Should I use mouthwash?

Dr. Mel Rosenberg

20.03.08, 10:32

Despite what most of us think (that mouthwash was invented just a century ago, and was using intimidating images to make people think they have bad breath), mouthwashes were actually invented several thousand years ago for breath freshening. The Chinese medicine, back in 2700 B.C.E., recommends using mouthwash for the treatment of gingivitis. Another concoction, suggested in the Jewish Talmud, consists of dough water, salt and olive oil. Several years ago I encountered someone who prepares a similar brew on a regular basis. Commercial mouthwashes usually contain a concoction consisting of flavor, alcohol, and antibacterial agent(s).
Several types of mouthwash have been shown to reduce malodor in clinical trials, including 0.2% chlorhexidine mouthrinses, Listerine and a two-phase oil:water mouthwash invented in this laboratory and marketed in Israel and the UK (Dentyl pH, as seen in the image above).

Active ingredients in commercial brands of mouthwash can include:

Essential oils:

  • Clove oil
  • Cinammon
  • Thymol
  • Menthol
  • Eucalyptol
  • Methyl salicylate
  • Hexetidine

Cationic agents:

  • Benzalkonium chloride
  • Chlorhexidine gluconate
  • Cetylpyridinium chloride

Preservatives:

  • Fluoride
  • Methylparaben
  • Domiphen bromide
  • Sodium benzoate
  • Enzymes 

Oxidizing agents:

  • Sodium chlorite
  • Hydrogen peroxide

General ingredients such as water, sweeteners such as sorbitol, Sucralose, sodium saccharine, xylitol (which doubles as a bacterial inhibitor).

In some mothwashes, a significant amount of alcohol (up to around 20%) is included, as a carrier for the flavor, to add "bite" and to contribute an antibacterial effect. The alcohol content in such mouthrinses might cause a person to fail a breathalyzer test after rinsing. There is another downside to using an alcohol-containing mouthwash – alcohol is a drying agent and may worsen chronic bad breath. Some assumptions were recently made of a possible carcinogenic character of alcohol used in mouthrinses, but no clear evidence was found. Commercial mouthwashes usually contain a preservative such as sodium benzoate to preserve freshness once the container has been opened.

Another thing to remember is that many commercial mouthwashes are quite acidic on the pH scale. If you have heartburn, acid reflux or acid indigestion, it is important to use a mouthwash with a neutral pH to avoid irritation.
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