Should You Use Mouthwash, or Not?

Cartoon showing two smiling teeth looking curiously at bottle of green mouthwash, with three question marks above

Mouthwash, also known as mouth rinse, now comes in more flavors, colors, and varieties than ever. Is it absolutely necessary for oral health? What do you need to know to make the best choice? In this interview, Kelly Richardson, DDS answers your questions.

Closeup of Dr. Kelly Richardson, DDS, leaning out of office doorway

Are twice-daily flossing and brushing enough, or should I also use mouthwash?

If your mouth is healthy, daily flossing and twice-daily brushing are frequently all you need. You can certainly add an over-the-counter mouthwash to your oral care routine if you choose; it’s a matter of preference. For patients with gum disease, we may prescribe a medicated mouth rinse to help keep your mouth healthy.

Remember that using mouthwash is not a replacement for brushing and flossing, which are the most effective way to clean your teeth.

What should I look for in a mouthwash? Are they all the same?

Most importantly, you should always choose a product without alcohol. For years, many over-the-counter formulas contained alcohol. This can be drying to the mouth and could harm it in other ways. In one instance earlier in my career, I practiced in an area where many residents used a brand that contained 70% alcohol, and it caused quite a few patients to develop sores inside their mouths. They had to stop using the product altogether. The good news is that nowadays, many more brands without alcohol are available.

Of course, these days there are also many different formulas: fluoride mouth rinses for children with cavities; special formulations for people with xerostomia (dry mouth); and even whitening rinses. (These are not as effective as in-office whitening treatments, but they may help somewhat.) With that much variety, it’s important to read labels carefully.

If I use mouthwash, what are the possible risks to my teeth and mouth?

The most common risk is developing a dry mouth due to using an alcohol-based product. Obviously, you shouldn’t swallow your mouthwash either—a small amount could cause minor stomach upset, while a large amount could lead to more serious symptoms requiring medical attention. Also, holding a mouthful of any type of mouth rinse (with or without alcohol) in your mouth too long can do damage to the skin inside your mouth, so be sure to swish it and spit it out right away.

The prescription rinse known as chlorhexadine is effective for treating gum disease, but using this product for too long will cause it to stain your teeth. We usually limit patients on this rinse to two weeks of use.

How young is too young for mouthwash?

Because it’s important not to ever swallow mouthwash, we recommend that parents only allow children older than age 6 to use it. In any case, children should not use it until they can spit it out properly.

Can I safely use mouthwash with dentures, implants, and ALF appliances?

If you wear dentures, remove them before you use any mouthwash. Always clean your dentures separately as directed by your dentist. Using an over-the-counter mouth rinse with implants and ALF appliances does not present any risk.

How often should I use mouthwash?

Up to twice a day is fine. If we’ve prescribed a medicinal mouthwash for you, use it only according to the directions. All things in moderation!