Is Mouthwash Necessary? The Essential Guide to Oral Health

28 August 2024

Is Mouthwash Necessary? The Essential Guide to Oral Health

Most of us are well-acquainted with the basics of oral hygiene, namely brushing twice a day and flossing regularly. However, there’s one aspect of the daily dental routine that sparks debate – mouthwash.

Some people swear by it, while others dismiss it as unnecessary. But what’s the truth? Is mouthwash necessary for a healthy smile, or is it just another optional extra?

Let’s dive into the science, explore the benefits and drawbacks, and help you decide whether incorporating mouthwash into your oral care routine is essential.

The Role Of Mouthwash In Oral Hygiene

Mouthwash is essentially a liquid solution designed to be swished around the mouth and then spat out. Modern varieties come in various formulations, including antiseptic, fluoride, cosmetic, and natural varieties. The primary purposes of mouthwash include reducing oral bacteria, freshening breath, and delivering active ingredients to areas where brushing and flossing might not reach.

Here’s what the World Dental Federation has to say about it…

“The huge diversity of mouthwashes vary according to their recommended use, chemical composition and effectiveness and can have a beneficial or negative effect depending upon their characteristics”

In other words, some are good and some are bad, or so it seems… the question is…”Which are which?”

To answer this, it’s important to take a look at the facts – e.g. the advantages and disadvantages.

So, first, the benefits…

The Advantages Of Using Mouthwash

Reduces Plaque and Gingivitis

Mouthwash, especially those containing antibacterial agents like chlorhexidine or essential oils, are proven to reduce plaque and gingivitis. A study published in the Journal of Clinical Periodontology found that chlorhexidine mouthwash may reduce plaque by up to 60% and gingivitis by up to 45% in some cases when used regularly along with brushing and flossing. However, the journal also stipulates that in no way should mouthwash be used in place of conventional brushing and flossing, but rather, as an additional part of an oral care routine.

Helps Prevent Cavities

Fluoride mouthwashes are formulated to strengthen tooth enamel, making it more resistant to decay. According to the British Dental Association (BDA), fluoride is one of the most effective agents in preventing dental caries (cavities). A study in the Cochrane Database of Systematic Reviews concluded that regular use of fluoride mouthwash can reduce the risk of tooth decay by up to 26%.

Controls Bad Breath

One of the most common reasons people use mouthwash is to combat bad breath, also known as halitosis. Cosmetic mouthwashes contain ingredients like menthol or eucalyptol that mask odours, while antiseptic mouthwashes target the bacteria that cause bad breath. However, it’s important to note that while mouthwash can temporarily improve breath, it may not address underlying causes such as dental decay, dry mouth, or certain systemic conditions.

Targets Hard-To-Reach Areas

Brushing and flossing are crucial for removing food particles and plaque from the teeth and gum line. However, even the most diligent brushing can miss certain areas of the mouth, especially in people with orthodontic appliances, bridges, or deep gum pockets. Mouthwash can reach these difficult areas, providing an extra layer of protection against oral health issues.

So, those are the key benefits, what about the disadvantages?

The Downsides of Mouthwash

Despite its benefits, mouthwash is not without potential drawbacks, and it’s important to consider these before making it a staple part of your routine.

Potential Disruption Of The Oral Microbiome

Our mouths are home to a delicate balance of bacteria, many of which play a crucial role in maintaining oral health. Overuse of antiseptic mouthwashes, particularly those with strong antibacterial agents like chlorhexidine, can disrupt this balance by killing not only harmful bacteria but also beneficial ones.

One 2020 study, for example, found a major shift occurred in the salivary biome of 91% of all patients surveyed within 7 days of using a particular chlorhexidine mouthwash. The shift turned from one that was balanced to a biome that was overly acidic. Such a disruption on a long-term basis could lead to an increased risk of oral infections and even systemic health issues.

Risk Of Overuse And Oral Irritation

Excessive use of mouthwash, especially those containing alcohol, can cause oral irritation, dry mouth, and even damage to the soft tissues inside the mouth. While alcohol-based mouthwashes are effective at killing bacteria, they can also lead to discomfort, especially for those with sensitive gums and teeth.

Cetylpyridinium chloride discolours teeth

Did you know that mouthwashes containing cetylpyridinium chlorides (CPCs) can stain teeth in some people? While most tooth staining comes from lifestyle factors like dietary intake and smoking, mouthwashes containing this ammonium compound have been known to contribute towards extrinsic tooth staining on natural teeth and dental restorations.

Mouthwash and Oral Cancer Concerns

There has been ongoing debate about whether the regular use of alcohol-containing mouthwashes increases the risk of oral cancer. Some studies have suggested a potential link, while others have found no significant association. The International Journal of Cancer concluded in a meta-analysis that while there is no conclusive evidence to confirm that alcohol-based mouthwash increases oral cancer risk, caution is advised, especially for heavy smokers and drinkers, already high-risk groups for oral cancer.

So, Is Mouthwash Necessary?

The answer to whether mouthwash is necessary depends on individual needs and oral health conditions. Here’s how you can determine if it’s right for you:

Consult Your Dentist

The best way to determine if mouthwash should be part of your routine is to consult with your dentist. They can recommend specific formulations based on your oral health needs, whether it’s for additional cavity protection, gum health, or simply freshening breath.

Consider Your Oral Health Goals

If you’re prone to cavities, a fluoride mouthwash might be a good addition to your routine. If you’re dealing with gum issues, an antiseptic mouthwash could help. On the other hand, if your oral hygiene is tip-top and you don’t have specific concerns, mouthwash might be an optional step rather than a necessity.

Understand the Limitations

Remember that mouthwash is not a cure-all. It’s most effective when used as part of a comprehensive routine that includes brushing, flossing, and dental check-ups. Over-reliance on mouthwash may cause further dental health problems.

Choose the Right Type

If you decide to use mouthwash, choose a product that aligns with your needs. For instance, if you have sensitive teeth, opt for an alcohol-free formula. If you’re concerned about plaque, choose a mouthwash with antibacterial properties.

As a top tip, it pays to check out the Oral Health Foundation website where they have a list of approved products.

So, Is mouthwash necessary?

Unfortunately, there is no definitive, one-size-fits-all answer. While mouthwash clearly offers benefits, such as reducing plaque, preventing cavities, and freshening breath, it may cause more harm than good depending upon use or circumstance. Either way, it’s essential to use mouthwash wisely and in moderation as directed by your dentist.

For those interested in optimising their oral health, a measured approach, one that includes regular dental check-ups, a balanced diet, and good brushing and flossing habits, is key. Mouthwash can be part of this routine, but whether it’s truly necessary is a decision best made with professional guidance and a clear understanding of your unique oral health needs.

If you’d like to know whether mouthwash is necessary for you, come and talk to our experienced team at Cheadle Hulme Dental. We’ll help you decide whether it should be part of your routine or not.

Call us on  0161 486 0743 or schedule an appointment online to find out more.