Nothing can replace a dental health routine that makes brushing and flossing a priority. And if you’re especially particular about having fresh breath and clean teeth, you’re probably using mouthwash, too.
But according to New York City-based dentist Dr. Azadeh Akhavan, most people might not actually need mouthwash since it’s not as effective a way to rid teeth of plaque compared to the act of physical brushing. However, for some, it can be an important routine addition, especially for people dealing with specific oral health concerns.
For instance, she said that “anyone who is especially prone to caries (cavities) or have dental sensitivity, a fluoride-containing mouthwash can help to strengthen the teeth and prevent cariogenic bacteria from demineralizing the enamel, which is the protective outer coating of the tooth.”
Another reason Akhavan shared is dry mouth, which can be caused by certain medications or treatments. She said this is because bacteria binds more readily to teeth in mouths that are dry, resulting in bacterial colonies that promote cavities or problems with the gums and supporting bone.
But whatever your particular reason for using it, she said mouthwash should be used at the end of your oral hygiene routine.
“The fluoride and antimicrobial agents in mouthwash are only effective when they remain on oral surfaces for at least 30 minutes,” she said. This especially applies to dry mouth-focused preparations.
She also cautioned that many mouthwash brands contain potentially harmful ingredients. Some of these include alcohols, abrasive charcoals and cetylpyridinium chloride (CPC), an effective antibacterial that became popular during the COVID pandemic but can cause brown stains that have to be cleaned off professionally.
Conversely, Akhavan assured us that there are dentist-approved formulas you can look for that can be particularly useful whatever your condition. In the list ahead, find rinses that are great for gingivitis, dry mouth, cavities and more.
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This anti-cavity oral rinse contains fluoride and xylitol, both essentials in fighting bacteria, and has an elevated pH to neutralize decay-causing acids in the mouth.
In addition to fluoride, this particular anti-cavity preparation helps to whiten teeth with the use of hydrogen peroxide, an effective stain-lifting agent that Akhavan said should be avoided only in high concentrations because it has the potential to abrade enamel. This popular zero-alcohol rinse also contains bacteria-fighting xylitol and glycerin.
"For individuals undergoing radiation therapy or taking medications that cause dry mouth, regular use of a mouthwash containing a wetting agent is important for keeping the mouth moist," Akhavan said. Bacteria binds more readily to teeth in a dry mouth, resulting in bacterial colonies that promote cavities or problems with the gums and supporting bone.
In cases like these, Akhavan suggests Biotene oral rinse because it contains glycerol, a mouth moisturizer that quickly soothes and lubricates the mouth for up to four hours. The brand also claims this formula works to help maintain a balanced pH in the mouth.
"Biotene or any mouth-wetting mouthwash should also stay on the teeth as long as possible, without dilution, for maximal effectiveness. So ideally, mouthwash should be used prior to bedtime with no rinsing after use," she added.
Akhavan also said baking soda and xylitol are two great mouthwash ingredients.
"Baking soda decreases the pH of saliva and discourages bacterial growth and xylitol prevents the binding of bacteria to the teeth," she explained.
One brand she liked is no longer in production, but we spotted this pH-balancing mouthwash by Cleure that features baking soda and xylitol and is free from Akhavan's less-favored ingredients like alcohol and acidic fruit flavorings that can erode enamel over time. This simple-ingredient mouthwash also contains glycerin, a popular hydrator that can help address dry mouth.
This Total Care option from Listerine contains all four of those oils in addition to fluoride in order to protect against cavities — all without the inclusion of alcohol, which Chern said can cause or exacerbate dry mouth.
"If you have a high risk of cavities, mouthwashes with extra fluoride or nano-hydroxyapatite are excellent in preventing future cavities," Chern said.
"One thing that will be interesting to watch is hydroxyapatite, an ingredient that some toothpastes are starting to include," Akhavan said. "Very preliminary studies suggest that it may be as effective as fluoride toothpaste in strengthening the enamel."
Based on this mention, we tracked down Boka's convenient mouthwash tablets that contain hydroxyapatite instead of fluoride to help remineralize teeth without stripping the mouth of important microbes. The Boka tablets, which don't require water to use, also contain dentist-preferred ingredients like baking soda and xylitol.