If you regularly use a mouthwash, here are some things you must know

Mouthwashes have become a staple in many daily oral health routines. Available in most supermarkets today they promise fresh breath and clean teeth. 

Despite this, questions have been raised about their potential impact on oral as well as overall health. Content creator Dr Rupy Aujla, recently spoke about his concerns about mouthwashes, referring to several studies that detail the adverse effects of their consistent use, on oral microbiome. 

“I, personally, have been using one, but that’s specifically at the request of my dentist and for a defined period of time. But what about general daily use? Is this really healthy? And are there any harms associated with it?” he captioned the reel. 

 

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A post shared by Dr Rupy Aujla (@doctors_kitchen) 

Long-term effects of consistent daily use of mouthwash on oral health and overall well-being

Dr Punit K Menon, dentist at Dental Lounge, Gurgaon, says, “Mouthwash reaches places that are hard for a toothbrush or even floss to reach, helps reduce plaque and gingivitis, gives fresh breath, and reduces risk of cavities due to the fluoride component of certain mouthwashes that help with strengthening enamel of teeth.” 

This leads to overall improved oral hygiene, he agrees. However, long-term use has some negative effects as well, including the alcohol content of antiseptic mouthwashes that can cause dry mouth and eventually bad breath, oral microbiome disruption, and, in some cases, prolonged use can mask underlying symptoms that may be indicative of other diseases or problems. 

Does an antiseptic mouthwash disrupt the oral microbiome and affect nitric oxide production? 

Dr Aujla mentions in his reel about a study that found that antiseptic mouthwash can disrupt the oral microbiome and affects nitric oxide production. Dr Menon says, “The oral microbiome is a complex ecosystem containing both beneficial bacteria, which aid in the breakdown of food for absorption by the body, and harmful bacteria that can negatively affect our oral health.”

Agreeing with Dr Aujla he says that antiseptic mouthwash, like those containing chlorhexidine, works by disrupting bacterial cell walls and membranes, inhibiting enzymes that are crucial for bacterial growth and reproduction and breaking the biofilm that bacteria creates in the oral environment. This antimicrobial action is effective against a wide range of bacteria present in the mouth, including both beneficial and harmful ones. 

“Some bacteria in the oral microbiome are crucial for converting dietary nitrate into nitrite, which is essential for the body to produce nitric oxide—a molecule important for cardiovascular health. However, the use of antiseptic mouthwash can reduce the population of these nitrate-producing bacteria, alter the oral pH potentially leading to a decrease in nitric oxide production and affecting cardiovascular well-being,” he confirms.

The alcohol content of antiseptic mouthwashes can cause dry mouth and eventually bad breath (Source: Freepik)

Differences in the potential health impact of using mouthwash once daily versus multiple times a day

Dr Menon stresses that the frequency of using a mouthwash can alter the balance of the beneficial and harmful bacteria in the mouth. “For mouthwashes whose main antiseptic agent is alcohol or chlorhexidine, frequent use can cause dryness, burning sensations, inflammation of the oral tissues, or alteration of the composition of saliva.” 

Prolonged use of antiseptic mouthwashes in large quantities can also have systemic effects depending person to person. These effects can include but are not limited to hypertension, intestinal health, and malnutrition. 

While short-term use may be beneficial for specific oral health purposes, such as reducing plaque or gingivitis, Dr Menon elaborates that the effects of prolonged and frequent use are less clear and may have unintended consequences. 

Alternative oral hygiene practices or products that can maintain oral health 

To maintain oral health without disrupting the oral microbiome or impacting nitric oxide levels, Dr Menon recommends the following practices: 

*Try non-alcohol mouthwashes that contain fluoride or antibacterial agents

*Opt for neutral pH toothpaste 

*Use electric toothbrushes with soft bristles 

*Use interdental brushes and water flossers to help reach hard-to-get-to places

*Go for regular dental check-ups

*Eat a  balanced diet 

*Oral probiotics

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