Dentists recommend brushing your teeth twice a day with fluoride toothpaste and flossing daily to prevent plaque and gum problems. But many people are unsure if they should use an antimicrobial mouthwash as part of their daily oral health routine. Please continue reading to find out the pros and cons of using an antibacterial mouthwash or mouth rinse. 

What is the difference between antiseptic mouthwash and regular mouthwash?

According to the American Dental Association (ADA), there are primarily two types of mouthwashes: cosmetic and therapeutic.

Cosmetic mouthwashes 

These are designed to provide temporary breath freshening and to leave behind a pleasant taste. They are not for reducing plaque. While cosmetic mouth rinses eliminate odor, they do not have antimicrobial properties. Therefore, cosmetic mouthwashes do not prevent cavities. 

Therapeutic mouthwashes 

These contain antiseptic ingredients that help control bad breath, tooth decay (plaque), and gingivitis (gum disease). The active ingredients in a therapeutic mouthwash work like an antibiotic to kill bacteria. Ingredients in therapeutic mouthwashes may include cetylpyridinium chloride, fluoride, peroxide, chlorhexidine, and essential oils. Some therapeutic mouthwashes are available over-the-counter, for example, Listerine Antiseptic. However, some patients may be given a prescription mouthwash such as Peridex. 

Can antibacterial mouthwash help prevent tooth decay and gum disease?

An antibacterial mouthwash can help to prevent tooth decay and gum disease because it can reach areas of the mouth that are not easily accessible with brushing and flossing. This can help control plaque and lower the risk of mouth infections.

However, with that said, most people who brush and floss faithfully and go for regular dental checkups and cleanings do not require mouthwash to kill bacteria and keep their teeth and gums healthy.

Is antiseptic mouthwash healthy?

An antiseptic or antibacterial mouthwash is healthy. Studies have shown the benefits of antiseptic mouthwash in preventing:

• Plaque, tooth decay, and gingivitis (gum inflammation).
• Spread of an active infection such as the flu or COVID-19 when used by a patient before dental treatment.
• Alveolar osteitis (AO) or dry socket  (a common postoperative complication after dental extractions). 
• Pain from mouth ulcers (canker sores or aphthous ulcers).
• Xerostomia or dry mouth (alcohol-free mouthwash is recommended for people with this condition).
• Bad breath (cosmetic mouth rinses temporarily mask foul odors while therapeutic mouthwashes help with long-term control of bad breath by controlling bacteria in the mouth).
• Tooth staining (some mouth rinses reduce stains and help to whiten teeth).

When should I use antiseptic mouthwash?

Whether you use an antibacterial mouthwash before brushing and flossing or after brushing and flossing depends on your personal preference. Manufacturers sometimes recommend a particular order of use to maximize benefits. For instance, if fluoride toothpaste can make a mouthwash less effective, the manufacturer may recommend using the mouthwash before brushing and flossing or vigorously rinsing your mouth after brushing and flossing and before using the mouthwash.

How often should you use antiseptic mouthwash? 

Regular use of mouthwash twice a day has many benefits for oral health. It can kill harmful bacteria and help prevent tooth decay and periodontal disease. Most dentists recommend adding mouthwash to your morning and evening teeth brushing routine. People with certain medical conditions such as dry mouth, tooth sensitivity, and dry sockets may be given a prescription antimicrobial mouthwash to use twice a day.

What are the pros and cons of using a mouth rinse?

Advantages of Using a Mouthwash

• Thorough cleaning of the mouth for good oral hygiene, resulting in healthy gums and teeth.
• Fresh breath.
• Fewer stains.
• Stronger enamel. 

Disadvantages of Using a Mouthwash

• Alcohol-containing mouthwashes can cause irritation, burning, dry mouth, and slower healing of mouth ulcers or canker sores.
• There are safety concerns about the long-term use of mouthwash. Some studies have found that regular use of alcohol-containing mouthwash can increase the risk of oral cancer. However, this has not been proven.
• Delays in diagnosing a dental condition may occur due to mouthwash masking symptoms like bad breath.
• Some mouthwashes can stain your teeth.
• The high salt content of some mouthwashes can be problematic if swallowed.
• An antibacterial mouthwash kills both harmful and good bacteria in your mouth, reducing your natural immunity.

Tips on using an antimicrobial mouthwash for oral health

Children younger than six years old should not use mouthwash for oral hygiene unless recommended by a dentist. A child can inadvertently swallow large amounts of mouth rinse, which can lead to nausea, vomiting, and alcohol intoxication.

A prescription mouthwash should be used as directed for an oral health condition. If you miss a dose, do not double up on the dose. 

Choose over-the-counter mouth rinses and mouthwashes that have the ADA Seal of Acceptance. This ensures the product is safe and effective and does what it claims to do.

Remember that using mouthwash is not a substitute for regular brushing and flossing.  It can, however, provide additional benefits in reducing bad breath, cavities, and gum disease.

References:

1. https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/mouthrinse-mouthwash