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Mouthwash Guide: Top Picks to Fight Bad Breath, Gum Disease and More

Contributors:  , &

Are you looking for the best mouthwash for gum disease, ulcers, bad breath or dry mouth? Do you want to avoid specific ingredients like fluoride or alcohol—perhaps try a homemade mouth rinse? Or do you just want to know how and when to use mouthwash if you want the best effects?

receding gums mouthwash
Are you making any mistakes?

Whatever your questions, we have the answers in this comprehensive guide to mouthwash. You can read about:

  • The best mouthwash brands in the US
  • The best kinds for specific needs
  • Ingredients to look out for or avoid
  • Recipes for natural homemade mouth rinses
  • How to use mouthwash correctly (and whether you really need to use it at all)

We hope this information helps you make the right choices for your oral hygiene needs. If you just want a quick answer about the best mouthwash (or mouth rinse) for a certain purpose, the table below has our recommendations. You can read about all these and more in the rest of the article.

MouthwashBest forActive IngredientPrice
TheraBreath Healthy GumsTreating gum diseaseCetylpyridinum chlorideCheck price here
TheraBreath Fresh BreathStronger bad breath protectionChlorine dioxideCheck price here
Biotène Dry Mouth Oral RinseDry MouthCetylpyridinum chlorideCheck price here
Colgate Optic WhiteWhiteningHydrogen peroxideCheck price here
Colgate Peroxyl Mouth Sore RinseCanker SoresHydrogen peroxideCheck price here
Sensodyne PronamelSensitive Teeth, Enamel ProtectionSodium fluorideCheck price here
Tom's of Maine Wicked FreshFluoride-freeSodium monofluorophosphateCheck price here
Colgate Total Gum Health Alcohol FreeAlcohol-freeCetylpyridinum chlorideCheck price here
ACT Kids AnticavityKidsSodium fluorideCheck price here

Does mouthwash work and is it necessary?

antifungal mouthwash
We all know that mouthwash freshens breath

We may as well address these questions first so you know whether it's worth using oral rinses at all. You might be wondering “Is mouthwash good for you or bad for you?” but it's not really that simple. There are many different kinds of mouth rinse which contain different ingredients to target different oral health needs. 

Benefits of mouthwash

It's well established that oral rinses are good for freshening breath, and if you choose a fluoride mouthwash then it can help strengthen your teeth, too. A dentist may advise you to use an antimicrobial mouthwash for gum disease, herpes on the tongue, or a special rinse for dry mouth.

So, a mouth rinse can be a helpful addition to your oral hygiene routine if you have one of these specific needs.

Ask a dentist: Why should I use mouth rinse?

Research shows that around 31 percent of American adults use mouth rinse. However, many more probably should and don’t. As a patient, how do you know if you need to use it? Simple answer? Talk to your dentist. A comprehensive dental exam can reveal if you need mouth rinse, what kind you need, and how often you should use it.

Mouth rinse is a good addition to your oral care routine but does NOT replace the regular use of brushing and flossing. It reaches in between spaces in the mouth that toothbrushes or floss can’t reach. Always consult with a dentist before you start using mouth rinse to determine kind and frequency. Some mouthwashes have a high alcohol content and can damage your teeth enamel if not used appropriately or if used too much.

Dr. Kevin Varley, Stonebrook Family Dental

Can mouth rinse be bad for you?

There are a few drawbacks to using oral rinses that you should be aware of before deciding whether to use it regularly:

  • Mouth rinse can make you think your teeth are clean when they are not. It is not a substitute for brushing twice a day and cleaning between teeth daily since it doesn't do an effective job of removing plaque.
  • It can wash away fluoride and other beneficial ingredients in your toothpaste. Wait at least 30 minutes after brushing before rinsing your mouth, otherwise, the fluoride in your toothpaste won't be as effective.
  • Regular use for bad breath may be masking a more serious problem. Halitosis (chronic bad breath) can be caused by rotting teeth, gum disease, and other medical conditions. If you're on the keto diet, you may even have keto breath. Visit your dentist rather than trying to cover up the issue.
  • Antibacterial mouthwash can disrupt the good as well as the bad bacteria in your mouth. Certain bacteria are an important part of your immune system, and you may experience side effects from wiping them out on a daily basis.
  • Some people experience a reaction to certain ingredients. If it feels like your oral rinse is burning your tongue or making it sting, stop using it and try a different formula.

