How to Choose the Best Mouthwash in 2022

mouthwash-in-hand

Last Updated on December 23, 2022 by Dr Gustavo Assatourians DDS

When we talk about dental hygiene, brushing is always recommended and with frequency along with toothpaste, flossing, and rinsing. However, it is often not clear what the purpose of mouthwash is, the role it plays in oral hygiene, when to apply it, and which one works best, taking into account health conditions, age, and many other factors. The products are extensive, in addition to the fact that all these products have gained approval by the American Dental Association (ADA). Then standing in front of the shelf, it is not easy to decide the best mouthwash.

What is a Mouthwash and why is it used?

Technically, mouthwashes are a tool used in one’s daily dental hygiene, without implying that they replace brushing. But together with brushing and the use of dental floss, they promote oral health.

A mouthwash is a liquid solution or rinses that act around the teeth, gums, and tongue. Its use can have hygienic, preventive, and curative purposes or only function as a kind of “deodorant”, providing a fresh and clean sensation while eliminating bad breath.

best-mouthwash-and-toothbrush

The purpose of mouthwash is to help control or eliminate certain risks and fight bacteria; however, the purpose cannot be generalized since according to your dental health condition or objective, you should use the most appropriate one for different indications:

Types of Mouthwash

According to the Food and Drug Administration of the United States (FDA), mouthwashes are regulated as cosmetics, some as therapeutic, or depending upon their objective, it can be both. Some of these are:

  • Cosmetic

mouthwash This mouthwash is available over the counter used to control bad breath and leave a pleasant taste in the mouth. It does not have any other application, nor does it help fight plaque or bacteria. However, mouthwash helps remove food debris that may remain after brushing, and it leaves the mouth feeling clean. However, this effect is short-lived.

  • Therapeutic

These mouthwashes have active ingredients with multiple benefits, according to the formulation indicated by the dentist for the prevention or relief of different diseases. It is important to note that some mouthwashes contain significant percentages of alcohol (between 18 and 26 percent). Although not designed to be swallowed, some people experience sensitivity when rinsing with an alcohol-containing mouthwash.

What Ingredients can I find in the Rinses?

There is a wide variety of active ingredients in mouthwashes. They have different types of action or can be combined to combat plaque, cavities, gingivitis, among other oral health problems. 

Ingredient Action
Cetylpyridinium chloride Antibacterial action
Delmopinol hydrochloride Interacts with the particles of the dental film or enamel,inhibiting the adherence of bacteria..
Essential oils (for example: thymol (thyme), eucalyptus, menthol, clove) Bacteriostatic, antifungal, and helps reduce gases that cause bad breath (halitosis)
Heavy metal salts (for example: zinc chloride, tin fluoride) Inhibits the growth of dental plaque, fighting cavities and preventing the formation of tartar. It also strengthens tooth enamel.
Lysozyme Controls bacterial growth (attacks cell walls of bacteria) and prevents tartar formation
Sanguinarine (plant extract) Bacteriostatic (suppresses bacterial enzymes)
Sodium benzoate Decreases dental plaque formation
Baking soda Antiseptic that helps neutralize acids produced by bacteria in the mouth, inhibiting their growth
Sodium chloride Temporary and limited effect; a fresh sensation
Triclosan Antibacterial and antifungal activity
Chlorhexidine Reduces bacterial plaque and controls gingivitis
Carbamide or hydrogen peroxide Helps whiten teeth, but prolonged use can damage the enamel and increase the risk of cavities.
  • Alcohol Mouthwash

This agent is common in many types of mouthwash, but it does not have a specific action; rather, its main objective is to help dilute the active ingredients. Generally, those with this ingredient are indicated to freshen breath and combat bleeding or gum disease.

