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The risks of mouthwashes

Are oral mouthwashes doing you more harm than good?

There are mouthwashes and there are mouthwashes.

Some are pro-biotic, some are fluoridated to help strengthen tooth enamel, while others contain alcohol and are meant to zap all the oral bacteria in your mouth to kingdom come – or for at least 24 hours till they regenerate and the bad breath starts up again! However, it’s the latter mouthwash option that has come under increasing scrutiny and been red flagged by oral health researchers in recent years.

Should you use alcohol-containing mouthwash to eliminate “99%” of the germs in your mouth?

Maybe not. While it’s true that certain oral bacteria cause acidic plaque that should be prevented to maintain good oral health, there are other essential oral bacteria that are quite beneficial and extremely important to your oral and digestive health.

Together, this community of “good and bad” oral bacteria make up what is known as the oral microbiome. Using a mouthwash that kills 99% of oral bacteria in your mouth means that you are eliminating not just the bad bugs but the good ones as well.

Additionally, alcohol-based mouthwashes can dry out your mouth and reduce saliva which is essential for oral health.

What is the oral microbiome?

The oral microbiome is a large and diverse ecosystem of microbiota aka oral bacteria in your mouth that is second only to the gut microbiome in size. Within it are well over 700 species of oral bacteria living side by side. When your oral microbiome is in balance, your gut flora usually is also and vice-versa.

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How do good oral bacteria contribute to good oral health?

When your oral microbiome is in balance, the presence of good bacteria outcompetes the pathogenic bacteria and prevents them from accumulating together en masse via plaque and dumping huge amounts of bacterial acid onto your teeth – thus causing bad breath, tooth decay and gum disease.

Additionally, beneficial bacteria can prevent pathogenic oral bacteria from reaching critical mass, after which they may start to invade your bloodstream and other parts of your body.

Good helpful oral bacterial strains include Lactobacillus salivarius, Lactobacillus reuteri, Lactobacillus brevis and A12.

Since beneficial bacteria can keep pathogenic bacteria in check, you’ll experience a reduction in:

  • plaque build-up,
  • gum disease inflammation,
  • gingivitis,
  • bleeding gums, and
  • bad breath (halitosis).

Certain beneficial oral bacteria can also help prevent oral infection and oral cancer.

What causes an imbalance of good and bad oral bacteria?

Unfortunately, when your diet predominately consists of refined carbohydrates and simple sugars – i.e. sweets, pastries, white flour products and sweet drinks – bad oral bacteria can take over your oral micrbiome. Pathogenic gram negative bacteria outnumber the beneficial ones and start to wreak havoc on your teeth.

Other factors that may contribute to an imbalance of your oral flora include poor oral care, a weakened immune system, genetics and a reduced saliva flow, aka dry mouth.

Mouthwashes that may be harmful to your oral microbiome

You may take probiotics – as opposed to antibiotics – to improve your gut bacterial flora. So why shouldn’t it be any different for your oral microbiome? Essentially, alcohol-containing mouthwashes act as antiseptics and antibiotics destroying a large part of your oral microbiome indiscriminately.

The most harmful mouthwashes to your oral microbiome include ones containing alcohol, hydrogen peroxide and chlorhexidine.

The best way to rebalance your oral microbiome

Eat more fermented pre and probiotic foods, such as raw asparagus and sauerkraut, and fibre-rich vegetables, such as celery, to balance your oral and gut flora.

Include calcium rich foods in your diet such as yoghurt, soft cheeses, kefir and vegetable stalks, such as the stalks of silverbeet or broccoli. Keep in mind that the stalks of any above-ground vegetables often contain higher concentrations of calcium than the leaves or flowers.

Pre and probiotics are also available in concentrated supplements. However, people with weakened immune system should consult their G.P. if they are considering taking them.

Gentler mouthwash options

Listerine, Colgate and other producers of mouthwash are currently researching mouthwash formulas that selectively target pathogenic oral bacteria. However, these products are still in the pipeline.

Fortunately, there are a wide range of probiotic oral mouth washes and rinses available that are alcohol free. These may gentler on your beneficial oral bacteria, teeth and gums. To check out what’s available near you, just Google “oral probiotic mouthwash/mouthrinse” in their Shopping Search bar. Check out product reviews and testimonials to find a product that suits your oral health needs.

Click the following links to check out clinical studies that examine the role of beneficial oral bacteria and the oral microbiome: