Is Mouthwash Bad for Your Health?

Is mouthwash bad?

Mouthwash, often called an “oral rinse” or “mouth rinse,” usually contains antibacterial components to help clean between teeth, along with flavoring agents. Some varieties include alcohol as an inactive ingredient, while others are formulated without alcohol.

For certain individuals, mouthwash can produce uncomfortable side effects. These unwanted effects may outweigh the advantages of using an over-the-counter oral rinse as part of a daily regimen. Some people also worry about the artificial colors and flavors present in particular mouthwash brands.

That being said, mouthwash isn’t inherently harmful. Let’s review the possible side effects of mouthwash and what to consider to use it safely.

Side effects of alcohol-based mouthwash

Alcohol often serves as a preservative and a carrier for other active ingredients in mouthwash rather than acting primarily as an antiseptic.

Not every user will experience all of the listed side effects, and different formulations are more or less likely to produce specific reactions.

May cause or aggravate canker sores

Sodium lauryl sulfate (SLS) is an ingredient found in some toothpastes and oral rinses to create a foaming effect in the mouth.

If you’re susceptible to canker sores, using an oral rinse (or other oral care product) that contains SLS may trigger an outbreak or intensify existing sores. Individuals undergoing chemotherapy may also notice similar sensitivity.

If you lack these sensitivities, you probably won’t experience this particular side effect.

May cause dry mouth

Xerostomia, commonly called dry mouth, describes a condition in which salivary glands don’t produce enough saliva to keep the tongue moist and protect against cavities.

An oral rinse containing fluoride may actually be advised if you have dry mouth, according to the American Dental Association. However, an alcohol-containing mouthwash can worsen dry mouth symptoms.

May cause burning or pain when used

Some users appreciate the tingling sensation from alcohol-based mouthwash, but others find it to be a burning pain.

Certain mouthwashes have alcohol concentrations up to 25 percent, which can make the sensation more intense.

Side effects of alcohol-free mouthwash

Some mouthwash side effects are unrelated to whether alcohol is present in the formula.

May disrupt your healthy oral microbiome

Any kind of mouthwash, whether alcohol-free or alcohol-based, can reduce the number of bacteria in your mouth.

While certain oral bacteria contribute to cavities and bad breath, other bacteria are part of the oral microbiome that helps break down food and supports healthy teeth and gums.

Regularly eliminating a large proportion of oral bacteria is not advisable, so milder antiseptic options may be a better choice.

May cause teeth staining

The most frequently reported side effect of mouthwash use, according to a review  published in 2019, was tooth staining.

Mouthwash containing chlorhexidine (CHX), which typically requires a prescription, is more prone  to cause temporary staining of teeth after use.

Mouthwashes with vivid dyes are more likely to leave stains than dye-free alternatives.

May be associated with increased cancer risk

Mouthwash can also include synthetic components that have been linked in some studies to a modestly higher risk of certain cancers.

A 2016 study  found that regular mouthwash users might have a slightly elevated risk of head and neck cancers compared with never-users.

Much more research is necessary to determine whether this association is causal and, if so, which ingredients are responsible.

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Signs that you’re overusing mouthwash

It is possible to use mouthwash excessively.

Most nonprescription mouthwashes recommend using the product twice daily, along with brushing and flossing. Some people use mouthwash more frequently to freshen breath or get that “clean mouth” feeling between meals.

You should reduce or stop mouthwash use if you notice any of the following symptoms:

• ongoing or inflamed canker sores
• gum bleeding when using your mouthwash
• dry mouth symptoms
• pain or sensitivity when brushing after mouthwash use
• tooth staining

Who shouldn’t use mouthwash

Children under 6 years old should not use mouthwash, and those over 6 should be supervised when using it, per the American Dental Association.

If you have mouth sores, a weakened immune system, or are undergoing chemotherapy, you may want to avoid mouthwash.

If you’ve had an allergic reaction to any mouthwash ingredient (such as flomenthol, xylitol, or SLS), read labels carefully to avoid products that could trigger irritation.

Is mouthwash necessary?

Mouthwash offers certain oral health benefits. However, the American Dental Association recommends choosing formulations that carry its seal of approval.

Over-the-counter mouthwash can:

• freshen breath and address halitosis
• help lower the risk of gingivitis (gum disease)
• reduce plaque buildup to help prevent cavities
• make teeth appear whiter

Still, no mouthwash replaces regular brushing and flossing twice daily, which remain the cornerstone of good oral hygiene.

Alternatives to mouthwash

There are options other than mouthwash. Brushing and flossing twice daily have stronger evidence of benefit and fewer potential adverse effects.

You may also ask your dentist about prescription oral rinses. These rinses contain higher concentrations of specific active ingredients and can be effective for short-term treatment of particular oral issues. Prescription rinses can be used for:

• dry mouth symptoms
• gum disease prevention
• relief from mouth ulcers or canker sores
• preventing infection and dry socket after a dental extraction or other oral surgery

Takeaway

Mouthwash can cause some unpleasant side effects. Some of these occur only with alcohol-containing formulas or with specific ingredients.

Overall, mouthwash is not broadly harmful to your health. You can include it as part of a solid oral hygiene routine or choose not to use it—largely a matter of personal preference.

If you have persistent bad breath, concerns about plaque and gum disease, or want to improve your oral health, consult your dentist.