How to use mouthwash

So now that you know which is the best mouth rinse for your needs, let's make sure you understand how to use it correctly.

xylitol mouthwash
Swish the oral rinse vigorously for best results
  1. Check the instructions on the label. With stronger, medicated mouthwash you might need to dilute the solution before use. The packet will also tell you how much to use, and how for how long.
  2. Measure out the correct amount. You can pour it into a glass or the bottle cap (which might have a marker to show the right amount), but don't tip it straight into your mouth without measuring it. 
  3. Swish vigorously. Keeping your mouth closed, swish the liquid around your mouth and between your teeth. You might choose to gargle, too. Keep going for the specified time, usually 30 or 60 seconds.
  4. Spit. Don't swallow any mouth rinse, since the ingredients can be harmful if ingested in large enough quantities.
  5. If using a fluoride mouthwash, don't eat or drink for 30 minutes after use. This lets the fluoride have maximum effect protecting your teeth against decay.

When to use mouth rinse

Unsure whether to use mouth rinse before or after brushing? Unless specifically directed by your dentist, the answer is unclear. That is to say, you won't get much benefit from using mouthwash before you brush, and if you use it right after brushing it will wash away the beneficial ingredients in your toothpaste (particularly fluoride). Even if you use a fluoride mouth rinse, the concentration is much lower than most toothpastes—around 100–250 ppm compared to 1350–1500 ppm.

So, when should you use mouthwash? It depends on who you ask. The American Dental Association says to follow the instructions on your mouthwash, or to do what you prefer, and international organizations like the NHS say to just not use it after brushing with a fluoride toothpaste.

Ask an expert: Who shouldn't use mouthwash?

Mouthwash may seem like an everyday product that's safe for anyone to use, but there are some circumstances in which it is not recommended:

  • For people who are allergic or hypersensitive to any of the mouthwash ingredients
  • For children under six years of age, due to risk of swallowing
  • Iodine-containing mouthwash should be avoided by people with hyperthyroidism or other thyroid diseases, due to possible systemic absorption of iodine.

Renad Nahhas, Pharmacist

How often should you use mouthwash?

Again, check the label or follow your dentist's instructions. Many mouth rinses are safe for daily use over a prolonged period of time. However, some stronger rinses are only for short-term use. Excessive mouth rinse usage may cause stains on teeth and other problems.

If you find yourself relying on oral rinse throughout the day to cover up bad breath (and it's not from smoking, food or drink), it's best to visit your dentist and find out if there is an underlying cause that needs to be treated.

Here's a short video on how frequently you should use a mouth rinse:

This video explains the answer to the question "Should I use mouthwash everyday?" and goes through 3 examples of mouthwash.

Our top recommendations

There are a lot of oral rinse brands in the US to choose from. Big names like Listerine, Colgate and Crest dominate the market, but you'll find all kinds of other specialist brands, too. Here you can find our recommended mouthwashes to tackle specific problems or requirements.

Best mouthwash for gum disease in the US

Has your dentist recommended you use a gingivitis mouthwash or an antibiotic mouthwash for better gum health? The best mouthwash to reverse gingivitis contains active antiseptic or antimicrobial ingredients that will kill the plaque bacteria which are responsible for bleeding gums and inflammation.

best mouthwash for receding gums
Help fight periodontitis with this mouth rinse

It's important to note that gingivitis mouthwash is not a substitute for good oral hygiene. Gum disease will soon return if you don't maintain good teeth-cleaning habits. If you regularly get gingivitis symptoms, consult your dentist. You might need to have a deep dental cleaning and receive some advice on how to take better care of your teeth and gums

TheraBreath Healthy Gums mouthwash is an effective solution for gum disease, or gingivitis, and may be one of the best mouthwashes for periodontal disease. It is formulated by certified periodontists to fight the bacteria that cause gum disease, and to sooth the symptoms that accompany it.

