I remember a little while ago, in the comment box some readers shared their thoughts on using mouthwashes, or rather, not using mouthwash. I came across a very interesting article in the Bangkok Post last week, that reminded me of this fleeting discussion so I thought I’d like to open this up for further discussion.
We often see lots of ads on TV encouraging us to use a mouthwash or to gargle with one to prevent cavities and gum disease. There are some that are so strong it feels like they strip off the interior lining of your tongue and mouth (Listerine, ouch!), some that taste so sweet it feels almost ridiculous, some that even stain your teeth red (Plax, ugh!) and some that claim to be all natural (Ah Yuan and Aesop).
In most cases, I have not seen them advertised as being a substitute for regular brushing and flossing, but I can imagine that sometimes, if in a hurry or tired people may just think a mouthwash could serve as a quick substitute. After all, it’s supposed to be good for your oral hygiene… or is it?
Do you use a mouthwash regularly and if so, why? Is it because you were advised to?
A mouthwash is not a substitute for brushing and flossing teeth
According to 2 dentists interviewed by the Bangkok Post, both of them didn’t think using a mouthwash was necessary at all. This reminded me that even my regular dentist doesn’t ask me to use one. He only advises me to brush and floss regularly.
It is interesting to note that because mouthwashes have been touted to prevent bacterial growth and gum disease among other claims, some people have taken to using them in place of brushing and flossing. I liked this analogy given by Dr. Suwanee in the article
“If you want to wash a bowl, for instance, you’d put some washing liquid on it, but if you don’t also use a cleaning pad to wash off the dirt, then the bowl doesn’t get really clean. The stains are still there”
So to effectively use a mouthwash, it should be used immediately after properly brushing and flossing and to gargle for at least a minute.
Honestly, if it wasn’t necessary, other than to give the mouth a fleeting feeling of freshness, I wouldn’t bother! LOL!
Mouthwash is only a temporary relief for bad breath
If you use mouthwash as a way to cover up bad breath, then you might want to get to the root of your problem first. Why are you having bad breath? If it is temporary from eating a garlic infused lunch, then I would assume that a quick rinse with a mouthwash can help make life for the people around you more pleasant.
If it is to cover a persistent problem with bad breath, then it could be a health problem or gum disease and it might be best to see a dentist or doctor and get yourself checked.
High alcohol content in mouthwashes can be bad for oral health
One of the warnings given by the dentists is to avoid using mouthwashes that have high alcohol content. These give your mouth a burning sensation as very high alcohol content can irritate the sensitive tissue in your mouth. So, if you have experienced this (and I have) and find it hard to keep the mouthwash in your mouth for the recommended 1 minute, then it isn’t the right one for you.
When I used mouthwashes, I did notice that my tolerance level did go up with each use, which is when I decided to stop. I felt that it wasn’t right for me to feel that burning sensation all the time. Sometimes, it was like I’d eaten the spiciest chilli in the world and my tongue would get all numb. Scared me half to death it did 😛
Mouthwashes and oral cancer?
There apparently have been reports that prolonged and regular use of mouthwashes with high alcohol content have been linked to an elevated risk of oral cancer (source) but it has thus far not been accepted as conclusive evidence (source and source). The only thing everyone can agree on is that high intake of alcohol can increase the risk of cancer and so, regular and prolonged use of mouthwashes that contain high levels of alcohol may similarly increase the risk.
Get a prescription mouthwash if you really want to use one
I’ve also read that the only effective mouthwashes are those that have fluoride in them or anti-bacterial properties to prevent gum disease. These can be prescribed by your dentist, and they don’t recommend you use them for too long either. So, ideally, the take away is to check with your dentist to see if a mouthwash is truly necessary or if it might just cause you more harm than good.
I thought the article in the Bangkok Post was an interesting and thought-provoking read and you can read it in full here if you like, and draw your own conclusions. From everything I’ve read so far, mouthwashes don’t seem necessary and if used improperly could even cause more harm than good.
Do you use a mouthwash daily? Do you have any thoughts on whether they are necessary?
I actually don’t use a mouthwash daily or otherwise. I brush regularly and floss when I remember (I know, I know, I’m working on getting better at flossing! :P) I sometimes gargle with some salt water but not too regularly because it is acidic and not good for your teeth either. I saturate a glass of water with a few teaspoons of salt (also a very good sore throat remedy) as salt has natural antiseptic properties. If you have an ulcer in your mouth, a salt water gargle can help too, but the pain may kill you 😛
Paris B
Disclaimer: These are my own thoughts and conclusions based on articles I have read. If in doubt please consult your dentist or doctor.
