Good oral hygiene goes far beyond brushing your teeth several times a day. To achieve optimal oral health, we must perform other daily actions that complement daily brushing: using dental floss, a tongue scraper, and also a toothbrush.
In 2023, the Council of Dentists published a demographic survey on oral health in post-pandemic Spain, in which 65% of respondents reported using mouthwashes. However, in this survey they emphasize that “it is necessary to emphasize to the general public the importance of not using mouthwashes without the indication and supervision of the dentist.”
There are several studies that focus on the effect of continued use of these products on bacteria. This one published in the Journal of Medical Microbiology focuses on daily use of Listerine Menthol (Listerino Cool Mint) and points to an increased number of bacteria linked to gum disease and even others like cancer.
On the other hand, a review of studies published in the International Dental Journal highlights the importance of studying the possibility of mouthwashes being prescription-only, as some of them can cause dysbiosis of the oral microbiome (imbalance of the set of natural microorganisms in the mouth).
When browsing supermarkets, pharmacies and other stores, we can find a large number of these products. But which mouthwash is best for us? How and when should we use it? We answer these and other questions with the help of a dentist.
Types of mouthwashes
There are several types of mouthwashes and their composition changes depending on the specific treatment area they are intended for, although they all have something in common: “Due to their liquid presentation, they act where the paste cannot reach,” explains dentist Alberto Villacieros.
Pharmaceutical companies offer specific product lines for oral care, as well as dozens of mouthwashes in various flavors, designed to satisfy different consumer tastes.
There are antiplaque mouthwashes: “These mainly attack biofilmwhich is a sticky substance that forms between 15 and 30 minutes after eating, delaying its adhesion to the tooth due to the polarity of its composition,” explains Villacieros. There are also some to prevent cavities thanks to their high fluoride content, which increases the resistance of the enamel. On the other hand, specific rinses for tooth sensitivity “are mainly composed of potassium nitrate, allantoin and fluoride, and are responsible for sealing the dentinal tubules, thus reducing nerve irritation,” says the dentist.
Mouthwashes for gingivitis, Villacieros continues, “contain in their formula antiseptics such as chlorhexidine, triclosan or cetylpyridinium chloride, which help reduce pathogenic bacteria in the oral cavity.” There are also mouthwashes for xerostomia (also known as dry mouth syndrome), “intended to improve dry mouth, as they contain products that help stimulate saliva.”
These are the most common mouthwashes but, as the expert explains, “there are some for practically every ailment.” For each problem there is a specific mouthwash, because during life the mouth, its characteristics and therefore its needs change. “For example, in the mouth of a growing child, we focus on brushing mainly to prevent cavities, and this is what we recommend to parents,” explains the dentist. “In the mouth of a teenager, it is common to find gingivitis due to poor brushing; in an adult, periodontal problems, bad breath and smoking; In a person over 70 years of age, it is common to observe irritation of the gums due to the use of removable prostheses and a lack of saliva due to medication.
Aspects to consider
One of the most important things to keep in mind about mouthwashes is that “we must use them all under one principle: in no case do they replace brushing the mouth,” explains Villacieros.
Although their use is not mandatory, it is recommended due to the benefits they offer to our health. Although approved brands also distribute mouthwashes in supermarkets, it is best to buy them in pharmacies with professional advice regarding the type and frequency of use.
As a general rule, as Villacieros explains, “the usual recommended use is twice a day after brushing, with 30-second rinses morning and evening with the pure product, that is, undiluted.”
The reason why experts recommend professional advice to choose it and know its use is that “its improper use can lead to common negative consequences such as dysgeusia (strange flavors) or tooth discoloration. In addition, it should be kept in mind that its ingestion can cause discomfort in the digestive tract.
Since each mouthwash has its own indication and each patient is different, “it is advisable to do a thorough anamnesis to evaluate allergies or intolerances to the components of the formulas. My main recommendation is that the product is alcohol-free to avoid irritation of the mucous membranes and drying out,” explains Villacieros.