This oral rinse can be used for gingivitis to stop it from progressing to periodontitis, a later stage of gum disease. Its active ingredient is cetylpyridinium chloride (CPC), which is approved by the FDA and has been clinically proven to actually kill the germs linked to gum disease and other periodontal issues.

CPC is being used by many brands in the US as a much safer alternative to chlorhexidine gluconate (CHG), which until recently was considered the best way to reduce plaque and gingival inflammation. However, side effects such as staining and increased tartar formation have halted its widespread use in the US.

Alternatively, for severe gum disease you may be prescribed a chlorhexidine mouthwash, which should only be used as directed by your dentist. 

Best mouthwash for bad breath

An antibacterial mouthwash can help combat bad breath by killing the plaque bacteria which cause bad smells in the mouth. Also look for a mouthwash without alcohol, since this can dry the mouth out and make it smell worse in the long run.

best mouthwash for tonsil stones
This oral rinse will freshen your breath

Before we talk about the best mouthwash for bad breath in the US, a word of warning. The best way to get rid of bad breath is by brushing your teeth properly twice a day and cleaning between teeth daily with floss or an interdental brush. Using a tongue scraper can also make a big difference to your breath.

If you are already doing this and you still have persistent bad breath, it may have another underlying cause like gum disease, cavities, or some other medical problem. In this case, you may want to see a dentist.

For the times you need to freshen up after a coffee or tuna sandwich, TheraBreath makes a wide range of mouthwashes which come highly rated by people who haven't had great results with mainstream brands. Among these, their most popular option (and our top recommendation) is TheraBreath Fresh Breath.

One satisfied customer says:

“Seriously, this stuff is a miracle! After 1 use, my husband's breath was fresh, no after-odor.”

Some people report only needing to use it once a day to keep their breath in check though, and if you haven't had any luck with cheaper mouth rinses for bad breath then this could be worth a try.

The downside is the price—it's more expensive than standard brands. Listerine Total Care Zero and Colgate Total Mouthwash are two of the big-name brands which also meet the criteria. If you're looking for an affordable bad breath mouthwash then these are a good place to start.

Best rinse for dry mouth

mouthwash tablets
Treat dry mouth with this Biotène rinse

Dry mouth occurs when you don't produce enough saliva. This makes it easier for bacteria to build up, causing bad breath. Always use an alcohol-free mouthwash for dry mouth, since alcohol can dry the mouth out further.

Biotène Dry Mouth Oral Rinse has a special formula that immediately moisturizes the mouth for up to four hours. It can be used up to five times a day. Biotène mouthwash does cost more than most standard oral rinses, but most people find it makes a big difference to their symptoms.

One reviewer who suffers from chronic dry mouth says about this rinse:

“Keeps my mouth well moisturised and lasts for a good few hours. The taste is pleasant which helps too.”

Biotène is also available as a spray, which is more convenient to use throughout the day.

Whitening mouthwash

Many brands include a teeth whitening mouth rinse in their range, containing hydrogen peroxide or another whitening agent. The concentration of these agents in teeth whitening mouthwash is generally quite low and on its own, the effects are minimal.

fluoridated mouthwash

You might notice a difference if you use it every day for several months, but then again you might not. If you want to noticeably whiten your teeth, we would recommend that you use a whitening mouthwash in addition to other whitening methods, like using whitening toothpaste, or possibly even home whitening kits.

As far as the best teeth whitening mouthwash goes, our top recommendation depends on what ingredients you prefer. For a mouth rinse with hydrogen peroxide, one of our favorites is Colgate Optic White. From America's most trusted brand of oral hygiene products, it's been formulated almost exclusively for whitening, which inspires a bit more confidence than an all-purpose mouth rinse with some peroxide thrown in.

A more natural option from Hello includes activated charcoal instead of hydrogen peroxide. The scientific community hasn't reached a consensus on the whitening effects of charcoal, but some cultures have used it for years and many people swear by it.

