Bad breath or halitosis is caused by the breakdown of food and various other factors that include dry mouth, poor oral hygiene, infections, use of tobacco, and dieting.

When you go to a store, you will find shelf after shelf stacked with mouthwashes, making it difficult for you to decide which one is suitable for your needs.

An addition of mouthwash in your oral hygiene routine will give great results. But do you know how to choose the best mouthwash for bad breath or halitosis?

A typical mouthwash may or may not have ingredients such as alcohol, Cetylpyridinium chloride, fluoride, chlorhexidine, essential oils, etc.

It is essential to know about them and look for them in the label of the container.

Why Use Mouthwash?

Mouthwashes help in reaching areas where your toothbrush can’t reach. It helps to reduce the risk of dental cavities and gum disease.

Just like toothbrushes, dental floss, and water flossers, your mouthwash can help in the following ways –

  • Reduces plaque
  • Prevent or control tooth decay
  • Prevent or minimize gingivitis
  • Keeps your breath fresh

How do mouthwashes work?

Mouthwashes are designed to eliminate halitosis in two ways –

  • Firstly, they kill the bacteria responsible for bad breath. These therapeutic mouthwashes prevent bad breath for as long as eight hours.
  • Secondly, they mask the foul odor of your mouth. This method is less effective and the effects last no more than thirty minutes.

Types of mouthwashes

Based on their cosmetic and therapeutic uses, mouthwashes have two main types –

Cosmetic mouthwashes

Cosmetic mouthwashes work by masking the odor, rather than working on the elimination of halitosis. It is a quick fix for fresh breath. But it doesn’t reduce the risk of other dental problems.

Many youngsters use it before a date or a job interview.

Therapeutic mouthwashes

You can use therapeutic mouthwash for the long run. These mouthwashes help in the elimination of your harmful bacteria that cause dental problems.

The active ingredients present in them help in fighting bacteria, which results in plaque reduction and protection from gingivitis.

Ingredients to look for in a mouthwash

A mouthwash contains the following ingredients –

Chlorhexidine

Chlorhexidine-containing mouthwashes with a concentration of 0.2 percent are most commonly used in oral healthcare.

They are considered to be a gold standard antiplaque agent with bacteriostatic and bactericidal properties. (1)

Chlorhexidine mouthwashes are also used in the management of oral ulceration and in the oral care of physically or mentally disabled patients who are unable to practice adequate daily oral hygiene.

The common side effects include stubborn brown staining of teeth and oral appliances, including dentures, dysgeusia, dryness and burning sensation of the oral mucosa.

Alcohol

It is an antiseptic, solvent and preservative which help in preventing and reducing gingivitis.

The antibacterial property fights off the germs in your mouth. In some cases, they may cause burning sensations and dryness.

Researchers are concerned about the risk of oral cancer with long term use of products with alcohol. But according to ADA, alcohol rinses are considered safe to use. (2)

You must avoid alcohol-based rinses if you have a history of oral cancer or have other risk factors such as smoking or tobacco use.

Cetylpyridinium chloride

They exhibit a broad spectrum of antimicrobial agent that promotes gingival health.

It also exhibits the antibacterial property equivalent to chlorhexidine that kills bacteria by altering bacterial metabolism which inhibits cell growth. (3)

They are non-toxic and non-irritant with high bioavailability.

Essential oils

Antimicrobial oils such as thymol, menthol, and eucalyptol are bacteriostatic and mask the sulfides which are responsible for your bad breath. They provide a fresh feel in your mouth. (4)

They are also necessary to cover the non-pleasant taste of other ingredients present in mouthwash.

Fluoride

A familiar ingredient from your toothpaste which helps to protect your tooth enamel by repelling sugars, acids, and bacteria. They have the best anti-cariogenic property.

The most common form of fluoride used in mouthwashes is aisstannous and sodium fluoride. They promote the remineralization of enamel.

You don’t need a fluoride rinse if you use fluoridated toothpaste and consume fluoride containing water unless you are prone to caries.

Hydrogen Peroxide

They are present in teeth whitening mouthwashes. (5) It helps in soothing mouth ulcers and disinfects your mouth. It is often used in the short term to treat acute necrotizing ulcerative gingivitis.

Due to its low pH, its long term use might increase the risk of dental erosion.

Other ingredients

Heavy metal salts (e.g., zinc chloride)

Reported to inhibit the growth of dental plaque and combat bad breath by neutralizing the sulfur gases in the odor. They are also responsible for inhibiting bacterial growth.

Mouthwashes containing zinc offer a long term solution from bad breath.

Sanguinarine

Extract of the bloodroot plant (Sanguinaria Canadensis). They have shown to exhibit antioxidant, antimicrobial and anti-inflammatory properties.

They help in suppressing bacterial enzymes and are useful in treating supragingival plaque.

Sodium benzoate

It is a preservative and an anti-microbial agent that alters glycolytic potential of plaque biofilm formed in your mouth.

They disperse the carbohydrates, fats, and proteins which weakens the plaque attachment to the tooth surface.

Sodium bicarbonate

The bacteria present in your mouth produce acids which are neutralized by this ingredient. Sodium bicarbonate increases the salivary pH of your mouth.

Sodium bicarbonate containing mouthwashes are highly recommended in patients with xerostomia.

Sodium chloride

Saline is known to show antiseptic and cleaning properties. They loosen the food debris in your oral cavity, for easy cleaning of your mouth.

Saltwater mouthwashes encourage the drainage of pus present in cases of dental abscess in the mouth. They are recommended after dental extractions and oral surgeries.

Triclosan

It is used as a topical antimicrobial agent that delays plaque maturation. They exhibit excellent antiseptic and anti-inflammatory properties.

They inhibit prostaglandins and leukotrienes, which are mediators of inflammation. They also increase the binding ability of your mouthwash to the oral mucosa which prolongs the effects.

Things to note

Make sure you read the instructions carefully before using – Here are some important points:

  • Always check for the ADA seal on the bottle before buying. The seal means that the product is tested and shown to be safe to use.
  • Some products recommend diluting the mouthwash before use. (Check the label!)
  • Rinsing immediately after a meal helps to inhibit bacteria growth and bad breath.
  • Avoid eating or drinking for at least 30 minutes after using a fluoridated mouthwash. It gives the fluoride more time to strengthen your teeth.
  • Mouthwashes work best when you brush and floss before using them as toothpaste may deactivate and wash away the ingredients and thus reduce the effects of mouthwashes.

Children and mouthwashes

Mouthwashes are not recommended for children under six years of age because their skills are not enough to keep them from ingesting the mouthwash.

You must avoid alcohol-based mouthwashes in older children as well. Mouthwashes containing high levels of fluoride may cause fluorosis in developing teeth.

Remember, mouthwash is great for your mouth, but not for your stomach!

Takeaway

A rinse with mouthwash cleans all non-accessible surfaces of your oral cavity that reduces the bacterial growth in your mouth.

The effectiveness of a mouthwash depends on the ingredients. You must choose the bottle correctly keeping in mind the above points. You must follow the instructions carefully.

No mouthwash can ever take the place of thorough brushing and flossing or regular visits to the dentist. If you practice good oral hygiene routine, you may not need a mouthwash at all!

The effectiveness of a good mouthwash that can curb bad breath depends on its ingredients such as Chlorhexidine, essential oils, fluoride, etc.