The question you need to answer first is what is your reason for using mouthwash--bad breath, gum health, removing debris?
The active ingredient is the main function of mouthwash REGARDLESS what the front of the bottle says. The inactive ingredients have less influence and are simply additives. Most mouthwashes have one main purpose aside from addressing bad breath.
We bought and tested every common mouthwash below so you don't have to. We do not receive any financial backing from any of the mouthwashes we recommend. Note that short-term use of any of these are fine but there are good and bad mouthwashes if used long term. We used 2 criteria to categorize these. 1) what the mouthwash actually does based on ingredients and NOT what the front of the bottle says 2) whether they create a cavity-causing environment by having a 5.5 pH or less.--the best alkaline mouthwash in each category is ideal.
5 Types of Mouthwash
Prevent Cavities
Any mouthwash with the main ingredient fluoride helps prevent cavities. We need 2,000ppm of fluoride daily to effectively fight cavities and note that most of these mouthwashes below have 90-225ppm. Though fluoride mouthwash is a drop in the bucket, every little bit helps. Fluoride improves the threshold of your mouth making it much more difficult for the bacteria to grow and is essential in fighting cavities. Of these mouthwashes we do recommend, all have 225ppm except ACT Dry Mouth and Equate Restoring, which only have 90ppm fluoride.
Fight Gingivitis
We will clump any gingivitis ("gums") mouthwashes together even though there are subtle differences among the chemical compounds. Some kill bacteria like essential oils (Listerines) or those containing alcohol (no, not that kind), while others act as a bacterial stun gun like cetylpyridinium chloride (Colgate Totals or Crest Pro Health). Normally if your gums bleed, are swollen, or Dr. Nelson says you have gingivitis or periodontitis like 95% of the population, this is what you should use. All of these are extremely acidic mouthwashes except for Plax, which does kill bacteria.
Bad Breath & Dry Mouth
Bad Breath
If it does not have any of the compounds that fight cavities or gingivitis, it's likely a "cosmetic mouthwash" and the lone purpose is fighting bad breath. Note that NEARLY ALL mouthwashes already address bad breath so why not use a different mouthwash category that has a second feature? The only two we recommend have a healthy pH. Hello Charcoal surprisingly tasted good--the color may startle you. TheraBreath is extremely effective but doesn't give that minty aftertaste you expect from rinses.
Dry Mouth
This is interesting! We found that the labeled mouthwashes for dry mouth share the same main ingredients that bad breath mouthwashes have. They have non-sugary sweeteners as the primary ingredient and these enhance saliva flow. That’s it. They don’t protect from gingivitis or directly prevent cavities. If you don’t have saliva you will have a rampant and aggressive attack of cavities in a short time period! No mouthwash cures dry mouth but simply alleviates the symptoms. ACT and Biotene taste pretty good, but be cautious with Smartmouth--definitely an acquired taste!
Major Reset Mouthwash
If you have neglected your teeth and gums, have rampant cavities, or need to start a major repentance process, this is your mouthwash! Use chlorhexidine gluconate (Peridex) for 2 weeks and stop for 3 months. Repeat. It drastically improves gum swelling, bleeding, and kills bad bacteria that start cavities. After 2 weeks of using this mouthwash it will usually take the bacteria another 3 months to reach the original bacterial state your mouth was in prior to using the mouthwash.
The Natural Dentist aloe vera mouthwash is naturalistic and claims the same results as chlorhexidine gluconate but with its strong acidic pH we don't recommend it for long term.
Whitening Mouthwash
It must contain the active ingredient hydrogen peroxide to truly be an effective whitening mouthwash according to the ADA. Several "whitening" mouthwashes say they whiten yet have zero hydrogen peroxide. In fact, some like Crest 3D White Brilliance are labeled "whiteners" yet the only whitening ingredient they have is an abrasive that removes external stains like coffee--it does not change your internal teeth color from yellow to white. Some products like charcoal, oil pulling, etc. have their benefits but research is limited.
One ADA endorsed study found that 12 weeks of using these mouth rinses daily will achieve the same color as if you were to whiten your teeth for 2 weeks with whitening gels from our dental office. However, the pH of these are so acidic (4.1-5.5 pH) we encourage you to just whiten with whitening gels that have a 7.2 pH instead. Also ALL true "whitening" products generally have a less desirable taste so why inflict yourself for 12 weeks when you could just whiten with gels for less than 2 weeks with similar results?
What About a 6th Type of Mouthwash: Oil Pulling?
It's so special, it gets its own article (Jan 2023).
Conclusion
Mouthwash should never replace brushing or flossing but plays a great supportive role along with waterpiks and tongue scrapers. Mouthwash reaches areas that floss and a toothbrush cannot and we highly endorse using mouthwash daily. Whether to use mouthwash before or after toothpaste is addressed here. Like drinking soda once in a while, none of these mouthwashes are going to cause cavities immediately but with long-term use we HIGHLY suggest using any of the ones we recommended in green mainly due to pH levels.
Which mouthwash to use depends on your needs. Know there are really 5 types of mouthwashes so determine first what your main reason why you use it (cavity prevention, healthier gums, dry mouth, bad breath, major reset, or whitening) and choose the brands we recommend.
Comments