Mouth rinses are either cosmetic or therapeutic
- Therapeutic mouthwashes can be purchased over-the-counter and may be recommended by your dentist to reduce or control plaque, gingivitis, bad breath, and tooth decay
- Children younger than the age of 6 should not use a mouthwash because they may swallow the liquid and is not required for a child
- No child should be given an alcohol containing mouth rinse.
- Using a mouthwash does not replace the need for optimal brushing and flossing.
A cosmetic mouthwash might taste pleasant and temporarily control bad breath but has no use beyond this. Therapeutic mouthrinses have active ingredients which may control or reduce conditions like bad breath, gingivitis, plaque, and tooth decay.
Active ingredients may include the following:
- cetylpyridinium chloride
- chlorhexidine - can help to control infections, plaque buildup and gum disease
- essential oils
- fluoride - proven to prevent decay
- peroxide - present in whitening mouthrinses
Mouthrinses should not be used as a replacement for daily brushing and flossing, but may be helpful for some people to address certain conditions as per the below:
Dry Socket is an infection that can occur following a tooth extraction and chlorhexidine based mouthrinses, without the use of antibiotics, has been shown to be effective, to reduce the chances of an infection. There may be minor reactions to chlorhexidine use, including brown staining of teeth and an altered taste. The Swiss brand Curasept has anti staining technology added to it
Volatile sulfur compounds (VSCs) cause bad breath from the breakdown of food, and the bacteria associated with dental disease. Cosmetic mouthwashes can temporarily mask bad breath with their pleasant flavour, but do not have an actual effect on the bacteria or VSCs. Mouthwashes with therapeutic agents like antimicrobials, may be effective for bad breath, however it should be prescribed by a dental professional, in case there is active decay, an infected tooth or periodontal disease which needs to be addressed with some treatment or for preventive measures.
Plaque and Gingivitis
When used in mouthwashes, antimicrobial ingredients like cetylpyridinium, chlorhexidine, and essential oils may reduce the plaque levels and gum disease when combined with daily brushing and flossing. Chlorhexidine has been found to be better for plaque control than essential oils, however both may cause brown staining of the teeth and any restorations.
Fluoride promotes remineralisation and a Cochrane review found that with regular use there is a reduction in tooth decay.
Topical Pain Relief
Mouthwashes with topical local anesthetics such as lidocaine, benzocaine/butamin/tetracaine hydrochloride, dyclonine hydrochloride, or phenol may provide pain relief, for example for an ulcer
Mouthwashes with carbamide peroxide or hydrogen peroxide among the active ingredients may reduce extrinsic staining of the teeth.
Xerostomia is a reduced amount of saliva which protect the teeth and the tissues in the mouth, which increases the risk of caries, and a fluoride mouthwash may reverse the risk. Mouthwashes containing enzymes or cellulose derivatives have the composition and feel of saliva.
Oral Cancer Concern
Alcohol consumption is a known risk factor for head and neck cancers and there has been some debate about whether the use of alcohol containing mouthwash increases the risk.
With regular dental checks, hygiene appointments with the dental hygienist and bitewing x-rays each 2 years, your dental health can be monitored closely by your dental professional. With meticulous home care and care from your dental professional, use of an electric toothbrush with a pressure sensor and timer for 2 minutes morning and night, a health diet, and daily flossing there is no need for the average person to use a mouthrinse with any regularity. For mouth ulcers that heal within 3 weeks, the use of warm salt water rinses should be adequate. For severe periodontal disease or bleeding gums, Curasept might be recommended for plaque control, along with regular maintenance at 3 monthly intervals with your dentist, or periodontist.