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Mouthwash or mouth rinse is a product used for oral hygiene. Antiseptic and anti-plaque mouth rinse claims to kill the germs that cause plaque, gingivitis, and bad breath. Anti-cavity mouth rinse uses fluoride to protect against tooth decay. However, it is generally agreed that the use of mouthwash does not eliminate the need for both brushing and flossing.
Anthony van Leeuwenhoek, the famous 17th century microscopist, discovered living organisms (living, because they were motile) in deposits on the teeth (what we now call dental plaque). He also found organisms in water from the canal next to his home in Delft. He experimented with samples by adding vinegar or brandy and found that this resulted in the immediate immobilization or killing of the organisms suspended in water. Next he tried rinsing the mouth of himself and somebody else with a rather foul mouth with vinegar or brandy and found that living organisms remained in the dental plaque. He concluded - correctly - that the mouthwash either did not reach, or was not present long enough, to kill the plaque organisms.
That remained the state of affairs until the late 1960s when Harald Loe (at the time a professor at the Royal Dental College in Aarhus, Denmark) demonstrated that a chlorhexidine compound could prevent the build-up of dental plaque. The reason for chlorhexidine effectiveness is that it strongly adheres to surfaces in the mouth and thus remains present in effective concentrations for many hours. Rinses in this category include Listerine and Scope.
Since then commercial interest in mouthwashes has been intense and several newer products claim effectiveness in reducing the build-up in dental plaque and the associated severity of gingivitis (inflammation of the gums), in addition to fighting bad breath. Many of these solutions target controlling the Volatile Sulfur Compound (VSC) creating anaerobic bacteria that live in your mouth and excrete substances that lead to bad breath and unpleasant mouth taste. Brands in this category include TheraBreath and Closys II. Other formulas, like SmartMouth, add 'zinc ion technology' to prevent future odors.
Common use involves rinsing the mouth with about 20 ml (2/3 fl oz) of mouthwash two times a day after brushing. The mouthwash is typically swished or gargled for about half a minute and then spat out.
Active ingredients in commercial brands of mouthwash can include thymol, eucalyptol, hexetidine, methyl salicylate, menthol, chlorhexidine gluconate, benzalkonium chloride, cetylpyridinium chloride, methylparaben, hydrogen peroxide, domiphen bromide and sometimes fluoride, enzymes and calcium. Ingredients also include water, sweeteners such as sorbitol and sodium saccharine, and a significant amount of alcohol (around 20%). Because of the alcohol content, it is possible to fail a breathalyzer test after rinsing; in addition, alcohol is a drying agent and may worsen chronic bad breath. Many newer brands are alcohol-free and contain odor-elimination agents such as oxidizers, as well as odor-preventing agents such as zinc ion technology to keep future bad breath from developing. A salt mouthwash is a home treatment for mouth infections and/or injuries, or post extraction, and is made by dissolving a teaspoon of salt in a cup of warm water. Plain (diluted) hydrogen peroxide is another common mouthwash.
One thing to note is that many commercial mouthwashes are very acidic on the PH scale. If you have heartburn, acid reflux or acid indigestion, it is important to use a mouthwash with a neutral PH to avoid irritation. TheraBreath products have been clinically shown to have a neutral PH and are recommended for patients who may have problems with a more acidic product.
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