Most people feel that since they brush and floss daily, they do not need a mouthwash. But a mouthwash provides major benefits. The most obvious one is, of course, that it can reach every corner of your mouth, gums and teeth where your tooth brush cannot. Other important benefits are that it is a quick and sure way to kill germs and reduce bad mouth odor. Mouthwash can also reduce and prevent plaque, tooth decay, gingivitis, whiten teeth, provide relief from pain and from xerostomia aka dry mouth.
There are two types of mouthwashes: Cosmetic and Therapeutic.
The most commonly used is the Cosmetic Mouthwash easily available over the counter. The only use of a cosmetic mouthwash is to reduce bad breath. But this is a temporary cure. Cosmetic mouthwashes have a pleasant taste and your breath will smell sweet at least or a short while. But, the major cause of bad breath is Volatile sulfur compounds (VSCs), food debris, plaque and bacteria. Cosmetic mouthwashes only temporarily mask bad breath and give you a fresh mouth feeling. While they can be life saving if you have a meeting, personal or business, have eaten spicy curry and have had no time to brush, they do not address the root cause of bad breath. They do not kill bacteria or affect VSCs. They are a short-term remedy for bad breath.
Therapeutic mouthwashes on the other hand contain ingredients that can help control and cure not only bad breath in the long term but also prevent and control gingivitis, plaque, and tooth decay. Therapeutic mouthwashes that contain peroxide can whiten teeth. Xerostomia or dry mouth caused by a lack of saliva in the oral membranes can cause caries., so a mouthwash which contains fluoride can help manage this problem. Mouthwashes with enzymes or animal mucins mimic the feel of saliva and provide relief from symptoms of xerostomia or dry mouth.
Most therapeutic mouthwashes will contain:
- cetylpyridinium chloride which helps to reduce bad breath.
- chlorhexidine and essential oils which apart from helping to reduce bad breath also help control plaque and gingivitis. ;
- fluoride which prevents tooth decay.
- Some mouthwashes may also contain peroxide which is a whitening agent and zinc salts, ketone, terpene, and ionone.
While therapeutic mouthwashes are available over the counter, some mouthwashes particularly those containing chlorhexidine will need to be prescribed by your dentist. Also, the combination of chlorhexidine and cetylpyridinium chloride plus zinc lactate while significantly reducing bad breath can also equally significantly contribute to tooth staining. Talk to your dentist before you begin using a therapeutic mouthwash.
Since some mouthwashes contain alcohol there were concerns that use of alcohol might increase risk of cancer. However a recent study and review failed to find any association between use of alcohol containing mouthwash and oral cancer or mouthwash dose response and oral cancer.( Gandini S, Negri E, Boffetta P, La Vecchia C, Boyle P. Mouthwash and oral cancer risk quantitative meta-analysis of epidemiologic studies. Ann Agric Environ Med 2012;19(2):173-80.)