MouthwashWhether it’s to mask bad breath, fight cavities or prevent the buildup of plaque, the sticky material that contains germs and can lead to oral diseases, mouthwash serves a variety of purposes. Or so we think.

Though they may leave your mouth with a clean, fresh taste, some washes can be harmful, concealing bad breath and unpleasant taste that are signs of periodontal diseases which cause inflammation and degeneration of the supporting structures of the teeth and tooth decay. Your dentist will tell you, most mouth rinses just don’t wash.

What are the differences?

Mouthwash is generally classified by the U.S. Food and Drug Administration (FDA) as either cosmetic or therapeutic, or a combination of the two. Cosmetic rinses are commercial over-the-counter (OTC) products that help remove oral debris before or after brushing, temporarily suppress bad breath, diminish bacteria in the mouth, and refresh the mouth with a pleasant taste. Therapeutic washes have the benefits of their cosmetic counterparts, but also contain an added active ingredient that helps protect against some oral diseases. Therapeutic washes are regulated by the FDA and are voluntarily approved by the American Dental Association (ADA). They also can be categorized into types according to use: antiplaque, antigingivitis, and anticavity fluoride washes.

Should I use a mouthwash?

That depends upon your needs. Most are, at the very least, effective oral antiseptics that freshen the mouth and curb bad breath for up to three hours. However, their success in preventing tooth decay, gingivitis, and periodontal disease is limited.

They are not considered substitutes for regular dental examinations and proper home care. A regimen of brushing, flossing, and routine trips to the dentist should be sufficient in fighting tooth decay and periodontal disease.

Which type should I use?

Again, that depends upon your needs. Studies have shown that most over-the-counter antiplaque mouthwashes and antiseptics are only marginally effective (20-20 percent) at reducing plaque.

Anticavity mouthwash with fluoride, however, has been clinically proven to fight up to 50 percent more of the bacteria that cause cavities. But again, many dentists consider the use of fluoride toothpaste alone to be more than adequate protection against cavities.

Certain mouthwashes may be prescribed for patients with more severe oral problems such as caries, periodontal disease, gum inflammation, and dry mouth. Likewise, many therapeutic washes are strongly recommended for those who can’t brush due to physical impairments or medical reasons.

When and how often should I rinse?

If it’s an anticavity rinse, dentists suggest the following steps, practiced after every meal: brush, floss, then rinse. Teeth should be as clean as possible before applying an anticavity wash to reap the full preventive benefits of the liquid fluoride. The same steps can be followed for antiplaque rinses.

If ever in doubt, ask us in person about your specific brand or follow the instructions on the bottle. Be sure to heed all precautions listed.

Are there any side effects to mouthwashes?

Yes, and they vary depending on the type. Habitual use of antiseptic mouthwashes containing high levels of alcohol (ranging from 18 to 26 percent) may produce a burning sensation in the cheeks, teeth and gums. It can cause intoxication if swallowed, used excessively, or used by children. For a child weighing only 26 pounds, 5 to 10 ounces of many OTC rinses containing alcohol can be potentially lethal.

Many prescribed rinses with more concentrated formulas can lead to ulcers, root sensitivity, stains, soreness, numbness, or changes in taste sensation. Most anticavity rinses contain sodium fluoride, which if taken excessively or swallowed, can lead over time to fluoride toxicity. Because children tend to accidentally swallow mouthwash, they should only use rinses under adult supervision. If you experience any irritating or adverse reactions to a mouth rinse, discontinue its use immediately and consult your dentist.