However, some dentists raise concerns since the degree of alcohol present can cause other oral health problems such as altered taste, discoloration of the teeth, or a dry sensation. Sometimes it can present an alcoholic breath. BY ON AMAZON

  • Rinses with Chlorhexidine

These rinses are the most widely used antibacterial mouthwashes, indicated in gum disease. Studies have shown that it can reduce inflammation caused by gum disease. However, its chronic consumption also causes inflammation of the base of the tooth and tongue and can possibly alter the taste or cause dry mouth. To avoid major problems if its use is contraindicated, consult your dentist. BY ON AMAZON

  • Rinses with Fluoride

It is well known that fluoride helps prevent dental caries, but it is recommended in people who are at high risk such as those with orthodontics, the elderly, some health conditions with immunocompromise, patients with xerostomia (mouth dry) and those with partial dentures.

It is recommended not to consume or swallow mouthwash with this active ingredient. It can be toxic and is contraindicated in children under 7 years of age. In addition, there are mouthwashes for children according to their age. This particular rinse does not replace the use of toothpaste and brushing twice a day, at least. BY ON AMAZON

  • Rinses with Peroxide

This substance is present in many cleaning products in the home. It has antimicrobial action and is safe in concentrations of 1 to 3%. However, if not properly diluted, it can cause infected nerves that will eventually die, and something called pulpitis. It is not highly recommended and is in fact suggested to be avoided if you do not have proper guidance. BY ON AMAZON

  • Essential oils

These are extracted from plants, seeds, roots, or stems since they have antioxidant, antimicrobial, and anti-inflammatory properties. For this reason, they are sometimes attributed to having healing properties and have gained popularity in the market as a natural active ingredient, making them safe to use. BY ON AMAZON

Which is the Best Mouthwash to Use and for what?

There are different types of mouthwash depending on the content and active ingredient. Consider the following when looking for  the most suitable type:

  • Combat Bad Breath (Halitosis)

It is normal to suffer from bad breath at some point in life, especially if we do not carry out regular oral hygiene when we have a dry mouth, or we consume foods that leave an unpleasant breath, among other factors that can cause bad breath such as an infection.

In this case, whatever is multi-protective or helps prevent cavities is useful. The product may improve bad breath as it usually contains cetylpyridinium chloride (CPC), which helps reduce plaque buildup and decreases mouth odor.

Some specific examples: Listerine Zero Cool Mint, TheraBreath Fresh Breath Oral Rinse Mild Mint, and Crest Scope Get Fresh. In general, all rinses will help control bad breath. BY ON AMAZON

  • Gingivitis

This condition manifests when the accumulation of dental plaque occurs, which becomes tartar. Not being removed, it is deposited under the gums to initiate gingivitis and periodontal diseases. Many rinses work for plaque control and gingivitis prevention.

Some examples are: TheraBreath Healthy Gums, Nature’s Answer PerioBrite, Listerine total care, Listerine Ultraclean Oral Care Antiseptic Mouthwash, Listerine Freshburst, and Crest Pro-Health Mouthwash. It is important to read the indications or specific actions of the rinses. In the case of Peridex, it is quite strong and contains chlorhexidine gluconate; thus its use must be guided carefully so as not to stain the teeth. BY ON AMAZON

  • Tooth Decay

Bacteria inside the mouth metabolize food debris and produce acids,  causing the enamel to erode and exposing the tooth to the entry of bacteria and the generation of cavities. Fluoride helps prevent cavities, as it strengthens tooth enamel and prevents the attack of acids produced by bacteria, thus impacting the generation of dental plaque while minimizing it.

Some examples: ACT Anticavity Zero Alcohol Fluoride Mouthwash, Listerine total care Zero Alcohol, Listerine Ultraclean Oral Care Antiseptic Mouthwash, and ACT Total Care Mouthwash. BY ON AMAZON

  • Pain Relief

Sometimes, we have a plaque in the mouth, ulcers, or other dental problems that cause pain. For this, some rinses have incorporated local anesthetics such as lidocaine that help gently numb the mouth. ConsiderCankAid Mouth Rinse. In case of sensitive teeth or gums, you could use: CloSYS Sensitive Mouthwash. BY ON AMAZON

