Chapter 8- Mouthwashes

Most mouthwashes you can chuck in your trolley at the supermarket are colored water with a bit of antiseptic and they won’t do you any good at all.

There are specific mouthwashes for specific purposes with specific ingredients which, if you need one for whatever reason your dentist will ‘prescribe’ it [ a prescription doesn’t necessarily involve a bit of paper, it means in medical speak, what you have been advised to do].

Some people like to use a mouthwash for whatever reason- perhaps they are going out straight from the office and just want a bit of a refresh all sorts of reasons.

There are a few things to say;-

Don’t use it when you clean your teeth, there is no point in leaving the toothpaste on your teeth to toughen up the outside of your enamel and then sloshing it all off with mouthwash which probably has a lower concentration of fluoride. Use at another time of day. I usually get my patients to use it after lunch. If you have big gaps in between your teeth in which your sandwich will collect, stick a little brush through first. If you are applying something to a surface it’s no good if it’s covered in debris.  Keep a little bottle in your handbag, a bottle in your car/ van door pocket etc.

A mouthwash is no substitute to thorough oral hygiene, it won’t make up for the inadequacies in your technique. That’s a bit like wearing dirty underwear and disguising the stale smell with heavy perfume! A mouthwash is an adjunct to thorough cleaning not a replacement.

Choose a mouthwash without alcohol. Alcohol will dry your mouth out leading to bad breath. There is also a very small theoretical risk that it will increase the risk of mouth cancer especially if you smoke.

There is no real evidence that pre brush rinses have any beneficial effect on efficiency of cleaning.

Keep it in your mouth for long enough, slosh it between your teeth and balloon out your lips so you get it everywhere. Keep it in your mouth for a minute, time it, count 60 elephants, recite a favorite poem in your head, go for a wee and wash your hands that will take at least a minute. If you don’t keep it in your mouth for long enough it’s not going to have the desired effect, you might as well save your money and not bother!

You may have been prescribed a high dose fluoride mouthwash by your dentist because; – you have a lot of early cavities, you have a brace [orthodontic appliance], you have a lot of exposed roots which are vulnerable to caries attack, you have poor eyesight or severe arthritis so you do your best but efficient cleaning is very difficult, you have a dry mouth because of reduced protective saliva from drugs you may be on and lots of other medical and dental reasons. You must use it if you have been advised to it’s a medicine.

You may have been prescribed a mouthwash specifically to help with the treatment of gum disease [periodontal disease] most probably either Corsodyl or another Chlorhexidine containing mouthwash or for more long term maintenance, one containing essential oils. Similarly use it if you have been advised to, for the length of time advised, at a time of day advised and just as important stop when told to. If you have been advised a mouthwash with essential oils it will have alcohol in it as the alcohol is a solvent for other ingredients and it enhances the effect of the essential oils.

[The timing for Corsodyl is very important as sodium laurel sulphate a detergent ingredient in most toothpastes reduces its effectiveness].

If you can’t remember the regime advised at the dental surgery write it down or phone for advice.

If you haven’t been advised a particular mouthwash as a ‘medicine’ choose one that contains fluoride and is alcohol free.

There is some evidence to suggest that mouthwash unless advised otherwise in the short term should only be used once a day. Why? Because mouthwashes are indiscriminate killers of bacteria, they can’t tell the good ones from the bad ones. We know that some of the bacteria present in your mouth are protective against Type 2 diabetes.

So as a general rule of thumb unless told otherwise-

Fluoride containing, alcohol free, once a day, 1 minute, at a different time to brushing.

Halitosis/ Bad breath.

There is a chapter on bad breath further on but suffice it to say unless you have temporary bad breath from eating a lot of garlic or spicy food there will be a good reason for your problem. It is most likely dental [sometimes medical]. Go and see your dentist, you need to have the cause or causes diagnosed and you need help, advice and treatment.

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