Oh wait…what?! I just started to introduce mouth wash into my nightly brushing routine and now this? So confused…
I brush twice a day (at least). Rain or shine, healthy or sick, happy or sad. No exceptions. But flossing is a different story. I do when I “feel” like it. LOL. I’m lazy that way. 😛
Now, to me, mouth wash is kind of like a bonus step. Doesn’t bother me if I don’t have it. And if I do use it, then it’s a bonus. 😀
I know! I was using mouthwashes for a spell too but stopped coz I got erm… lazy 😛 I’m the same with flossing. I floss when I remember not out of habit, which is a bad thing, but I think something I should cultivate more properly.
I don’t use mouthwash everyday or even regularly but I do keep one around all the time. Sometimes you just need that extra clean feeling, know what I mean? Then I will use the mouthwash. At the moment, I’m neutral as to whether it does more bad than good, but I guess everything must be used in moderation.
I know that feeling. Lovely minty feel and you’re right about doing things in moderation. I think there is a lot of truth in these things being bad for us, and as much truth in there being some benefit for us. But I do wonder, if so many dentists that I know don’t recommend it, then what?
forget about mouth wash, too much chemicals in it.
just 20mins of oil pulling daily with virgin coconut oil does wonders. it cures anything from gum diseases, acne to athlete’s foot. but it’s a slow process, it takes a few weeks to a few months to see results. just goggle on ‘oil pulling’.
Hmm you know what Amelie? This is the first time I’ve come across oil pulling and it’s intriguing! I’m not sure I have the patience to do this daily and I’m also uncertain about the taste and feel of coconut oil in my mouth (because I inherently dislike the smell) but it is intriguing and I’ll have to look up more on this! Are you doing this daily?
yes, doing it daily. I had some loose molars which need deep scaling every 3 mths. had been doing it for years so they do not get worst. after a few mths of daily oil pulling they are no longer loose and gums are healthier. my dentist noticed and asked what had i done.
i find virgin coconut oil to be the most pleasant compared to sunflower and evoo. coconut oil has anti fungal properties too. best to do it upon waking up. after oil pulling, you do not need to brush your teeth, just rinse mouth & gargle with salt water. nothing to loose as there’s no harmful chemicals involved, just 20 mins daily and some patience.
just to spread some awareness, google on ‘soapnut’. it has 90% replaced my detergent, dish wash & shampoo (ditched the conditioner too).
Good to know Amelie. I’ll give it a go soon and see how I like it 🙂
I use it occasionally if I can remember and I only use the alcohol-free ones. Listerine does one that does not bring tears to the eyes. I remember speaking with a dentist friend and she said it’s really too harsh. I take her word for it because she really has great teeth.
Ever since I had tears brought to my eyes, I totally stopped looking at these mouthwashes. Didn’t even know Listerine did alcohol free ones!
I’ve been told to use mouthwash but ever since oral b called back their stocks for some issues, i had to switch to listerine which turned me off… it was too painful to gargle it without diluting it first…. now i only use it when i have any public speaking…. haha…
Haha sounds like all of us experienced the same thing with Listerine! I don’t know how they still sell it!
I don’t bother with it at all unless I have a sore throat coming… I don’t know how people can use Listerine, it’s painful as sin. I am a lazy (and cheap) flosser – I only do it several times a week 😛
Speaking of mouthwashes, there’s a three and a half minute Betadine mouthwash ad on YouTube featuring local comedian/actual practicing physician Dr Jason Leong, which is really hilarious but I am not sure if non-Malaysians would get the humour. I won’t put the link here, but I believe you can Google it.
That said, I just think that long term use (especially Listerine) does a number on the tastebuds, besides the natural aging process…
I don’t get how Listerine is still selling so well either. It stings! I haven’t seen that ad – will go look for it. I was prescribed Betadine when I had a sore throat recently, for gargling purposes. Hated it with a vengeance! Horrible thing 😛
To me mouthwash its just an insurance, as oil pulling takes time (good choice to make though) after I brush and floss and sometimes I still find “particles” after all these process only to have the mouthwash flushed it out.
