Should I use a mouthwash? On the scent of fresh answers to mouthwash questions

A common question patients ask is Should I use mouthwash? My experience is they are usually on a mission.

Some are searching for a way to bolster their oral hygiene habits using all the available resources. Others are looking for a solution to make oral hygiene a little easier.

The big news is: mouthwashes offer some benefits, but they aren’t a silver bullet. That is, they’ll never replace those dentist favourites – regular brushing and flossing – when it comes to good oral hygiene.

Now, don’t get me wrong, mouthwashes can have a place in oral hygiene, but it’s probably not what you think.

If you’ve ever asked Should I use a mouthwash? or Which is the best mouthwash? then you can relax and read on. You’ll find the answers to your mouthwash questions answered right here.

What’s the purpose of a mouthwash?

My xperience as a Gold Coast dentist has taught me most people want to do what’s best for their teeth when they know how. The big limiting factor is they’re unsure what the right thing is.

Like many dental products, including toothbrushes and toothpastes, commercialisation of mouthwashes has caused confusion for the average person. Now readily available in every supermarket and chemist, there’s a perception mouthwashes are for every day, just like brushing and flossing.

Actually, the opposite is true. Most people don’t need a mouthwash, especially if they’re diligent with their oral hygiene practices.

That said, some patients like the added freshness a mouthwash gives. Maybe it’s date night, and they’re heading out for dinner. Or perhaps they just appreciate the fresher scent a mouthwash gives. In these circumstances, it’s okay to use a mouthwash.

Bear in mind though, if it’s fresher breath you want and you feel brushing and flossing hasn’t done the job, you have other things to consider that may be impacting on your oral health, for example periodontal (gum) disease. You might choose to use a mouthwash, however you might want to review your choice of toothpaste or toothbrush too. When brushing your teeth, instead of just brushing teeth and gums, you could brush the back of your tongue too. Cleaning your tongue regularly will help keep bacteria in check – and help with mouth freshness.

The key message here is mouthwash won’t ever replace brushing and flossing. It’s only one tool in a repertoire of oral hygiene practices. Why? Because evidence shows rinsing with mouthwash will reduce plaque levels but only to a degree. It won’t replace brushing and flossing, but if nothing else was available, and for a short time only, it would be the next best thing.

Which is the best mouthwash for me?

Defining the best mouthwash is subjective.

Most people know mouthwashes as something they pick up at the supermarket and chemist. In fact, dentists can prescribe mouthwashes to treat very specific conditions.

Many non-prescription mouthwashes sourced at the supermarket or chemist have antibacterial formulations. Certainly, these can be effective at killing bacteria and reducing bacteria immediately after use. However, only a small number give a sustained benefit once you’ve stopped using the mouthwash. Would I recommend using these commercial mouthwashes? Only on the basis as I described above. While patients might advocate for mouthwashes, they’re not the easy solution to good oral hygiene. On the other hand, regular brushing and flossing are.

Other mouthwashes contain fluoride. These can help harden and protect teeth against tooth decay. Their mode of action is on hardening the teeth and because they don’t clean the teeth these mouthwashes with fluoride are used as an adjunct to brushing and flossing. You particularly want advice about the concentration of fluoride, which can vary between products. And if you’re in any doubt about which mouthwash is right for you, seek advice from your dentist.

Mouthwashes which have grown in popularity are those that whiten teeth. These mouthwashes use different formulations and active ingredients, but the concentration is usually too low or the active ingredient too unstable to have a meaningful whitening effect. In fact, these mouthwashes can sometimes cause irritation to gum and mouth tissues.

What about prescription mouthwashes?

Mouthwashes prescribed by dentists are different again. Many contain chlorhexidine, an ingredient used to kill harmful bacteria and some can contain specific antibiotics. While elimination of harmful bacteria is important, prescription mouthwashes come with their own set of side effects. Stained teeth, altered taste, changes to mouth tissue (if used over a longer time) are among these. Alcohol-based mouthwashes can even cause your mouth to dry out.

None of these side effects is ideal. Add to this the continuing debate about the net benefits of mouthwashes, and it probably won’t take much convincing for you to stick with your regular oral hygiene routine, that is, brushing and flossing.

When the average patient asks me Should I use a mouthwash? my answer is usually no. Of course I have some patients for whom I prescribe a mouthwash. In all cases, this is to treat a very specific condition for a finite period of time, say, over a two week period. Used judiciously, and under the guidance of a dentist, these mouthwashes can help ease the symptoms of certain dental conditions. If you really feel you can’t live without a mouthwash, I suggest to patients they use it no more than once daily. If that’s you, even consider watering your mouthwash down so it’s not as strong.

What about mouthwash for kids? Is there a safe mouthwash?

I’ve already shared my concerns about adults using mouthwashes, so it will come as no surprise to you there are few solutions to a safe mouthwash for kids. My answer to this question is a general No, with one exception: only under specific instructions from your dentist.

In certain circumstances, for example, where a child is at a high risk of tooth decay or they have an infection, a mouthwash prescribed by your dentist may be appropriate. This is a safe mouthwash solution. By contrast, diagnosing at home and sourcing products from the supermarket or chemist is not a safe mouthwash solution.

In all cases, it’s wise to at least consult with your dentist. More than anything, we want to be teaching our kids good oral hygiene habits, starting with brushing and flossing. Mouthwash for kids is really only a last resort, applied under guidance from their dentist, and in conjunction with brushing and flossing.

And a final word on mouthwashes…

A general statement I’m happy to make is that every person should brush and floss every day. I would also say that generally, most people shouldn’t use a mouthwash every day. A mouthwash is only an adjunct to your regular oral hygiene regime. And I can back this up with my own practice. I don’t use a mouthwash regularly on a permanent basis and it is very rare that I have patients who need mouthwashes on a permanent basis. If patients are prescribed a mouthwash, it’s only for treatment of a specific condition and usually for a specific period of time.

If you’re considering adding a mouthwash to your oral hygiene repertoire, be sure to do your research and consult with your dentist. He or she will be able to guide you as to whether you should use a mouthwash and which mouthwash is best for you.

Owned by Dr Les Jabbour, Define Dental is a Benowa dentist. As the Gold Coast’s premier dental practice providing quality dental care to local residents longer than any other, Define Dental has decades of experience of providing exceptional dental care for the local Benowa community and wider Gold Coast region. The team at Define Dental is experienced in helping patients choose a mouthwash as part of their oral health regime. We work with all patients to assess and activate their oral health journey, and then support them with treatment and ongoing maintenance. Want to know more? Call 5597 2100 to book an appointment.