Is mouthwash important for dental health?
I am just wondering if mouthwash is absolutely essential for dental health?
I do not consider mouthwash an essential for a general audience for this reason: most mouthwashes DO NOT have the abililty to break up and remove plaque from the surfaces of the teeth.
The fundamental principle for oral home care is still thorough plaque removal from ALL surfaces of the teeth, even those areas that are not directly visible (such as in the interdental spaces in between the teeth).
Plaque is most efficiently removed using mechanical means such as a toothbrush, floss, interdental brushes etc. Most people will brush daily but interdental cleaning is still very neglected for the vast majority. Many patients use mouthwash in the misguided hope that it will replace interdental cleaning - it will NOT!
For certain groups of patients such as:
1) Those at high risk of decay
2) Those undergoing orthodontic treatment
3) Those with severe gum disease
4) After oral surgery (e.g. wisdom tooth removal, implant surgery)
5) Those with chronically dry mouth (from medication, Sjogren's syndrome, after radiotherapy to the head and neck)
6) Those with a condition called geographic tongue that may be painful
7) Those suffering from recurrent mouth ulcers
Certain types of medicated mouthwashes may be prescribed on the advice of your dentist as an additional measure IN ADDITION to daily brushing and interdental cleaning.
Some chlorhexidine-medicated mouthwashes do not taste pleasant, may cause taste disturbances and stain the teeth brown.
Another widely held belief is that mouthwash can freshen the breath.
However this effect is short-lived (especially if the source of the smell is an infection, or coming from another source such as the back of the nose or the throat).
Mouthwash is also believed to kill oral bacteria. Antibacterial mouthwashes are extremely popular for this reason. Most antibacterial mouthwashes have a very short duration of effectiveness and do not have the ability to persist in the oral cavity once the mouthwash is spit out.
Alcohol-containing mouthrinses may also cause peeling of the lining of the mouth and may trigger ulcers in certain individuals. There is increasing awareness that the key to good oral health may be linked to a healthy oral microbiome (resident good bacteria) and overuse of antimicrobial topical products may be inhibit these helpful microbes.
In short, if you do not have any of the oral conditions that I have listed above, it is unlikely that you will benefit from using a mouthwash regularly. Furthermore, most patients do not use mouthrinses correctly (such as rinsing out the mouth with plain water afterwards) which results in reduced effectiveness. Your efforts are better spent on developing a thorough brushing technique (I prefer electric toothbrushes), regular interdental cleaning and having your teeth professionally cleaned regularly.