toothpaste, but they serve as an added goodness to your oral hygiene routine. Mouthwashes with 0.05% fluoride are effective.
It would be best if you didn’t swallow fluoride mouthwashes because it has the potential to cause toxicity. Children below six years of age have immature swallowing reflexes so children must not use fluoride rinses.
A few over-the-counter fluoride rinses are as follows:
- Crest Pro-Health Densify Fluoride Mouthwash
- Tom’s Of Maine Whole Care Natural Fluoride Mouthwash
- ACT Alcohol-Free Anticavity Fluoride Rinse
- CloSYS Silver Fluoride Mouthwash
- Listerine Total Care Anticavity Fluoride Mouthwash
- The Natural Dentist Healthy Teeth Fluoride Anticavity Mouth Wash
4. Want No Staining – Choose CPC and CHX free mouth rinses.
Cetylpyridinium (CPC) and chlorhexidine (CHX) stain your teeth. CPC stains your margin along the gums.
Although staining is not permanent and will go away with regular cleaning, it still looks bad.
You may look for mouthwashes that whiten your teeth containing carbamide or hydrogen peroxide as a whitening agent.
Essential oil mouthwashes have excellent antioxidant and antimicrobial properties and are known to show anti-inflammatory effects.
Essential oil mouthwashes are more expensive than other over-the-counter ones, so you may make one at home.
Simply mix ten drops of any essential oil with one cup of filtered water, and you’re good to go.
Some of the over-the-counter mouth rinses with major essential oils are
- Lucky Teeth Organic Mouthwash
- BR Organic Brushing Rinse
- Desert Essence Tea Tree Oil Mouthwash
- Thieves Fresh Essence Mouthwash
- Nature’s Answer Essential Oil Mouthwash
5. You Have Got Yellowish Teeth – Choose Whitening Mouthrinses
Hydrogen peroxide and carbamide peroxide are commonly used as whitening ingredients. Hydrogen peroxide is widely used in household cleaning and is best known for its antimicrobial and antioxidant effects.
As soon as the two ingredients come in contact with bacteria, they release oxygen molecules that kill bacteria. The farms produce during the process provide the bleaching effect.
Mouthwashes with higher concentrations of hydrogen peroxide provide an antiseptic effect, while lower concentrations give a whitening effect.
OTC mouthwashes with hydrogen peroxide are
- Meijer Sore Mouth Peroxide Rinse
- Bee’s Whitening Pre-Brush Oral Rinse,
- Colgate Peroxyl Antiseptic Mouth Sore Rinse
- Equaling Glowing White Anticavity Mouthwash
- Arc Teeth Whitening Rinse
- Crest Breath Bacterial Blast Mint Mouthwash
- Crest 3D White Anticavity Fluoride Mouthwash
- Orajel Antiseptic Mouth Sore Rinse
6. Want Immediate Healing – Choose Saltwater Mouthwash
Saltwater rinses are usually recommended by an oral maxillofacial surgeon or your general dentist after dental extraction.
The antibacterial property decreases the risk of infection and helps fight sore throat and ulcers.
These are best to use occasionally., not recommended for long-term use. There are several saltwater mouthwashes in the store. Here are a few:
- H2O Healing Rinse Natural Sea Salt Oral Care
- CVS Health Daily Sea Salt Oral Rinse
- Gargle Water Salt, Rinse Mouthwash
- Walgreen’s Sea Salt Mouth Rinse Spearmint
- Tom’s of Maine Sea Salt Natural Mouthwash
Mouthrinses Myths and Claims: True or False ?
Claim #1 – Mouthwashes stain the teeth:
All mouthwashes don’t cause stains.
Only mouthwashes that contain cetylpyridinium chloride or chlorhexidine gluconate will cause stains on your teeth. Most of the time, these stains occur along the gumline and between the teeth.
The staining ingredients react with the color compound in your foods to leave stains on the topmost surface of your teeth. These ingredients only cause stains in 3% of individuals, and if it hasn’t done any yet, you must not worry and continue using it.
These stains are usually polished off at your regular dental cleaning appointment, so you shouldn’t worry about it.
Claim #2 – Mouthwashes causes cavities:
This claim is not generally accurate with the therapeutic types of mouthwashes, but you may have an increased risk of caries with cosmetic mouthwashes because they are flavored.
If you’re at risk of caries and looking for a mouthwash that lowers the overall bacterial load and prevents cavities, then you must look for alcohol-free and acid-free mouthwashes.
Non-alcohol mouthwashes are easy to find; however, to see the acidity, you must check for the pH of the mouthwash.
The lower the pH, the higher the acidic content of the mouthwash. pHs between 1-6 are acidic, seven are neutral, which is the pH of water, and 8 to 14 are alkaline in nature, which is your soaps.
Mouthwashes with pH 7 are best for caries-prone individuals.