Best mouthwash for canker sores

best mouthwash for bleeding gums

If you are prone to canker sores, then you are definitely looking for an antiseptic mouthwash that will help your mouth feel better, and fast. Colgate Peroxyl Mouth Sore Rinse cleanses and helps heal minor oral wounds including canker sores, irritation and burns. This debriding agent uses oxygenating action to remove oral debris, while 1.5% hydrogen peroxide leaves wounds clean. 

One happy customer says:

“My canker sores were healing within a day of using it, and they were gone in just about 3. This is my new go-to for flare-ups.”

It can also help soothe gum inflammation due to dental procedures and wounds caused by braces or retainers. Some people have success using it for tonsil stones as well, which in turn leads to much fresher breath. 

Best fluoride mouthwash for sensitive teeth

mouthwash for sore gums
Fluoride helps rebuild enamel

If you're looking for a mouthwash for sensitive teeth, choose one that's alcohol-free and contains fluoride, which strengthens tooth enamel. Potassium nitrate, a desensitizing ingredient, is also included in many sensitive teeth mouthwashes.

So, what is the best mouthwash for sensitive teeth? Sensodyne Pronamel Mouthwash may be the best fluoride mouth rinse for you, as it has one of the highest fluoride concentrations around, at 450ppm–that's double all the other fluoride mouthwashes featured here.

It's designed to protect teeth from acids we consume every day in things like fruit, soda and wine. The taste of this Sensodyne mouthwash is not overbearing and it's a good supplement to their sensitive toothpaste range.

If you suffer from sensitivity, consider using one of these sensitive toothpastes in our guide here as well.

Best fluoride-free mouthwash

mouthwash for sore throat
Tom's mouth rinse has no fluoride


Choosing a fluoride mouthwash means you get extra enamel protection—one of the main benefits of using a daily mouth rinse. However, for people who prefer to avoid fluoride, there are plenty of fluoride-free mouthwashes available in the US as well.

One popular fluoride-free mouthwash is Tom's of Maine Wicked Fresh! It contains natural ingredients including soothing aloe vera. Its “wicked fresh” mint flavor will keep your breath smelling great as well.

Also worth considering are the range of oral rinses from Hello Oral Care, none of which contain fluoride or alcohol.

All the mouthwashes from these brands are vegan/vegetarian too.

Kids' mouthwash

kids mouthwash
This kids' mouthwash tastes like bubblegum

Can you use mouthwash for kids? Some brands, including Listerine and ACT mouthwash, make special children's mouth rinse with a child-friendly taste and fluoride to prevent cavities. Although not an essential part of a child's oral hygiene routine, your dentist might recommend using one for extra enamel protection.

Many ‘adult' daily use mouthwashes are also fine for children aged 6+, provided they don't contain alcohol, but children shouldn't use stronger, medicated rinses. 

It's important that children don't swallow mouthwash, so make sure they are supervised until you're confident they will spit it out every time.

Alcohol-free mouthwash

Many types of antiseptic mouthwash contain ethanol, a type of alcohol, which helps fight the plaque bacteria that cause tooth decay and bad breath. Ethanol also helps other ingredients blend together and acts as a preservative.

non alcohol mouthwash

The alcohol content can be quite high, ranging from around 14% to 26% in different brands. Swishing a capful around your mouth won't get you tipsy, but there are a number of reasons why you might want to avoid a mouthwash that contains alcohol:

  • Children will be using it
  • There are older children or recovering alcoholics in the household who might be tempted to deliberately ingest it
  • You don't like the strong taste
  • It causes a burning sensation or sensitivity in the mouth
  • You find it makes your mouth dry
  • You're worried about the possible links with oral cancer

Fortunately, there are plenty of good alcohol-free mouthwashes available as well. One of our top picks is Colgate's Total Gum Health Alcohol Free mouthwash, which contains CPC (cetylpyridinium chloride) as an alternative ingredient to fight plaque.

Other types of mouthwash and alternatives

Natural Mouthwashes

Oral rinses with natural ingredients are becoming more popular as consumers are beginning to worry more about the possible negative effects that could be caused by key ingredients and chemicals used in popular oral rinses.

