What should I look for in mouthwash?

Originally Published: February 15, 2008 - Last Updated / Reviewed On: May 19, 2014
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Dear Alice,

I've been trying to take better care of my teeth lately (as a general health thing, not because my dentist says I'm in trouble or anything) and so I started using mouthwash after I brush. But I'm confused about what it actually does. If I get a kind with lots of alchohol (which bothers me) it seems like it's supposed to kill germs and keep bad breath away. But in the alchohol-free ones, there's a huge variety: freshening, fluouride, anti-plaque... What is the point of mouthwash supposed to be? What should I be looking for?

thanks,
curious mouthwasher

Dear curious mouthwasher,

Kudos to you for being on top of your oral hygiene. Oral hygiene is an often-overlooked but important aspect of staying healthy, so important in fact that doctors consider oral hygiene to be a reliable indicator of digestive, cardiovascular, and immune system health.

Using mouthwash can be a great addition to your regular brushing and flossing routine, but of course it doesn't replace either of the two. Brushing and flossing help rid the mouth of food and odor-causing bacteria. In addition, the lesser-known practice of tongue scraping can be very effective in ridding the mouth of odor- and plaque-causing bacteria. You're right that different types of mouthwash are good for different things, and we'll try to outline for you here some of the main categories of mouthwash, and how to navigate your way down the dental hygiene isle of any drug store or supermarket.

Antibacterial mouthwashes, like Listerine and Cepacol, are the most effective in fighting gum disease, gingivitis, plaque, and bad breath, able to reduce bacteria counts in the mouth by roughly 75 percent. These formulas often contain high percentages of alcohol, and have quite a strong taste. While alcohol is a potent germicide, it can be drying and irritating to the mouth. If you find that you are bothered by the alcohol in these types of mouthwashes, there are plenty of low-alcohol or alcohol-free options.

Breath-freshening mouthwashes are easier on the taste buds and have lower alcohol content than the stronger antibacterials. Formulas containing chlorine or zinc work by defusing sulphur compounds produced by bacteria. Some products, like Scope, contain a germicide called cetylpyridinium, which has anti-gingivitis and anti-plaque benefits. All natural brands, like Tom's of Maine and Natural Dentist rely on a natural germ-fighting ingredients, like witch hazel or grapefruit-seed extract instead of alcohol as antibacterial agents. These washes are good for those who have bad breath but not significant gum disease or tooth decay.

If you are cavity-prone, fluoride rinses may be a good option for you. These types of anti-cavity rinses coat the teeth with a protective film that strengthens tooth enamel, making it more resistant to decay. Many U.S. cities fluoridate their water, so if you're a tap water drinker chances are you're getting adequate fluoride on your teeth already. However, those who drink bottled or filtered water may want to add a fluoride rinse to their routine. Fluoride has to remain on your teeth for about a half an hour to work, so if you're going to use this kind, swish for a full minute and don't eat or drink for a while afterward. No matter which type of mouthwash you choose, make sure to follow the instructions on the bottle.

It doesn't sound like you started using mouthwash in response to a problem, but if you find you have persistent bad breath you may want to consult a dental professional about other possible causes. Gum disease, tooth infection, cavities, poorly fitting crowns, and post-nasal drip can be the culprit of bad breath. Also, certain foods, medications, cigarettes and chewing tobacco, as well as infections in the tonsils or sinuses can contribute to halitosis.

The mouth offers a great environment for bacteria to flourish. It is moist, warm, dark, and comes into contact with all sorts of foreign objects. Any mouthwash, in addition to your regular flossing and brushing, will help improve freshness of breath and dental health. You can tailor the type of mouthwash you chose to the effect you'd like in your oral environment. Wishing you a minty-fresh day,

Alice