Mouthwash guide

What mouthwash does

The ADA says mouthrinse can be a helpful addition to oral hygiene but is not a replacement for daily brushing and flossing, and can reach areas a toothbrush misses. It says cosmetic rinses only mask bad breath temporarily and have no lasting antimicrobial effect, while therapeutic rinses contain active ingredients aimed at controlling bad breath, plaque, gingivitis or tooth decay.

How to use mouthwash

Follow the label. ADA News says to use mouthwash at a separate time from brushing, not right after, because brushing right before can wash away fluoride from the toothpaste, and to wait at least 30 minutes before eating or drinking after a fluoride-based mouthwash. The ADA page says before or after brushing is largely preference, and that manufacturers may specify an order. The sources we read do not say how long to swish or how much to use, so use the amount and time on the product's label. Our guide on whether mouthwash is necessary covers timing in detail.

Does alcohol-free mouthwash work?

The ADA says alcohol can be drying, so an alcohol-free rinse may be advisable for people with dry mouth. The sources we read do not say how well alcohol-free rinses kill bacteria compared with alcohol-containing ones, so look at the active ingredient and whether the product is therapeutic or cosmetic. Rinses with enzymes, cellulose derivatives or animal mucins may also help relieve dry mouth symptoms, according to the ADA.

Fluoride rinses

Cleveland Clinic says low-strength fluoride mouthwash is available over the counter and stronger concentrations require a prescription, and that children under 6 should not use fluoride mouth rinses unless a dentist or healthcare provider recommends it. Healthline says fluoride mouthwash may help keep fluoride levels elevated, and non-fluoride mouthwash used right after fluoride toothpaste may wash fluoride off the teeth.

Chlorhexidine and staining

The ADA says chlorhexidine, a prescription rinse, helps control plaque and gingivitis, lowers the risk of dry socket after third molar extraction and can reduce aerosol bacteria before procedures, but can stain teeth, tongue and restorations, change taste and cause calculus formation. Cleveland Clinic's page on pericoronitis also notes temporary staining or taste changes. The sources we read do not discuss whether a particular brand such as Listerine stains teeth, so ask your dentist about a specific product.

Who may benefit

The ADA says mouthrinse may help people who cannot control plaque and gingivitis with brushing and interdental cleaning alone, people with dry mouth, bad breath or pain from oral sores, and may be recommended for conditions such as dry socket. ADA News says it can help prevent tooth decay, reduce plaque and reduce gingivitis. For people prone to cavities, Healthline says skipping the rinse after brushing and spitting out toothpaste better preserves fluoride.

Children and mouthwash

The ADA says children under 6 should not use mouthrinse unless a dentist directs it, because they may swallow large amounts, and to check product labels for age guidance. For older children, supervise and make sure they spit it out.

Choosing a product

Look for the ADA Seal of Acceptance on over-the-counter products, which indicates the ADA reviewed the company's evidence of safety and effectiveness for the claimed purpose. Ask your dentist whether you need a therapeutic rinse and which, rather than choosing by taste or marketing.

Questions to ask your dentist

If you are unsure whether you need a rinse, ask at your next visit.

• Do I need a therapeutic rinse, and which type?
• Should it contain fluoride, and when should I use it?
• Is alcohol-free better for me?
• How long should I use a prescription rinse and what side effects should I expect?
• Is it safe for my child, and from what age?

Guides in this topic

Frequently asked questions