So what's the best natural mouthwash? Well, as you might suspect, it depends on what you are looking for in a mouth rinse. Some natural mouthwash is for periodontal disease, some is for remineralizing enamel. Some mouthwash is non-alcoholic, other types are fluoride-free or vegan. For a closer look at these mouth rinses, check out our best natural mouthwash article.

If you like to know exactly what you're putting in your mouth, we have a separate article dedicated to making your own mouthwash at home. While we're on this topic, you might also be interested in our natural toothpaste recipes.

Prescription mouthwash

Prescription mouthwashes normally contain chlorhexidine gluconate and are not sold over the counter. The following is a list of the most common prescription mouthwashes. 

  • Peridex mouth rinse
  • PerioChip mouth rinse
  • Periogard mouth rinse
  • Paroex mouth rinse

These chlorhexidine gluconate mouthwashes are not meant to treat all kinds of gum disease, and should only be used as prescribed by your dentist. 

Magic mouth rinse

The “magic mouthwash” recipe is a special formula for people who are undergoing chemotherapy and radiation therapy for cancer. These cancer treatments can harm cells in the mouth, causing oral mucositis, with symptoms such as dry mouth, swollen gums and mouth sores. This mouthwash is prescribed by a doctor and then mixed by a pharmacist. According to the Mayo Clinic, it contains three or more of the following ingredients:

  • An antibiotic
  • An antihistamine or local anesthetic
  • An antifungal
  • A corticosteroid
  • An antacid

If you are undergoing cancer treatment, speak with your doctor about magic mouthwash. Don't use it without a prescription as some magic mouthwash side effects can include loss of taste, a burning sensation and nausea. 

Conclusion

man brushing teeth
Brushing properly is the best way to fight bad breath

Among all of the mouthwash options on the market these days, there is no single best one. That said, there are both all-purpose and special formulas to meet your specific need. To find the best mouthwash for you, ask your dentist what aspects of oral health you should be focusing on, and consider your own preferences.

If your gums and enamel are healthy, maybe you will want a whitening mouthwash. Maybe you don't have any specific goals but want to avoid animal products, so you wil want to look for a vegan natural mouthwash. In the end it depends on you.

One thing which we can say for certain is that mouthwash is not an appropriate substitute for regular brushing and flossing. Practicing proper oral hygiene is the best way to fight bad breath and gum disease. Mouthwash is meant to help in that fight, but isn't really meant to lead it.

FAQs

What happens if you drink or swallow mouthwash?

Drinking mouth rinse is dangerous and can lead to serious side effects like failure of certain organs, blindness, and even death. Because there are so many different formulas, there is no certain amount that we know will be harmful, and therefore you should never intentionally drink any amount.

However, if you have accidentally swallowed mouthwash while rinsing your mouth, don't panic. Although it's not meant to be swallowed, ingesting such a small amount is unlikely to cause any side effects.

Some people can be sensitive to ingredients like fluoride and ethanol, so it's good to watch out for side effects which might include drowsiness, dizziness, and shortness of breath. Seek medical advice if you have any concerns, and take the mouthwash bottle or a photo of the label so the medical staff know which ingredients you might be reacting to.

There is a greater risk of children swallowing mouthwash, which is why they should always be supervised while using it. Most bottles have a child-proof safety cap, and the strong taste should put them off drinking it if they do gain access. However, if you suspect your child has ingested more than a small mouthful of mouthwash or they are experiencing side effects, it's best to seek medical advice.

Does mouthwash stain teeth?

Stronger formulations containing chlorhexidine are intensive treatments designed for short-term use. Used over a prolonged period (four weeks or more), there is the potential for temporary teeth staining and tongue discoloration. 

You can minimize the chances of staining by avoiding coffee, tea, red wine, and other foods that stain teeth easily while using chlorhexidine mouthwash. Daily brushing and flossing will also help, and any stains left after treatment ends can be removed with a professional teeth cleaning.

How much alcohol is in mouth rinse?

The alcohol content of mouthwash brands in the US ranges from around 14% to 26%. Using it as instructed and spitting it out won't have any adverse effects, but there is the potential for abuse. Plenty of alcohol-free mouthwashes are available for people who would rather have a ‘non-alcoholic' option.

