Shopping for mouthwash has become an increasingly confusing affair. In drugstores you’ll find shelf after shelf of rinses that claim to prevent bad breath, fight cavities and plaque (the sticky material that contains bacteria), whiten teeth, reduce dry mouth and even provide “advanced care” or “total care.”
There are two basic types:
Cosmetic rinses for breath freshening: The Food and Drug Administration (FDA) regulates them minimally, and the American Dental Association (ADA) does not evaluate them.
Therapeutic rinses: The active ingredients kill bacteria and reduce plaque and thus help protect against gingivitis, a form of periodontal (gum) disease. Regulated by the FDA, they may apply for the ADA seal, which certifies that the product works as claimed. The only nonprescription mouthwash with the ADA seal is Listerine and its generics (labeled “antiseptic” rinses), as well as rinses containing fluoride.
Keep in mind: No mouthwash can take the place of thorough brushing and flossing and regular visits to the dentist. In fact, poor oral hygiene and periodontal disease are major causes of bad breath. If you practice good oral hygiene, you may not need a mouthwash at all.
A mouthful of ingredients
Alcohol: This antiseptic, found in most Listerine rinses and generics, has antibacterial activity and helps prevent and reduce gingivitis and plaque above the gum line. It can, however, cause a burning sensation and be drying. Some researchers are concerned that long-term use of products with alcohol may increase the risk of oral cancer, but the ADA says alcohol rinses are safe. The FDA also says the combination of ingredients in Listerine mouthwash is “generally recognized as safe and effective.” Still, if you have a history of oral cancer or risk factors for it, such as smoking, the ADA says it may be prudent to avoid such rinses.
Antibacterial enzymes: Bacteria can be killed by many agents, including enzymes made in the human body. Some products (Biotène, for instance) contain enzymes such as lysozyme and lactoperoxidase (found in saliva), which may help reduce dry mouth.
Cetylpyridinium chloride: An ammonium compound that kills bacteria and inhibits plaque formation, this is particularly good at eliminating bad breath.