Claim # 3 – Alcohol-free mouthwash is better than alcohol-containing mouthwash:
Alcohol-containing mouthwashes dry your mouth, which increases your susceptibility to caries. The saliva in your mouth acts as a buffer to the acidic pH of the mouth.
The mouth’s pH decreases as soon as you eat food, and bacteria act on it to produce acidic metabolites. The more saliva, the more you’ll be able to keep your mouth healthy and cavity-free.
Alcohol also kills all the bacteria in the mouth, including the good ones, which gives rise to malodors.
Should you use mouthwash before or after brushing?
According to the American Dental Association, rising before or after a toothbrush depends on personal preferences.
However, to maximize the benefits of these oral care products, manufacturers recommend a specific order of use based on ingredients.
For example, if your toothpaste contains salts like calcium hydroxide and aluminum hydroxide, rinsing it with mouthwash is recommended before brushing.
The calcium and aluminum form complexes with the fluoride ions, which might not form if rinsed with a mouthwash later.
Clinical Condition When You Must Use A Mouthwash
1. Dry Socket (Alveolar Osteitis)
When your tooth gets extracted, you’re provided with certain post-op instructions like not to spit for 24 hours, not to smoke, and not to drink with a straw to promote clot formation in the socket and healing. Failure to do so would lead to a dry socket.
This is usually presented with intense pain after 2 to 3 days after the procedure. Dry sockets are generally seen after third molar extractions. Mouthwashes with chlorhexidine and antibiotics significantly reduce the risk of this condition, according to ADA.
2. Bad Breath (Halitosis)
Breakdown of food by bacteria releases volatile sulfur compounds that produce oral malodor.
Cosmetic mouth rinse mask can temporarily mask the bad breath without treating the cause.
Therapeutic mouthwashes inhibit odor-causing compounds like zinc salts, ketones, terpene, and ionone.
3. Plaque & Gingivitis
Therapeutic mouth rinses help reduce plaque and gingivitis when combined with brushing and flossing.
Chlorhexidine is known to achieve better plaque control than essential oils.
Regular cleaning with a dentist twice a year can help you control the amount of plaque and tartar buildup on your tooth. If not cleaned, it may lead to gingivitis, periodontitis, and, ultimately, teeth loss.
4. Tooth Pain Relief & Tooth Decay
Mouthrinses that provide pain relief usually contain local anesthesia, like lidocaine and benzocaine, for pain relief. Additionally, you would find sodium hyaluronate for pain relief as well
5. Xerostomia
Decreased salivary flow is called xerostomia, which increases the risk of caries. Therapeutic mouth rinses are ideal in such conditions. These contain cellulose derivatives that mimic the feel of saliva in many cases.
6. Oral Cancers
Alcohol and tobacco use are the known risk factors for oral cancers.
Alcohol-containing mouth rinses may increase the risk of cancer.
Incorporating Mouthwash into Your Daily Oral Care Routine
Using mouthwash daily can significantly optimize your oral hygiene. It will not only help you get rid of excessive dental plaque and oral problems, but it will also provide you with fresh breath and a sense of well-being. For effective mouthwash use, consider these three things:
Proper timing for mouthwash use
There’ll always be an endless debate on whether to use mouth rinse products before or after brushing and flossing.
You may use it in whatever suits you best. If you are already using fluoride toothpaste, you must rinse before to allow fluorides to get into your tooth completely.
Frequency of use
These can be used one to two times daily, depending on your needs.
Therapeutic mouthwashes target specific dental problems, so you must use them more frequently than non-therapeutic ones. Overuse of mouthwash products is not advised as well.
Combining mouthwash with brushing and flossing
Mouthwashes are complimentary to brushing and flossing.
You can’t avoid brushing twice daily and flossing once daily by doing mouth rinses. These products are made to provide additional protection to your gums and teeth.
Maximizing the Benefits of Mouthwash
To make the most out of your mouthwash routine, you must avoid common mistakes. You need to follow certain things to achieve optimal oral health.
Tips for swishing effectively
Make sure you use an adequate amount of product, which is 20 milliliters or four teaspoons, for sufficient coverage. Swish it for up to 1 minute. The time will allow ingredients to act on your teeth and gum.
Swish it vigorously so that it reaches all parts of your mouth. Avoid consuming food or drink for at least 30 minutes to allow ingredients to continue their work.
Avoiding common mistakes
You must depend on your mouthwash only. Don’t forget to brush and floss daily. Mouthwashes with alcohol frequently can cause dry mouth and irritation. You must not swallow mouthwash as it may cause toxicity.
Monitoring improvements in oral health
Regular dental visits are necessary to rule out any disease on time.
Please keep track of your symptoms and inform your dentist about them on your visits. Ask for personalized feedback from your dentist and ask for prescription products.
