Do you use mouthwash to keep your breath fresh and protect your teeth and gums? If not, should you? Which mouthwash is best? Are any mouthwashes actually bad for your teeth? Can children use mouthwash?

These are just a few of the questions my patients ask me every day. Today I’ll try to teach you a bit about the history of mouthwash, as well as share my professional opinion on whether you should use mouthwash or not and offer some insights into the advantages of a few different types of mouthwash available today.

Mouthwash Throughout History

Did you know that people have been using mouthwash for almost 5000 years? Ancient mouthwashes were usually made from plants and other natural ingredients. As early as about 3000 BC, people in China were using saltwater rinses to treat gum infections and irritation.

The ancient Greeks and Romans used a variety of mouthwashes to help keep their teeth clean. Hippocrates, who you might know as one of the earliest doctors and as the originator of the Hippocratic Oath, used a mixture of vinegar and salt as a mouthwash. It probably didn’t taste that great, but people at the time loved it!

A bit later on, Native American tribes discovered that they could use local plants to create a mouth rinse that would make their sore throats heal faster and help their children feel better while teething. They probably used some mix of salt and clove oil-- both of which are found in modern natural mouthwashes.

Today’s Mouthwash

Until the early 1900’s, mouthwash wasn’t really that common. Many regions had their own folk recipes for homemade mouthwash, but there weren’t many companies making and selling commercial mouthwashes.

The most commonly known mouthwash, Listerine, was created in the late 1800’s and was originally used as an antiseptic to reduce infections after surgery. It wasn’t a very popular product for almost 50 years.

Then in the 1920’s, Listerine was advertised as a cure for chronic bad breath (also known as halitosis). Sales increased by over 7000% in less than a decade and from there more and more mouthwashes came onto the market.

Today, when we go to the drugstore, there’s an absolutely incredible variety of mouthwashes available to us. Which one, if any, should you use?

Keep reading to find out.

Should You Use Mouthwash?

I am pro-mouthwash for most people, especially those who suffer from gum disease.

Let’s face it: most of us could be doing a better job brushing or flossing (or both), so mouthwash could provide some benefit for most people, depending on the type of mouthwash and the type of dental problems the individual deals with.

Recently, I came across an article in the June 2015 issue of the Journal of the American Dental Association (JADA) that studied mouthwashes containing essential oils, like Listerine. The article revealed that there have been multiple published scientific studies that show some benefit to using essential oil-containing mouthwash when it comes to fighting plaque and gingivitis (mild gum disease).

I found that article to be a pretty compelling argument for the use of Listerine, or similar mouthwashes, for people with gum disease.

Speaking of Gum Disease

At my practice, we often prescribe a chlorhexidine-containing mouthwash to patients who receive treatment for periodontitis -- a more advanced form of gum disease.

This prescription-strength mouth rinse helps control bacteria that may be stirred up during the treatment. It also helps gum tissue to heal more quickly following treatment. Generally, we recommend patients use a prescription mouthwash for about 2 weeks and then return to their everyday mouthwash.

Which Mouthwash Should You Use?

For everyday use, I recommend a fluoride-containing mouth rinse for people who have a history of developing cavities or for those who are at high risk of developing cavities in the future (like major soda drinkers or people with dry mouth). For people with gum disease, I recommend an anti-plaque or anti-gingivitis rinse.

My favorite brand of fluoridated mouthwash is made by ACT. Crest ProHealth and Listerine are my favorite brands of rinse that can improve gum health.

The downside of most commercial mouthwashes is that they contain alcohol which can be harmful to people with dry mouth. The alcohol dries out the mouth even more, increasing the risk of cavities and exacerbating the symptoms of dry mouth, which can be quite painful.

If you suffer from dry mouth, I recommend you use an alcohol-free mouthwash like Crest ProHealth or Listerine Zero. ACT makes a great alcohol-free mouthwash that is specially formulated to help with dry mouth. Biotene also makes a mouthwash designed to help specifically with dry mouth symptoms (no fluoride though).

Interestingly, the alcohol-free versions of rinses designed to treat gum disease are not supported by the research as being as effective as their alcohol-containing counterparts. So if you suffer from both gum disease and dry mouth, ask your dentist about which mouthwash is best for you.

When Should You Use Mouthwash?

Adults probably don’t need to use mouthwash more than once or twice a day. Too much mouthwash can wash away the saliva in your mouth, upsetting the pH balance, allowing bacteria to grow and increasing your risk of cavities and gum disease.

Fluoridated mouthwashes work best when they’re not washed away by water, so I recommend using those right before bed, after brushing and flossing. Just don’t overdo it and make sure you follow the directions on the bottle.

Can Kids Use Mouthwash?

If your children are under 6 years old, they should only use a mouthwash that is prescribed by a doctor or dentist and only under your direct supervision. Commercial mouthwashes, even those designed for children, aren’t meant to be swallowed and young kids may have a hard time understanding that.

Older kids and teens can benefit from mouthwash (especially the fluoride-containing, anti-cavity variety), but they should only use it under adult supervision, just to be safe. If you’re worried that they may not understand how to swish and spit out mouthwash, they can dip their brush in mouthwash and scrub for a bit.

Older children with braces can benefit from fluoridated mouthwash that can protect their teeth from cavities and can also wash away bits of food that are stuck in places that are hard to reach with a toothbrush.

My Final Thoughts

Remember: Mouthwash isn’t a substitute for great home dental care.

No mouthwash can replace good brushing and flossing habits. No matter what mouthwash you choose to use, continue to take great care of your teeth by brushing and flossing regularly and avoiding excessive snacking.

Do you have more questions about which mouthwash is right for you? Leave them in the comments below or ask me during your next dental cleaning.

Photo Credits: Mike Mozart, John Loo, Twitchery, jchwhite, epSos .de