I just learned about oil pulling, Reese and now I’m really curious to try it! Don’t think I can keep it up LOL But still, it’s worth a shot! Have you tried it and did you derive benefits from it?
i floss & mouthwash nightly, non-fail. no matter how tired or sleepy. never been this hardworking before … until i spent a bomb on dental fees.
tried Watsons Alcohol Mouthwash once, i got it free . it was burning hell! no wonder thay are giving it away! after that awful experience, i made sure my mouthwashes doesn’t have alcohol. currently, i am liking Colgate Fresh Tea. it taste so good, i accidentally drank it once!
I’ve developed sensitive teeth on one side so that’s going to be a dent to the bill when I see my dentist next! Ouch!
i don’t like using mouth washes. had so bad experience with listerine. it burns the mouth 🙁 its chilli or whatever it is and i prefer brushin coz otherwise i do feel as if something is missing from life. i used to floss but i am too lazy to do it now but should start it!!!
Haha Listerine is burning up people everywhere not just here, it seems! I think we should all restart regular flossing. I just never got into the habit which is not a good thing of course.
I think I may be doing it the other way around – Nightly – Mouthwash first and then brush. But I find that my teeth come out cleaner. Makes easier brushing also. I’m too lazy to floss – notwithstanding my dentist reminding me that I should do so each time I visit.
And for the first time ever – a non “burning/remove 1 layer off your mouth” Listerine – ta dah! Listerine Green Tea.
For the occasional masochistic moments, Listerine Citrus.
That makes sense JK. If you use the mouthwash first, you get the particles out, then when you brush, you get rid of some of the chemicals. Makes sense to me 🙂 I too am guilty of the lazy to floss bug. Sigh. I didn’t know the Green Tea version doesn’t burn! But I’m not a fan of green tea anything though 😛
As a qualified dentist, I usually find myself discouraging mouthwash use rather than promoting it!
Most patients misuse/abuse mouthwash and are just wasting a whole lot of money and time in something that is at best, an aid to proper brushing and flossing.
For patients prone to tooth decay, rinsing with a mouthwash after brushing with toothpaste is counterproductive. You end up diluting the high concentration of fluoride from the toothpaste which will SLOW DOWN (brushing/flossing/fluoride will NOT stop your teeth from decaying. Avoiding sugar in food/drinks will) the decay process.
These patients should be rinsing with a 0.02% fluoridated alcohol-free mouthwash daily after lunch (if they cannot brush). Whenever they brush their teeth, I normally advise not rinsing out the toothpaste with water/mouthwash but just to spit out. Some patients who find the idea of not rinsing out psychologically unacceptable may find it useful to rinse with a mouthwash BEFORE brushing to remove major food particles.
I sometimes prescribe patients with gum disease a mouthwash that contains chlorhexidine. I don’t recommend 2x daily use for more than 2 weeks because it can stain the teeth brown (is this the red staining you got with Plax? As far as I know, Plax doesn’t have this ingredient in it but Colgate Periogard, Pearlie White Chlor-Rinse and Hexodane do).
For patients with severe gum disease, a mouthwash isn’t really going to help because it can only penetrate about 4mm into the gum crevice and it will not remove plaque/tartar. Some mouthwashes contain anti-tartar ingredients that will SLOW down the formation of tartar. Tartar forms when soft plaque is hardened by the minerals in saliva (which means you are letting plaque accumulate over a long period of time!).
Alcohol in mouthwash is there because it is a cheaper solvent than water. Luckily most brands (even Listerine) do have alcohol-free mouthwashes. I usually know when patients have been rinsing with alcoholic mouthwashes because the lining of their mouths will be peeling off! Some mouthwashes from Plax still give that burning/tingling sensation from menthol/peppermint which I personally find unpleasant. If you are concerned about bad breath, avoid alcoholic mouthwashes! The alcohol dries out your mouth which will only make your bad breath worse.
The only mouthwash that I’ve found really effective against bad breath is Therabreath (incredibly expensive though). I was at a lecture where it managed to neutralise the smell of raw onions after a 1 minute rinse. Another place to brush if you are worried about bad breath is the top surface of the tongue. If it’s covered in a creamy white plaque, you need to brush that off.
Avoid alcohol, coffee/tea, acidic food/drinks, protein/dairy and alliaceous food (garlic, onions) if you are concerned about bad breath. Keep your mouth moist by drinking plenty of water.
DAILY flossing and 2x daily brushing are the cornerstones of good oral hygiene. A mouthwash can help but I’ve seen too many patients use a mouthwash instead of cleaning their teeth properly. The plaque that forms on your teeth (and gums and tongue) CANNOT be rinsed off!
