Mouthwash- a miracle rinse or scam?

My patients always like to ask me can mouth wash replace flossing? What mouthwash is the most effective for my oral health?

There are hundreds of different brands of mouthwashes but all of them really just have a few active ingredients- According to the American Dental association these are what they allow in an American mouthwash.

Active ingredients that may be used in therapeutic mouthwash include:
  • Cetylpyridinium chloride; - crest prohealth
  • Chlorhexidine;- peridex
  • Essential oils; Listerine
  • Fluoride; ACT 
  • Peroxide. colgate peroxyl mouthwash- Whitening

So here is my take on how mouthwashes work. Using mouthwash to to clean your mouth is like using a pouring putting out a candle with bucket full of water. You'll put out the candle but you'll also get everything else in the room wet. When you use antiseptics like chlorhexidine, cetylpridinum chloride and peroxide it kills almost all of the bacteria in your mouth. 

That sounds like a great thing doesn't it? Unfortunately, not. Mouth rinses will for a few second greatly lower the amount of bacteria in your mouth. A minute after the same bacteria that was present will repopulate your mouth likely within the hour. The mouth rinse doesn't know which bacteria to target so they target everything. They kill both the good and bad bacteria. If your oral hygiene is poor you are still dealing with the same bacteria minutes after your rinse. This is why it is important to deal with the debris and plaque that is stuck onto your teeth. This is where the brush and floss come in.

Human tongue infected with oral candidiasis.jpgSomeone then asked me. What if I was to rinse my mouth every few hours with mouth rinse wouldn't that control the bacteria in my mouth? First of all that is way more work then just brushing twice a day and flossing once a day. Second, by killing all bacteria including good bacteria you are allowing yeast and fungal infections to develop in your mouth. The population of good bacteria prevent overgrowth of yeast and fungus that already exist in your mouth. I have seen patients that overly rinse their mouth with antiseptics. They develop a white and fuzzy appearance on their tongue which we call candidasis. This is a fungal infection which will require anti fungals to remove. This disease is painful and unpleasant and still you have not solved your dental problems. As soon as that mouthwash stops you are back to the same dental diseases.

So why do mouthwashes still exist? Stay tuned for what mouthwashes are good for. 


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