Mouthwash is often recommended for use as part of a complete oral care routine to help clean up the areas of the mouth that a toothbrush and dental floss cannot reach. However, not all mouthwashes are created equal. Many over-the-counter mouthwashes contain alcohol, which may not be as beneficial for oral health as you may have been lead to believe.

When you rinse your mouth with mouthwash, you probably experience a burning sensation, followed by relief when you can finally spit it out and you are left with a minty breath. Some people even believe that the more it burns, the more effective the mouthwash is. Unfortunately, it appears that not only is alcohol not necessary for a mouthwash to be effective, it may even be detrimental to your oral health.

What is the Purpose of Alcohol in Mouthwash?

First, let’s discuss what alcohol is actually doing for you.

Research has shown that alcohol is added to mouthwash not for the purpose of killing bacteria, but rather to act as a carrier agent for the active ingredients like eucalyptol, menthol, and thymol. It is these active ingredients that are responsible for penetrating plaque. In fact, Crest, a very popular seller of mouthwash products has admitted this on their website as well.

Another study conducted by Werner and Seymour which analyzed the data of other clinical studies regarding alcohol versus other non-alcohol mouthwashes concluded that “the alcohol component of mouthwashes affords little additional benefit to the other active ingredients in terms of plaque and gingivitis control”.

So that burning sensation you feel when you are swishing mouthwash for 30 seconds? Turns out it’s not even needed.

Is Alcohol-Based Mouthwash Bad for You?

In addition to the fact that alcohol in mouthwash is not even needed, it actually brings with it some detrimental effects that you may not be aware of.

Alcohol and Bacteria

Since there is only a 18-26% concentration of alcohol in mouthwash, along with the fact that it is not added for the purpose of killing bacteria but as a carrier agent, there is a possibility that it does not destroy all of the bacteria in your mouth. But even assuming that it does, that’s not necessarily a good thing.

There are bad bacteria in your mouth, but there are also good bacteria too. If alcohol is as potent as many people assume, then it would completely wipe out all of the bacteria good or bad. You are exposing yourself to the risk that when the bacteria returns, the hazardous bacteria could multiply faster and cause an infection.

Dry Mouth and Bad Breath (Halitosis)

You’ve probably experienced this personally – that after you use mouthwash your mouth produces significantly less saliva. This is because alcohol is a drying agent, and encourages bacterial growth since there is less saliva around to wash the bacteria off your teeth.

As bacterial activity increases due to mouthwash use, it will produce a foul odor which will ironically worsen your breath. So if the reason you used mouthwash is to freshen your breath up, know that it produces the opposite effect.

Link to Cancer

Some studies hypothesized that alcohol mouthwash is carcinogenic (cancer-inducing). However, it is not conclusive and there is no consensus on this in the scientific community. The reason why it was brought up in the first place is because many smokers and heavy drinkers often use mouthwash to try to mask their breath. These people were already at a higher risk of developing oral cancer, so it may not necessarily be caused by alcohol-based mouthwash.

Alcoholism

People who have struggled with alcohol addiction in the past or are currently struggling to stay sober should stay away from alcohol-based mouthwash. Since there is a significant amount of alcohol content in the mouthwash, it may lead to temptation and it is better to not expose yourself to that in the first place for the other reasons listed above.

Alternatives to Alcohol-Based Mouthwash

At the end of the day, there is a strong case against using alcohol-based mouthwash. For mouthwash that is effective at lowering your risk of developing gingivitis and cavities, consider using therapeutic mouthwash or fluoride mouthwash instead.

Therapeutic Mouthwash

Therapeutic Mouthwashes contain active ingredients that eliminate bacteria which helps reduce gingivitis, cavities, plaque, and bad-breath. Therapeutic mouthwashes may contain fluoride, which is effective at protecting the tooth enamel from tooth decay.

A select few therapeutic mouthwashes need a prescription, but most mouthwashes can be purchased over-the-counter. Consider asking your dentist for recommendations on what kind of mouthwash would be most beneficial for your oral health.

When choosing a mouthwash, you should look for mouthwashes that have the American Dental Association (ADA) seal of acceptance, which means the product has been rigorously tested and proven to be effective and safe for use.

Fluoride Mouthwash

Fluoride mouthwashes don’t remove plaque, but they are effective at guarding your teeth against acids created by bacterial plaque which can lead to tooth decay. Many toothpastes contain fluoride as well, however fluoride mouthwash should be used as a substitute to brushing.

The fluoride found in a fluoride rinse can combine with the enamel coating of your teeth, providing better protection against cavities in those who are susceptible. Fluoride is important for adults, but it is even more essential for children, especially those who struggle to brush their teeth or have bad breath.

Not only can fluoride prevent and even reverse the effects of early stage tooth decay, it can bolster tooth enamel which lets teeth damaged by acid from bacterial plaque to remineralize themselves.

Therapeutic mouthwashes often have fluoride in them. With a prescription, you can get mouthwash with extra fluoride in it.

Cosmetic Mouthwash

Cosmetic mouthwash only provide superficial benefits. They can temporarily reduce bad breath by masking the odor with a pleasant aftertaste and smell, however they do not reduce the amount of bacteria or plaque in your mouth. They may be able to help wash away food particles that are stuck on teeth.

For the most part, a cosmetic mouthwash will not decrease one’s chances of developing gum disease and cavities. You have to be aware of what your mouthwash contains. Cosmetic mouthwashes do not contain fluoride unless the label states that it does. If you want to add a mouthwash into your oral care routine, make sure you are aware of their intended purpose.

Some only freshen breath, and can be used just prior to a social engagement to mask bad breath caused by food. However, it will not provide any protection to one’s teeth and gums. Others actually have an anti-cavity effect, and some have bacteria-eliminating ingredients that reduce the accumulation of bacterial plaque.