A good tool for educating patients about proper cleaning is plaque disclosing gel/tablets which stains the plaque bright pink/blue and makes it easy for patients to know what they need to brush and floss off their teeth. I think it’s only available through a dentist’s office though.
/soapbox
Love you for sharing your professional thoughts on this one, Firn! So many good tips in here for keeping teeth healthy especially the one about brushing your tongue! I never thought about that one. With Plax, my teeth were stained a shade of pink and if it’s not a good ingredient in there that caused it, it must have been colouring! I never used it again.
I’ve never had that problem with Plax. The pink one has been discontinued anyway.
Ah ok, good to know. Disliked the taste too 😛
Thanks for your information, Dr. Firn! I have heard about mouthwashes doing more harm than good. It definitely should not replace brushing teeth.
I have a question about swallowing toothpaste… my children brush teeth by themselves (actually, they don’t want me to help… urrrgh!!) and they love to suck up all the tooth paste (the children one from Boots) from the tooth brush before getting to the brushing part. Their toothpastes are not even the tasty one (just mild mint flavour)!! I wonder if this will be harmful on a long term period (say, 1 year?)?
The only danger of eating toothpaste is that the excess fluoride ingested can affect the formation of enamel (the hard white outer layer) of the adult teeth. This can manifest as white spots/mottling on the tooth. Toothpaste is toxic if ingested in large quantities (amount depending on the weight of the child)!
For kids below 7, they can use a kid’s toothpaste which has lower fluoride content. For kids above 7, they can start using adult toothpaste. Many parents use too much toothpaste: just a pea size is enough for bigger kids (>7 years old) and just a smear to wet the brush bristles for younger kids (<7 years old).
I advise parents to personally brush the teeth of their children because ALL kids cannot brush their teeth properly! They need to be brushing for 2 minutes (most kids and adults do about 30-60 seconds).
Children below 7 shouldn't be using mouthwash because they end up swallowing everything. When they are old enough to blow their own nose (7 years old), they can start using adult toothpaste and sometimes mouthwash at lunchtime (if they have lots of tooth decay).
Both children are below 7 (2 & 4, actually) and I use a smear, as you mentioned. No mouthwash. No, absolutely no!
Hmm… About brushing teeth for them… It’s going to be a challenge but I will try! :p
Normally after they do it themselves, I will do a quick check for them by brushing through once again. But it depends. Sometimes they absolutely refuse to let me do it… 🙁
The best way to teach anyone how to thoroughly clean their teeth is to get hold of disclosing gel/tablets. Ask your dentist (I assume you are in the UK/Australia?). Apply it before brushing and get them to brush off all the stain.
But still parents really have to get in there to make sure it’s clean! Kids who can’t write in cursive don’t have the dexterity to brush properly.
The disclosing gel/tablet is definitely an interesting option. I will have to look it up. Not sure if it’s available here though. I am now living in Bangkok. What about you? 🙂
It should be available from your dentist. Definitely not in pharmacies. In Singapore, there is a herbal toothpaste sold OTC that has a plaque disclosing function but it tastes really vile. I forgot what the name of it is, though…
I don’t use mouthwashes regularly..may be sometimes..some of them which I have tried are way too strong and giving burning sensation so I stay away from it!
Sounds like most of us have been there with the burning mouthwashes! Just as well we aren’t using them – we could be damaging our mouths!
I have a question on toothpaste. What do you think of toothpaste that controls bacteria in the mouth even after 12hrs with meals ( as advertised quite frequently on tv nowadays ). It puts me off, I don’t buy that, instead found it totally unnecessary, just a sales gimmick. We live with bacteria whether we like it or not. The question is balance between the good ones and bad ones. Thorough brushing with normal toothpaste (and flossing if I can remember) is good enough for me.
Hahaha I know which one it is! But I use it 😛 I don’t use it for their claims but I just sort of like how it feels – not too minty and not too grainy. I do agree that bacteria gets a lot of flack don’t they? People forget we need bacteria to survive too!
Wow, that’s very educational, thanks a lot Paris!
I’ve always felt guilty for not using a mouthwash regularly. I really hate the feeling of it inside my mouth, it’s a torture! So even when I made up my mind to use one everyday, I stopped within a week. I don’t feel particularly cleaned afterwards, it’s just my mouth feels weird. But I did notice that whenever I use that purple color Listerin mouthwash for a while, my teeth looks whiter.
Now that I know it’s not necessary, I’ll no longer feel guilty and save some money too!
