Can mouthwash replace flossing?
By
Dr Shivam Jha
This blog post will address the topic, “can mouthwash replace flossing” and cover topics like what research says, why mouthwash cannot replace flossing, types of mouthwash and choosing the one best for you, correct way of using mouthwash and what does research say about mouthwash preventing cavities.
Can Mouthwash Replace Flossing?
No, mouthwash cannot replace flossing and act as only an adjunct to brushing and flossing.
Using mouthwash along with brushing twice a day and flossing once daily maintains good oral hygiene and prevents plaque accumulation, thereby preventing bacterial acid attack and cavity formation.
What Does Research Say?
According to most of the research studies done on mouthwash and oral hygiene, mouthwash can only be used in conjunction with tooth brushing and flossing.
Many people, despite knowing the benefits of flossing daily, just neglect it.
According to a study, flossing is highly effective in reducing the interproximal caries risk.
Daily floss can help stimulate your gums and reduce plaque, leading to lesser inflammation risk and increased healing of the cavity in its earliest stage.
A 2011 meta-analysis concluded flossing to be beneficial in reducing gingivitis when done along with toothbrushing.
A 2017 published study reported flossing to be effective in reducing proximal caries in the primary teeth and hence recommended flossing for children with primary dentition as well.
A recent 2021 study done on Iranian population reported a lesser risk of severe chronic periodontitis in people who floss daily along with brushing their teeth.
A research study reported burning sensation, taste disturbances and staining as short-term side effects of regular use of chlorhexidine mouthwash.
Hence, it is very evident that mouthwash can’t replace mechanical methods of maintaining good oral hygiene such as brushing twice a day and flossing daily once.
Research recommends occasional and cautious use of therapeutic mouthwash.
Why Mouthwash Cannot Replace Flossing?
Mouthwash cannot replace flossing because of its alcohol content which on prolonged and daily use may cause oral dryness, leading to increased bacterial acid attack and thus weakening of the enamel.
Burning sensation, taste disturbances, staining, sore throat and sore mouth with tongue irritation are reported to be adverse effects associated with daily and prolonged use of mouthwash.
According to a review published in the International Journal Of Dental Hygiene, Chlorhexidine mouthwash resulted in more significant tooth discoloration compared to chlorhexidine gel.
Excessive use of fluoride-containing toothpaste and mouthrinses may stain teeth.
Types Of Mouthwash And One Which Is Best For You
Mouthwashes are categorised as Cosmetic and Therapeutic type by the FDA and American Dental Association (ADA).
Cosmetic Mouthwash:
Cosmetic Mouthwash is only to mask the bad breath and does not correct the dental condition causing bad breath.
Therapeutic Mouthwash:
Therapeutic mouthwashes, as the name suggests have therapeutic action and control dental conditions like gingivitis, tooth decay and periodontal diseases.
They also help remove halitosis and have been found effective in relieving sore throat symptoms.
Therapeutic Mouthwashes contain ADA listed active ingredients such as fluoride, peroxide, essential oils, cetylpyridinium chloride, and chlorhexidine, all regulated by the FDA.
All mouthwashes are different. Some mouthwash have alcohol, preservatives or antimicrobials as their main ingredient while others do not.
Categories of therapeutic mouthwash:
ALCOHOL BASED MOUTHWASH
Ethanol is the main ingredient in most alcohol-based mouthwashes.
Ethanol kills germs and bacteria and helps to reduce plaque and gingivitis by dissolving and dispersing essential oils like thymol or menthol.
ANTIMICROBIALS CONTAINING MOUTHWASH
Mouthwashes may contain both antimicrobials and alcohol or only antimicrobials. Chlorhexidine, a main antimicrobial ingredient, helps reduce and prevent plaque and gingivitis.
Studies have also found chlorhexidine to be effective in relieving the symptoms of sore throat.
PARABENS CONTAINING MOUTHWASH
Parabens are the most common type of preservative used in mouthwashes.
Parabens help to prevent infections and also to keep a mixture stable.