  • Whitening

Peroxides for whitening must be used for a long time to see any effects; however, they help reduce stains, while not removing them, so they are not a substitute for professional teeth whitening. For their use, you must be advised by your dentist. Examples include: Crest 3D White Brilliance Alcohol-free Whitening Mouthwash and Crest Pro-Health Advanced with Extra Whitening. BY ON AMAZON

  • Dry Mouth

Some people due to different health conditions may present with dry mouth, a condition known as xerostomia, and silk due to a reduction or absence of flow or production of saliva. Therefore, some mouthwashes can help while minimizing the sensation of pain or burning. The rinse should indicate a dry mouth and that it is free of alcohol, mint or menthol, eucalyptus or other products that irritate the gums. Some, on the contrary relieve and improve the lubrication in the mouth, helping alleviate the symptoms of dry mouth. 

Some examples are: Colgate Hydris Dry Mouth Mouthwash, Biotene Dry Mouth Oral Rinse, and ACT Total Care Dry Mouth. BY ON AMAZON

Keep in mind that before using any mouthwash, you should consult your dentist so that it does not become harmful to your oral health. Check the ingredients according to the objective that determines use.  Finally, you must properly follow the instructions before using.

According to recommendations by the American Dental Association (ADA) and the Oral Health Foundation, the use of a plaque-inhibiting mouthwash immediately after brushing can reduce the effects of fluoride in the toothpaste. However, in some specific cases, use may be appropriate if the immediate needs of the patient are improvements in plaque control rather than caries prevention. However, using mouthwash at times other than toothbrushing may better achieve the benefits of both the mouthwash and the fluoride in the toothpaste. Plaque-inhibiting mouthwashes may provide some, albeit relatively limited benefits when used in the middle of the day.

Tips on the use of Mouthwash

If mouthwash is not used correctly, it can mask other health problems. For this reason, we recommend the following points to be considered at the time of use:

mouthwash

  • Use the right amount
  • Swish vigorously with the mouth closed
  • No swallowing; spit it out.
  • Consult your dentist as to the best option.
  • Check the directions on the label. Those with ADA approval are recommended.
  • Mouthwash does not replace brushing.
  • If necessary, dilute it.
  • Hold in the mouth for 30 seconds. Use is advised an hour after brushing.
  • The use of a rinse is not always required for good oral hygiene.
  • Check the active ingredients.
  • Do not consume food or drink, or smoke within 30 minutes after the rinse.

 

Bibliography

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  2. Leitner B. The 8 Best Mouthwashes for Gingivitis of 2022. Verywell Health, Dental Health (internet). Published on May 27, 2022, (accessed on Nov 04, 2022). Available in: https://www.verywellhealth.com/best-mouthwashes-for-gingivitis-4174852
  3. DiGiacinto J. Best Mouthwashes Of 2022, According To Dentists. Forbes Health (Internet). Published on Aug 23, 2022, (accessed on Nov 04, 2022). Available in: https://www.forbes.com/health/body/best-mouthwash/
  4. Schultz R. The 10 Best Mouthwashes of 2022. Health (Internet). Published on Oct 19, 2022, (accessed on Nov 04, 2022). Available in: https://www.health.com/condition/oral-health/best-mouthwash
  5. Whelan C. The 9 Best Mouthwashes For Whitening, Cavities, Gums, Breath, and More. Healthline (Internet). Published on May 13, 2022, (accessed on Nov 04, 2022). Available in: https://www.healthline.com/health/dental-and-oral-health/best-mouthwash
  6. Redman J. 6 dentist-approved mouthwashes to fight bad breath. Select (netnet). Published on Jun 28, 2022, (accessed on Nov 04, 2022). Available in: https://www.nbcnews.com/select/shopping/best-mouthwashes-ada-ncna1296504
  7. DeltaDental (Internet). Mouthwash 101: What it does and how to use it. (accessed Nov 04, 2022). Available in: https://www.deltadental.com/us/en/protect-my-smile/oral-health-habits/mouthwash.html#:~:text=Look%20for%20mouthwash%20with%20fluoride,and%20reduce%20plaque %20and%20gingivitis

 

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