I’m glad you enjoyed this Emma 🙂 I find some mouthwashes are too sweet so after I rinse, I feel like I should brush my teeth again 😛 I think it’s silly of them to make them taste sweet!
I do not use mouthwash at all because I am lazy. LOL. But I do brush my teeth after every meal which usually means lunch and dinner because I usually only consume oats for breakfast. So I always have a set of toothbrush and toothpaste at work so that I can brush my teeth in the toilet after lunch. I would love to floss but I honestly do not know how to do it properly. Since I generally have good teeth, I guess just maintaining my current regime is enough for me on top of a yearly visit to the dentist.
My hubby on the other hand has really bad teeth due to accumulation of tartar around his gums. Since the problem was not taken care off when he was young, he had to suffer throughout adulthood. He needs to visit a dentist every 6 months to get rid of the tartar and ends up paying quite a bit on his yearly dental fees. He uses mouthwash after brushing his teeth thoroughly with an electronic toothbrush every morning and night. He too has not mastered the art of flossing but I think he uses this tiny brushes (which is sold as 6-8 pieces in a set) to manually remove tartar that has accumulated around the teeth area.
All I can say is that after seeing how my husband had to suffer due to bad teeth, parents must pay more attention to their children’s teeth when they are younger even if it means spending money to get the teeth fixed. These kids will certainly thank them for that when they grow up.
Ouch! You’re so hardworking Victoria! I tried to be a bit more diligent about brushing my teeth after lunch but I always never made it a habit 😛 I know it’s a good habit to have so it’s one you’ll have to make sure your kids pick up too in future! 😉 I don’t have the best teeth around either. Better see a dentist before I lose them all some day 😛
I thought mouthwash is doing more harm than good but then recently I went to endodontist for my tooth problem and he recommends using mouthwash. When I asked saying I read up that mouthwash is bad he say himself is using it.he recommends using Colgate plax that doesn’t contain alcohol. So I quickly went n bought mouthwash to use. Is very confusing though..I hate flossing cuz d thread just stuck in between my tooth and it freak me out. Maybe there a proper method to flossing? Haha..
That’s interesting, Leona! I suppose even dentists are divided in their views on this as with everything 🙂 I found that the waxed flosses don’t break so easily and I’m particular to stick only with Oral B. Sometimes, it breaks off when it catches on my teeth but it shouldn’t. Comes down to technique so practice will make perfect!
Thanks so much for sharing, Paris! I don’t use a mouthwash in general, only occasionally when a small bottle comes as a GWP. I like the “fresh” feeling, but I know the alcohol and so on can’t be good. I’m glad to find out I’ve been doing things right. Nothing replaces good brushing and flossing habits!
Glad you enjoyed this Sunny 🙂 Are you back from holidays already? I don’t think there’s a right or wrong way about things since I’m sure different dentists will have different views on this too. But it’s good to know it isn’t absolutely necessary for our dental health to use a mouthwash 🙂
Hey Paris, yes I’ve been back for a bit more than 2 weeks and work is rolling in from all sides LOL I suppose there are better mouthwashes and worse ones. If my dentist ever tells me to use one I will, but otherwise I wouldn’t look for it 😉
Haha the perils of returning from a long holiday! 😀 Almost makes you wish that you had another holiday so you can recover eh? 😀
I don’t use mouth wash. Not accustomed to the idea somehow. I tried some products a long time ago and felt that it was too strong for me. Gargling it felt like I was gargling a million mint bombs. I do brush my teeth at work after lunch though. Thought that was more effective 🙂
A million mint bombs! LOL!! So true too! Some others are too sweet which makes me feel like brushing my teeth again! I have to cultivate this habit of brushing my teeth after lunch. Seriously, I’m such a lazy bum, my teeth will all fall out one day 😛
I don’t use mouthwash, and I do believe that it does more harm than good.
It is a temporary solution for bad breath.
The real culprit of bad breath is the “white mold” that grows on the tongue. And that can easily be cleaned by using a tongue cleaner. All one needs to do is physically scrap the bacteria off.
Actually, the basis of it all, is that I hate the taste of mouthwashes.
Haha yeah, some of them taste really really weird! Like the ones that taste sweet. I mean, what’s up with that? Do I have to brush my teeth again after using that sweet mouthwash? It’s like gargling with coke 😛
They don’t do much for me. I prefer herbal tea for gargling ( sage, etc…) 🙂
Ooh that’s an interesting alternative Tina!