THE SKINNY ON MOUTHWASHES
by Ted L. Huppert, D.D.S.
You know that really yucchy taste you have in your mouth when you wake up in the morning, that awful smell when you huff into the palm of your hand? Oh, yeah. So, you shuffle into the bathroom, uncap the mouthwash, take a swig right out of the bottle and swoosh it around, maybe gargle. You spit and huff again. Ahhh, that’s better. Okay, so your breath smells better and your mouth feels fresher, but has that mouthwash really done anything?
First, let’s talk about where that bad breath comes from. Most people think it’s from dirty teeth. And sometimes it is. But, for the average person with fair oral hygiene, it’s usually from the back one-third of the tongue. What makes the smell? Bad odors from the mouth are created by food debris and bacteria lodged in the surface of the tongue and frequently by gases that contain sulfur compounds, which are given off by decomposing dead skin cells from our gums, tongue, and the lining of our mouths. The smelliest is called cadaverine and its most common source is obvious from its name. Anyway, as these dead cells break down, they give off noxious fumes. That’s what you’re smelling and tasting.
Most mouthwashes are primarily water and alcohol with sweeteners, flavoring, and coloring. They do have a little antiseptic action, due mostly to the alcohol, which can run anywhere from twenty to thirty percent. But, in general, these only coat the inside of the mouth with pleasant-tasting, fragrant oils, usually mint or cinnamon. They only serve to mask the smell. They do relatively little to eliminate the cause of the malodor. One exception is Cepacol. It contains an effective antiseptic and still tastes good!
The most effective mouthwash you can get without a prescription is Listerine. It is over 20% alcohol, but the most important ingredients are aromatic oils: thymol, menthol, and eucalyptol. These are also called essential oils, not because they are absolutely necessary, but because they are the essence of their respective source herbs, thyme, mint, and eucalyptus. Listerine kills lots of oral bacteria on contact, not only the ones that cause bad breath, but also the ones that form plaque on the teeth. Rinsing with Listerine after brushing and flossing, morning and night, can keep your breath fresh and help control plaque and calculus (tartar) on the teeth. It’s a good product that does what it claims to do. There is also a Listerine specifically compounded for tartar control and, if you form tartar rapidly, you might want to choose it.
If heavy plaque and tartar build-up or tender and swollen gums are a persistent problem, your dentist can prescribe a mouthwash that contains a powerful antiseptic called chlorhexadine. These mouthwashes are available by prescription only. A one-minute rinse with these products will kill about 95% or more of all the bacteria in the mouth, and believe me, that’s a lot of bacteria. The chlorhexadine can stain your teeth, though, so you need to practice excellent oral hygiene to minimize staining. But, this staining polishes off and is a worthwhile compromise if you need a chlorhexadine product to keep your gums healthy. The health of the gums is primary to keeping your teeth for a lifetime.
Most over-the-counter mouthwashes, including regular Listerine, and chlorhexadine products all contain alcohol. Alcohol can dry the mouth, and dry mouth can contribute to tooth decay and gum irritation. If you are troubled with dry mouth or if you take medications that cause dry mouth, and lots of meds do, you should look for a non-alcohol mouthwash. Non-alcohol mouthwashes would include Crest ProHealth, Listerine ZERO, and Smart Mouth. There are also mouthwashes that are specifically for treating dry mouth. They contain mouth moisturizers and enzymes that help stimulate salivary flow. Commonly available ones are Biotene and Oasis. If you have a specific requirement in mouthwash, just take the time to read some labels.
There are also mouthwashes that contain fluoride, like Act, Fluorigard, and Listerine Total Care. These can be helpful in fighting cavities if you have a problem with frequent decay, but you should use those only if your dentist recommends them. If too much fluoride is swallowed, especially by young children, spotting or pitting of the developing permanent teeth, which is termed fluorosis, may occur, so avoid fluoride mouthwash for kids who can’t or won’t spit it out.
If you have a problem with persistent bad breath, it would be wise to see your dentist or physician. Some serious medical conditions, including chronic sinusitis, diabetes, and some cancers, can produce bad breath. So, it is important to discover the cause of bad breath and not just cover it up with a swish of minty freshness.
