What is Mouthwash?

Generally speaking, mouthwash is any form of liquid, that can be gargled within the mouth to exert some local effects. The local effects might be to mask mouth odour, as an antibacterial agent, as an anti-plaque agent etc. According to the American Dental Association, Mouthwash can either be Therapeutic or Cosmetic. Cosmetic Mouthwashes are used usually to mask bad breath without chemical or biological application beyond their temporary benefit. Therapeutic mouthwashes contain ingredients that are used as antibacterial agents, antiplaque agents etc.

A mouthwash generally consists of water, ethanol, a humectant, a surfactant, flavour, colour and an active agent. The ethanol adds bite and freshness, and generally enhances flavour impact. The humectant improves the mouth feel of the product during use by adding “body”.The surfactant aids solubilisation of the flavour oil, provides some foaming action and assists in the removal of oral debris. 

The Controversy

It is a known fact that many known mouthwashes contain alcohol(ethanol). The concentration of alcohol can be as high as 26%. Some experts have expressed reservation about this bearing in mind that alcohol is a risk factor for oral cancer. Their argument is that the metabolite of alcohol, acetaldehyde is mutagenic and animal studies have shown that it is carcinogenic. Furthermore, alcohol is claimed to have burning sensation on the mouth, causes dryness of the mouth etc.

Experts in support of the use of alcohol-containing mouthwashes feel that the dose of mouthwash and the quantity of alcohol(ethanol) used are not enough to predispose the user(s) to oral cancer.

In conclusion, I would like to quote Werner Et al, in their published article in the British Dental Journal: ” The comparative studies between alcohol containing and alcohol-free mouthwashes have for the most part shown that the alcohol content adds little in the way of efficacy to the product. Besides this, alcohol-containing mouthwashes may be also avoided on the basis of cultural preferences. Therefore, as the benefit of alcohol in a mouthwash is negligible and it may carry a risk of oral cancer which is difficult to quantify, is there any value in members of the dental team prescribing/recommending alcohol containing mouthwashes to their patients?

In the light of the above, next time you visit your dentist and he/she recommends a mouthwash, you may want to request for an alcohol-free mouthwash. It is better to be on a safer side, more so, an alcohol- containing mouthwash does not offer any comparative advantage.

The following are the brands of mouthwash without alcohol:
Listerine Zero, Oral-B Sensitive Mint Mouthrinse, Colgate Peroxyl Mouth Sore Rinse.



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