The mouthwash/mouthrinse market has grown at a rapid rate in recent years.  Much of this has been fuelled by the fact that many consumers now accept using a mouthwash as a normal part of their daily oral care regime.  The desire to have a fresher breath throughout the day and strong marketing from the manufacturers have all helped this along.

Unfortunately some people can find good oral hygiene difficult no matter how hard they try due to problems with dexterity, medical reasons, or unusual anatomy within their mouth and mouthwashes can be very beneficial for these people.  A mouthwash cannot be a substitute however for a good brushing and flossing technique which most of the time can eliminate most of the plaque and undesirable bacteria.  Mouthwash can affect plaque bacterial levels but it is always better if the plaque isn't there at all!   We believe many of our customers would benefit more from having impeccable oral hygiene by mechanical means, namely good brushing, good flossing or interdental cleaning, and regular visits for professional maintenance with their dentist, hygienist or periodontist.  Having said this, there will always be residual disease causing bacterial levels present in the mouth and this is where mouthwashes can help.

In recent times there has been some media relating to the  majority of mouthwashes currently available having certain levels of alcohol content.  Manufacturers include alcohol in their mouthwash preparations for a number of reasons.  Typically this enhances solution solubility, preservability and antibacterial effect.  It can also enhance the taste and gives many mouthwashes more of a "zing" and makes it feel like something is definitely happening in your mouth.  There has been a variety of literature both for and against alcohol containing mouthwashes with most manufacturers happy that the denatured alcohol content in their preparations are safe.  The main perceived concerns include increasing the risk for developing oral cancer, xerostomia or dry mouth, burning or irritation, and weakening of dental restorations.  The oral cancer evidence seems weak.  Whilst dry mouth per se does not develop as a result of long term use of alcohol containing mouthwash, it does cause dry mouth type symptoms immediately following use which actually makes your mouth feel clean as your mouth and tissues are more dehydrated.  Some people do find alcohol containing mothwashes too strong and prefer a gentler non-alcohol alternative.  It is possible that some mouthwashes can have the ability to affect dental restorations on a surface level but there are a lot of things which can cause general wear and tear anyway and no restorations last forever regardless.

There are some people who would want to avoid alcohol in their mouthwashes.  They should definitely be kept away from children.  People with Xerostomia or dry mouth problems tend to prefer alcohol free mouhwashes.  Pregnant ladies also tend to avoid alcohol.  Some alcoholics prefer to avoid alcohol in any form, and one study showed that although regular use of alcohol containing mouthwash was not enough to set off a police breath alcohol test, use of mouthwash immediately prior to breath testing may significantly increase the measured breath alcohol value.

The mouthwashes for routine daily use that we supply at ToothShop have traditionally been alcohol free.  Given the concerns mentioned above, use of mouthwashes containing alcohol is safe and recently the New Zealand Dental Association has recently given its approval to several products including Listerine mouthwashes.  We now stock the Listerine Total Care mouthwash which contains essential oils to interfere with bacterial adsorption onto teeth and slow bacterial regeneration time and also contains 0.22mg/ml sodium fluoride.  Both the established Oral-B Tooth and Gum Care Alcohol-Free Mouth Rinse and the newer Colgate Plax Gentle Care Alcohol Free Mouthwash utilise 0.05% cetylpyridinium chloride as their active antibacterial component and this should be more than adequate for most mouths with the Oral-B Mouth Rinse having an added 0.05% sodium fluoride.  The new Listerine Smart Rinse has 0.3mg of cetylpyridinium chloride per ml as well as an additional 0.22mg sodium fluoride.  Targeted for the childrens' 6+ market this rinse is also suitable for adult use.  The Biotene Mouthwash is also very gentle and has been specifically designed to be of extra assistance and comfort for those with xerostomia or dry mouth.  If anything stronger than this is needed this really needs to be prescribed under the care of your dental professional for your particular condition.  Some of the treatment rinses that we recommend do use alcohol in them to allow more effective carriage of the active ingredients but these are recommended more as treatment rinses where we are looking to impart specific benefits.  Colgate Savacol is probably the most prescribed treatment rinse in NZ for minimising bacterial infection and especially for gum conditions.  The active ingredient chlorhexidine gluconate is particularly adept at eliminating bacteria but does leave a brown stain on teeth with continuous use over 2 weeks.  The stronger original green solution is available for shorter bursts of treatment or for occasional longer term use the blue solution at just over half strength is also available.  Colgate Peroxyl Oral Cleanser is also good at relieving minor oral inflammations without any staining by utilising hydrogen peroxide as the active ingredient which promotes an oxygenating cleansing action.  Our other treatment rinses are our Fluoride Rinses which act to promote tooth surface remineralisation and strengthening.