Mouthwashes

Mouthwashes in Oral Hygiene

Mouthwashes are solutions for rinsing the mouth and gargling, as an adjunct to maintaining oral hygiene. Good nutrition, brushing teeth, and flossing in between teeth are the primary defenses against plaque and tartar build-up, which potentially could lead to:

  • halitosis
  • dental caries
  • gingivitis
  • periodontitis

A plethora of mouthwashes are available, each meeting a specific dental need. It is important to correctly match the properties of a specific mouthwash with the dental issue that needs attention.

Ingredients in Mouthwash

Mouthwashes are formulated with active ingredients designed to accomplish varied goals in dental hygiene, such as:

  • to prevent dental caries
  • kill caries-causing bacteria
  • to freshen breath
  • to kill bacteria involved in halitosis
  • to protect teeth against plaque formation and gingivitis
  • to eliminate tooth stains

Active ingredients with antimicrobial activity include:

  • triclosan
  • benzalkonium chloride
  • chlorhexidine digluconate

Other additives include:

  • sanguinarine to control mouth odor
  • hydrogen peroxide as an oxidizing/antiplaque agent
  • fluoride to counteract the formation of dental caries
  • benzydamine for analgesic activity
  • xylitol to stimulate salivary gland activity and thereby prevents mouth dryness

Mouthwash and Children

Mouthwashes are a form of medication and, as such, a specific mouthwash may or may not be appropriate for a child.

Because of the risk of swallowing and ingesting a mouthwash, instead of spitting it out, children under six years of age are not candidates for mouthwashes.

Of particular concern are mouthwashes containing fluoride and alcohol. Dental caries (tooth decay) begins with bacterial metabolic activities of food debris on the surface of a tooth, resulting in the generation of acids which eat away and demineralize tooth enamel.

Fluoride, on the other hand, promotes remineralization of enamel with fluorapatite and fluorohydroxyapatite, making it resistant to acid attack. Ingestion of fluoride-containing mouthwash by preschool children has been reported. This may result in dental fluorosis (a mottled enamel).

Mild fluorosis, the most common form of fluorosis, is characterized as opaque paper white areas scattered irregularly over the tooth and may be of esthetic concern. With over the counter fluoride rinses, it is important that the child is able to follow the directions of expectorating.

Alcohol, added to some mouthwash as a preservative, or a solvent for a flavor, has antimicrobial properties. Alcohol-containing mouthwashes should be kept out of the reach of children. To be safe, look for mouthwashes that kill germs and specify alcohol-free.

Choosing a Mouthwash

When selecting a mouthwash for a child older than six years of age, focus on a product with therapeutic properties, rather than a mouthwash formulated solely for cosmetic properties.

For example, a cosmetic mouthwash would be one which solely freshens breath without eliminating the cause of the dental issue.

A therapeutic mouthwash, for example, may contain fluoride both to reduce tooth decay on tooth enamel and to kill germs. However, even here, the parent should understand that the mouthwash is not a replacement for brushing and flossing. Mouthwashes with sugars should be avoided.

For more information about mouthwashes or to learn more about our pediatric dentistry practice located in New York City on the Upper East Side please call hospital and university trained pediatric dentist Dr. Sara Babich at: 212.988.4070

Page Updated on May 30, 2023 by Dr. Sara Babich, DDS (Pediatric Dentist) of Pediatric Dentistry

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