Why does mouthwash burn my tongue or mouth?

If you're left with a burning or stinging feeling in your mouth after using an oral rinse, you're probably sensitive to one of the ingredients. The most likely culprits are alcohol, chlorhexidine (used in gum disease mouthwash, and available with prescription) and chlorine dioxide or other bleaching ingredients used in whitening mouthwash.

You'll probably have to experiment with a few different brands and formulations to find one that causes less sensitivity. A natural mouthwash might be a good option, although there is no guarantee you won't react to certain essential oils and other natural ingredients, too.

Do you use mouthwash before or after brushing?

Mouthwash is best when used at least 30 minutes after brushing, so it doesn't wash away the healthy effects of your toothpaste. Alternatively, you can use mouthwash during the day when you haven't brushed your teeth. But it should never be used as a replacement for brushing your teeth. 

Can you buy chlorhexidine mouthwash over the counter in the US?

No. In the United States, chlorhexidine mouthwash must be purchased at a pharmacy with a prescription. You can buy chlorhexidine itself (not as a mouthwash) but it isn't meant to be used as a mouthwash, and you shouldn't try to use it as a mouthwash because it can have dangerous effects. 

Is mouthwash bad for you?

Mouthwash can be a helpful part of your daily oral hygiene routine.  But when used incorrectly, it can have negative effects. Make sure to never use mouthwash as a replacement for brushing and flossing. Also, only used prescribed mouthwash according to your dentist's instructions, as many aren't meant for continued use. You should also be aware that although oral rinses make breath smell good, it could be masking a bigger problem, like bad breath caused by tooth decay or infection.

Can I use mouthwash after a tooth extraction?

For about two weeks after a tooth extraction, it is probably best to avoid most types of mouthwash. Instead you can use a time-honored technique of rinsing your mouth with salt water, which acts as a natural antiseptic.

Does whitening mouthwash work?

There isn't much evidence to show that whitening mouthwash alone will have a visible effect on your teeth. It does contain whitening agents and they may help to some degree, but really whitening mouthwash is meant to work together with other products like whitening toothpaste.

Mouthwash Guide: Top Picks to Fight Bad Breath, Gum Disease and More
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Contributors:
Amanda Napitu
Amanda Napitu
Amanda Napitu on FacebookAmanda Napitu on LinkedinAmanda Napitu on Website
Amanda specialises in writing informative content about dentistry. She has been a regular contributor to Dentaly.org since 2017, and collaborates with dozens of dentists to keep this content accurate and up-to-date.
Dr. Kevin Varley
Amanda Napitu on Website
Dr. Kevin Varley received his Bachelor’s Degree from Colorado State University and his Doctor of Dentistry from the Colorado School of Dentistry. Dr. Varley provides advanced family, cosmetic, and implant dentistry at his practice Stonebrook Family Dental in Aurora, CO. When he’s off work, Dr. Varley enjoys a wide range of hobbies from ice hockey to scuba diving and spending time with his family.
Renad S. Nahhas, PharmD
Amanda Napitu on Website
Renad Nahhas is a pharmacist from Jeddah, Saudi Arabia, and is a member of the Saudi Pharmaceutical society Student Chapter. She is interested in science, especially in pharmacotherapy, toxicology and socioeconomics. Renad has completed 400 hours of training in both outpatient and inpatient pharmacy and more than 100 hours of volunteering. She is convinced that: fear is half of disease, reassurance is half of medicine, and patience is the beginning of healing; therefore she always likes to connect with patients and help as much as she can.
Sources
Cochrane Library: Chlorhexidine mouth rinse as an adjunctive treatment for gingival health. Consulted 15th November 2019. NPR: Mouthwash and Poor Dental Hygiene May Up the Risk of Oral Cancer. Consulted 15th November 2019. Journal of Dental Hygiene: Cetylpyridinium Chloride Mouth Rinse on Gingivitis and Plaque. Consulted 15th November 2019. NCBI: The effect of xylitol on dental caries and oral flora. Consulted November 15th 2019. NCBI: Alcoholics who drink mouthwash: the spectrum of nonbeverage alcohol use. Consulted November 15th 2019.