Walk into any Walmart, Target, Walgreens, CVS, or any other store that caries dental hygiene products and shoppers will be inundated with different Mouthwash options.

You will see labels with advertisements like: Gum Health, Whitening, Cavity Fighting, Enamel Strengthening, and too many other options to list. On top of that, there will also be more brands then you can count on one hand and even more options within those brands to choose from.

So where should you start? Should you even be using mouthwash to begin with? Does it matter which one you choose? The list of questions and options goes on and on.

The goal of this post is to lay the foundational knowledge of if mouthwashes can improve your oral hygiene, and which types of mouthwash you may want to try. No product recommendations will be made in this post.

Let’s make this easy and start with some of the name brands and looking at their main active ingredients:

1. Listerine: If you look at their website they are currently offering multiple different options of mouthwash e.g. antiseptic, whitening, stain removing, e.t.c.
   • Focusing on their antiseptic brand, the main active ingredients are Essential Oils.
     • These are responsible for that ‘burn’ you feel if you have ever tried Listerine products.
   • What Does the Research Say? Multiple studies confirm that using a mouthwash such as Listerine with Essential Oils can help to lower your Plaque Index and levels of Gingivits when used for 6 months or more ^1,2,3
   • Should You Use It?: Your dentist may want you to use this product if you have plaque-induced gingivitis or periodontitis (Gum Disease).
   • Special Considerations: Listerine produces its Antiseptic Mouthwashes with Alcohol and without Alcohol, both variations were shown to reduce plaque and gingivitis². But if you have issues with dry mouth, you may want to choose the alcohol free product.

1. Crest: This brand has a ton of different options on their website
   • Whitening Products: Crest has multiple different whitening products with some different active ingredients in each
     • Sodium Hexametaphosphate: Studies do show that this ingredient is good for reducing stains on teeth ⁴
     • Hydrogen Peroxide: This ingredient has the ability to whiten enamel when used regularly ^5,6
   • Cavity Fighting/Enamel Repair:
     • Sodium Fluoride: This ingredient is capable of remineralization of tooth enamel with regular use ⁹
     • Great for the prevention of cavities
   • Gum Care Line Up:
     • Cetylpyridinium Chloride (CPC): Studies on this ingredient do show reductions in Plaque index and Gingivitis ⁷

1. Colgate:
   • On their website, they also advertise different mouthwashes that have the same ingredients as the Crest Products to help enamel and fight gingivitis: Cetylpyridinium Chloride, Sodium Fluoride
   • Interestingly, some of their mouthwashes also contain some Essential Oils similar to Listerine products which have been shown to reduce gingivitis.
   • Some Colgate mouthwashes advertised for Whitening also Hydrogen Peroxide.
     • Tetrapotassium pyrophosphate is also used.
     • I found one study that looked into this ingredient which showed positive effects against calculus, except it was used in a Toothpaste with mechanical brushing of teeth ¹⁰

1. Chlorhexidine Containing Mouthwashes:
   • This is a mouthwash that will be prescribed by your dentist if they feel you need a little extra help keeping the bugs/bacteria down in your gums to help prevent gingivitis and periodontitis.
   • Combined with Deep Cleanings from your dentist/periodontist, this mouthwash can help improve your gum health ¹¹
   • With prolonged use of this mouthwash, staining of teeth is possible so consult with your dentist if this is a concern/you begin to see staining ¹²

Final Thoughts:

This post is a basic summary of some of the ingredients in Popular Mouthwashes you may find in the Oral Hygiene section of a store. They do not replace Brushing, Flossing, and regular cleanings at your Dentist. The research shows that these products work, so feel free to add them to your cleaning routine. Consult your dentist if you have any questions about the use of these products, test them out and see which ones you like. Compare and contrast which brands are using which ingredients for whitening, gum health, and anti-cavity.

1. Gunsolley J.C.: Clinical efficacy of antimicrobial mouthrinses. J Dent 2010; 38: pp. S6-S10.
2. Lynch, M. C., Cortelli, S. C., McGuire, J. A., Zhang, J., Ricci-Nittel, D., Mordas, C. J., Aquino, D. R., & Cortelli, J. R. (2018). The effects of essential oil mouthrinses with or without alcohol on plaque and gingivitis: a randomized controlled clinical study. BMC oral health, 18(1), 6. https://doi.org/10.1186/s12903-017-0454-6
3. Serrano J., Escribano M., Roldán S., et al: Efficacy of adjunctive anti-plaque chemical agents in managing gingivitis: a systematic review and meta-analysis. J Clin Periodontol 2015; 42: pp. S106-S138
4. Térézhalmy G, Chaves E, Bsoul S, Baker R, He T . Clinical evaluation of the stain removal efficacy of a novel stannous fluoride and sodium hexametaphosphate dentifrice. Am J Dent 2007; 20: 53–58.
5. Jaime, I. M., França, F. M., Basting, R. T., Turssi, C. P., & Amaral, F. L. (2014). Efficacy of hydrogen-peroxide-based mouthwash in altering enamel color. American journal of dentistry, 27(1), 47–50.
6. Vaz, V., Jubilato, D. P., Oliveira, M., Bortolatto, J. F., Floros, M. C., Dantas, A., & Oliveira Junior, O. B. (2019). Whitening toothpaste containing activated charcoal, blue covarine, hydrogen peroxide or microbeads: which one is the most effective?. Journal of applied oral science : revista FOB, 27, e20180051. https://doi.org/10.1590/1678-7757-2018-0051
7. Gunsolley J.C.: A meta-analysis of six-month studies of antiplaque and antigingivitis agents. J Am Dent Assoc 2006; 137: pp. 1649-1657
8. Rahman, B., Alkawas, S., Al Zubaidi, E. A., Adel, O. I., & Hawas, N. (2014). Comparative antiplaque and antigingivitis effectiveness of tea tree oil mouthwash and a cetylpyridinium chloride mouthwash: A randomized controlled crossover study. Contemporary clinical dentistry, 5(4), 466–470. https://doi.org/10.4103/0976-237X.142813
9. Songsiripradubboon, Siriporn, Hidenori Hamba, Chutima Trairatvorakul, and Junji Tagami. 2014. “Sodium Fluoride Mouthrinse Used Twice Daily Increased Incipient Caries Lesion Remineralization in an in Situ Model.” Journal of Dentistry 42 (3): 271–78. doi:10.1016/j.jdent.2013.12.012.
10. Sowinski, J., Battista, G., Petrone, D. M., Petrone, M. E., DeVizio, W., Volpe, A. R., & Proskin, H. M. (2000). A twelve-week clinical comparison of two tartar control dentifrices. The Journal of clinical dentistry, 11(3), 76–79.
11. da Costa, L., Amaral, C., Barbirato, D., Leão, A., & Fogacci, M. F. (2017). Chlorhexidine mouthwash as an adjunct to mechanical therapy in chronic periodontitis: A meta-analysis. Journal of the American Dental Association (1939), 148(5), 308–318. https://doi.org/10.1016/j.adaj.2017.01.021
12. Celeste R. K. (2013). Oxygenating agents may inhibit tooth staining effect of chlorhexidine. The journal of evidence-based dental practice, 13(1), 9–10. https://doi.org/10.1016/j.jebdp.2012.12.003

The Author of this post does not assume any liability for any injury and/or damage to persons or property as a matter of products liability, malpractice, negligence, or otherwise, or from any use or operation of any methods, instructions or ideas contained. The foregoing parties will not be liable for any direct, special, indirect, incidental, consequential, or punitive damages as a result of the reader’s use of this information.