Why Mouthwash Isn’t for Everyone: Risks, Ingredients, and Safer Options

The oral microbiome is a diverse collection of bacteria that significantly impact overall health. An imbalance in the oral microbiome leads to inflammation and disease (tooth decay, gingivitis, oral thrush, etc.).

A major 2019 study published in the Journal of Oral Microbiology found that bacterial populations from the mouth enter the gut microbiota. That's why it's essential to choose oral hygiene products in consultation with your dentist.

Unpleasant Consequences of Improper Mouthwash Use

Using mouthwashes with aggressive ingredients can lead to unpleasant consequences. Here are some possible risks:

Destruction of the Microbiome

Mouthwash can be very effective at fighting bacteria. However, using an antibacterial rinse daily can disrupt the balance in your oral cavity. Beneficial bacteria regenerate more slowly than harmful ones, making it significantly harder to restore balance once it has been disrupted.

Mouthwashes with antiseptic properties should only be used when indicated. Your dentist will provide recommendations on the duration of use. It's important to follow this advice to ensure the treatment is beneficial.

Drying of the Oral Mucosa

Saliva provides remineralization of teeth, fights cavity-causing bacteria, and eliminates stale breath.

Rinses with antiseptic cause dry mouth. These are products that have alcohol or chlorhexidine in their composition. With a lack of saliva, there is no full protection against tooth decay.

Also, some types of rinse liquids can react with toothpaste residue. This causes dryness on the inside of the cheeks, gums, and tongue.

Dangerous Ingredients in Mouthwash

Mouthwash can cause a lot of problems if you choose it wrong. We have compiled a list of ingredients that are most likely to cause adverse reactions.

Ingredient	Side Effects
Alcohol	Some mouthwashes contain approximately 26% alcohol, primarily in the form of ethanol. Ethanol causes dry mouth. Dry mouth can lead to increased foul odor and flaky skin on the inside of the cheeks.
Chlorhexidine	The most common reaction to chlorhexidine is contact dermatitis, but in rare cases, some people may experience anaphylactic shock upon exposure. That said, chlorhexidine rinses remain an effective treatment for some oral conditions.
Cocamidopropyl betaine	It is a surfactant that can cause allergic reactions. EWG rates cocamidopropyl betaine as an ingredient of moderate hazard.
Parabens	Parabens disrupt the endocrine system and may also cause allergic reactions.
Formaldehyde	There are a number of hazards associated with exposure to formaldehyde. It can cause allergic reactions and cancer.
Cetylpyridinium chloride Antibacterial peroxidases	With prolonged use, it causes brown stains on the teeth.
Sodium hypochlorite	Causes brown stains on teeth and a burning sensation with prolonged use.
Antibacterial peroxidases	Increase the chances of tooth erosion, especially with prolonged use.

How to Use Mouthwash Correctly

According to the survey, 31.5% of respondents reported using mouthwash daily. However, there is no universal answer.

The American Dental Association states that mouthwash is not a substitute for regular brushing and flossing. It does not have to be used for daily oral hygiene unless your dentist has indicated otherwise.

Consult with your dentist before incorporating any mouthwash into your daily routine. This will ensure that you take advantage of the potential benefits of mouthwash without exposing yourself to unnecessary risks.

If you experience any of the following symptoms, you should reduce or stop using mouthwash.

Sores appearing in the mouth.
Bleeding gums.
Dryness in the mouth.
Pain or sensitivity when brushing your teeth after using mouthwash.
Staining of the teeth.

How to Use Rinse Aid Properly

Here's how to use rinse aid correctly to maximize its benefits.

Brush Your Teeth First

Start by brushing and flossing your teeth thoroughly. If you brush with fluoride toothpaste, wait 5-10 minutes before using mouthwash. Otherwise, it will wash away the concentrated fluoride that is in the toothpaste.

Pour the Mouthwash Into the Cup

Use only the amount of mouthwash specified in the product's instructions. This is usually three to five teaspoons.

Rinse Mouthwash

Pour the contents of the cup into your mouth and rinse for 30 seconds. You can time it on a timer or mentally count to 30. Do not swallow the mouthwash.

Spit it Out

Spit the mouthwash out into the sink.

Can You Use Mouthwash as a Substitute for Toothpaste?

No, mouthwash cannot replace brushing with toothpaste. No mouthwash formula can replace regular brushing and flossing twice a day.

Alternatives to Mouthwash

Flossing and brushing twice a day offer more proven benefits and fewer potential side effects. A better alternative to mouthwash is an irrigator. It will last a long time, remove stuck food particles, and rinse away plaque without disrupting the beneficial microflora.