If your dentist has just instructed you to start using a mouthwash, you might be flustered by all the options. When you reach the mouthwash aisle, you see row after row of different colors and promises, like “prevents cavities” and “freshens breath.”
They’re all the same, you might think, so you assume it all comes down to picking the best flavor: peppermint, spearmint, or cinnamon.
Here’s the thing: You’ll only get the results you want if you’re using the right mouthwash. “There is no holy grail of mouthwashes, and most should be used in conjunction with other oral hygiene methods,” says Dr. Ronald Konig, DDS, of the Konig Center for Cosmetic & Comprehensive Dentistry in Houston. “The first consideration is: What is the purpose of the mouthwash?”
Mouthwashes are formulated to address different oral health problems, such as gum disease, cavities, sensitivity, bad breath, and dry mouth. There’s no “best” mouthwash, but to pick the rinse that’s most appropriate for your dental health needs, keep these tips in mind:
1. Got dry mouth? Choose alcohol-free.
“Alcohol is the most common ingredient in mouthwashes, but some people may prefer to avoid alcohol because it is an irritant,” says Dr. Alan McDavid, DDS, of Stonebridge Dental. “For someone who already suffers from dry mouth from medications or cancer treatment, alcohol can cause further dryness and irritation to the tissue in their mouth.”
Dry mouth isn’t simply unpleasant: It actually increases the growth of bacteria, thus worsening tooth decay and bad breath. If you struggle with a parched mouth, an alcohol-free mouthwash might be best for you.
2. Need to attack plaque? Avoid “cosmetic” mouthwash.
Technically, there are two types of mouthwash: cosmetic and therapeutic. The latter has clinical benefits, like preventing cavities or treating gingivitis. Cosmetic mouthwash, on the other hand, “only freshens breath,” says Dr. Mike Golpa, DDS, director of G4 by Golpa. “It may also contain sugars and flavorings that can actually harm your teeth.”
Unfortunately, most cosmetic mouthwashes don’t call themselves such. For plaque control, look for mouthwashes that are antimicrobial, antiseptic, or germ-fighting. These contain ingredients like cetylpyridinium, chlorhexidine, or essential oils. “They kill the bacteria that cause plaque to build along the gum line that leads to tartar buildup and gum disease,” says Dr. Golpa.
3. Prone to cavities? Look for cavity-fighting mouthwash.
“Users susceptible to cavities—those who consume lots of sugary drinks or who already have tooth enamel issues, for example—should look for cavity-fighting mouthwashes to use after brushing,” says Dr. Golpa. “Cavity-fighting mouthwash contains extra fluoride and helps prevent cavities from forming.”
Fluoride helps prevent tooth decay by promoting remineralization, according to the American Dental Association. That’s the process in which your body repairs the enamel—the top, protective layer of your teeth—before a cavity forms.
4. Want to avoid staining? Avoid CPC.
It’s not just food that can stain your teeth. Cetylpyridinium chloride (CPC) is antibacterial fluoride added to many mouthwashes. It’s very effective at reducing bad breath, but there’s a cost: It may dim your smile.
CPC “has been known to adhere to crevices and at the margin of teeth after use, leaving a brownish stain,” says Dr. Jay Samuelson, DDS, founder and principal dentist of The Dentists at Hillsborough in Omaha, NE. “While this staining isn’t harmful or permanent, most consumers find it undesirable.”
Instead, look for whitening mouthwashes to help brighten your smile. These mouthwashes contain either carbamide peroxide or hydrogen peroxide. Just keep in mind that it may take about 12 weeks of consistent use before you see results. (Here are the pros and cons of different tooth whitening remedies.)
Adds Dr. Samuelson, “Many manufacturers have removed [CPC] and replaced it with other, just as effective ones. It’s still a good practice to check the label if staining is a concern for you.”
While there may be mouthwashes to address each of these common oral health problems, it’s important to remember that many of them are related, or can signal bigger problems, according to Dr. Konig.
For example, “bad breath can be an indicator of gum disease and gum infections, or even postnasal drip,” says Dr. Konig. If your bad breath is caused by gingivitis, you’d be better off finding a mouthwash that treats plaque and gingivitis than a cosmetic mouthwash that merely masks bad breath. (Here are a dentist’s tips to cure bad breath.)
“Choose the mouthwash based on what your needs are. If one does not work well, try another,” says Dr. Konig. “It is also a good idea to ask your dentist for suggestions.”