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The Truth About Mouthwash
Written By : Mark Rosenberg, MD 
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Most of us have a bottle of mouthwash in our medicine cabinets or on our bathroom counter. Maybe you use yours everyday or simply keep it around for those times when you need a quick breath freshener without having to pick up your toothbrush. Although the common belief is that mouthwash kills bad breath, experts have conflicting arguments about the benefits of mouthwash, or lack thereof. It's time to sort through the evidence and learn the truth about mouthwash once and for all.

Do You Know Your Mouthwash?

There are two schools of thought when it comes to formulating mouthwash. One style contains a high percentage of alcohol. For example, Listerine contains 26.9% alcohol, which is 5 times more than most beers and twice as much as wine.

Contrary to popular belief, the alcohol in such mouthwashes does not kill the bacteria responsible for bad breath. Rather, the alcohol is used as a carrier of essential oils, which are the active ingredients in the formula. In the case of Listerine, eucalyptol, menthol, methyl salicylate and thymol dissolve in the alcohol so they can reach your gums and effectively target plaque.

The problem with alcohol-based mouthwashes, argue some critics, is that alcohol is known to dry out the mouth. People with dry mouth are more prone to bad breath because they do not have enough saliva available to naturally wash away the bacteria, which release mouth odors. While dry mouth seems like a valid concern, members of the American Dental Association have noted that alcohol-containing mouthwashes do not exacerbate bad breath.

Research supports this claim. One study showed that people who already suffered from dry mouth who rinsed with Listerine threes times a day did not experience any additional dryness.

There may, however, be a more pressing problem with alcohol-based products. They can be a danger to children, who may be curious enough to drink such products. If there are children in your home, you might consider using an alcohol-free mouthwash, such as Crest Pro-Health.

Do They Really Work?

Regardless of what formula you choose, the question about mouthwash remains: Do they really work?

It is estimated that 25% of Americans suffer from chronic bad breath. While Listerine and various other products may be effective for preventing conditions like gingivitis, they do not kill bacteria in the mouth. Bad breath is the result of sulfur compounds released by bacteria. Everyone collects bacteria throughout the day. People with cavities or swollen gums have an additional challenge, however, because there is more damaged tissue where bacteria can grow. Studies have demonstrated that ingredients chlorine dioxide and zinc are effective at neutralizing some mouth odors.

To fight bad breath at its source, you need to get rid of bacteria. Unfortunately, mouthwash alone will not accomplish that goal. Experts suggest that twice or even three times daily brushing and flossing is the best defense against bacteria. Using a tongue scraper to remove additional bacteria is highly effective for many people with chronic bad breath. When you brush, floss or scrape, you are physically removing the odor-causing bacteria. Mouthwash may promote healthy gums and provide a fresh clean feeling, but it does not eliminate bacteria.

The final verdict?

If you enjoy using mouthwash in addition to regular brushing and flossing, there is no need to change your routine. If you are struggling with bad breath, you should focus your efforts on physically removing bacteria by brushing, flossing and any other solutions recommended by your dentist. Mouthwash can indeed mask and even neutralize unpleasant odors, but it will not solve the problem on its own.

Mark Rosenberg, M.D.
Institute For Healthy Aging

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