According to a research paper published in 2004, parabens can enter the body through skin and cause hormonal changes leading to cancer.
Therefore, it is advised to avoid mouthwashes containing parabens or consult your dentist before using such products.
NO PRESERVATIVES (NATURAL MOUTHWASH)
Natural Mouthwashes are gaining popularity due the rising concerns associated with chemicals and their harmful effects on the body.
According to a research article published in the International Journal of Pharma and Bio Sciences, herbal or natural mouthwash plays a significant role in fighting against sore throat-causing bacteria and is thus recommended in cases of sore throat.
Correct Way Of Using Mouthwash
Mouthwash must be used in a correct way to maximise its benefits and reduce the potential side-effects:
Step 1:- Brushing And Then Mouthwash – It is essential to know that mouthwash must only be used after brushing your teeth. Precaution must be taken to not use mouthwash rinse just after using fluoride toothpaste and should wait for at least 30 minutes to allow fluoride to leave its effect.
Step 2:- Use the recommended amount of mouthwash to rinse your mouth – as excessive use significantly stains the teeth in the long run.
Step 3:- Rinse for 30 seconds and do not ingest any amount of mouthwash – Once 30 seconds is complete, just spit it out safely in a sink.
Can Mouthwash Prevent Cavities: What Does Research Say?
Using mouthwash along with brushing twice a day and flossing once daily maintains good oral hygiene and prevents plaque accumulation, thereby preventing bacterial acid attack and cavity formation.
Therapeutic mouthwashes, as the name suggests have therapeutic action and control dental conditions like gingivitis, tooth decay and periodontal diseases. They also help remove halitosis.
Therapeutic Mouthwashes contain ADA listed active ingredients such as fluoride, peroxide, essential oils, cetylpyridinium chloride, and chlorhexidine, all regulated by the FDA.
According to a research published in the journal of clinical medicine research, mouthwash containing chlorhexidine gluconate or cetylpyridinium chloride showed antimicrobial activity against most bacteria in the plaque biofilm.
Another study concluded that the chlorhexidine and cetylpyridinium chloride containing antiseptic mouthwashes had higher in-vitro antibacterial activity against streptococcus mutans, a bacteria found in the plaque biofilm.
Many people today do not prefer alcohol-containing mouthwashes and opt for alcohol-free mouthwash. Are they effective in halting the bacterial activity inside our mouth?
Well, according to a research published in the journal of dental sciences, 10000 ppm of γ-PGA without alcohol could significantly kill 99% of bacterial growth without causing any cytotoxicity or genotoxicity.
Conclusion
This blog post addressed the question, “can mouthwash replace flossing”. We understood what research says, why mouthwash cannot replace flossing teeth, types of mouthwash and choosing the one best for you. The article outlined correct ways of using mouthwash and what research says about mouthwash preventing cavities.
FREQUENTLY ASKED QUESTIONS (FAQs): Can Mouthwash Replace Flossing
Can I use mouthwash instead of flossing?
No, your mouthwash can’t replace flossing and hence should be used occasionally in conjunction with flossing.
Flossing effectively removes any food particles or debris from between the teeth and significantly reduces the risk of interproximal caries.
Is it better to mouthwash or floss?
Flossing is better when you compare it with just mouthwash. Flossing helps remove plaque and foods that gets stuck in between the teeth and thus has a significant role in interproximal caries prevention and reducing gingivitis.
Mouthwash can only prevent plaque buildup and has proven to be disadvantageous when used daily for long periods causing tooth staining and even dryness of the mouth.
What can I use if I don’t have floss?
If you don’t have a floss, you can use an interdental brush to remove left food debris, or sugar-free chewing gums to stimulate gingiva and saliva production, or even floss picks.
Is flossing actually necessary?
Yes, flossing is necessary as brushing cannot remove plaque deposits and deposits of food particles and debris from in-between the teeth.
Flossing can clean the interproximal areas and hence is recommended by dental associations and organisations to be used daily once along with toothbrushing.
Can you floss twice daily?
Yes, you can floss twice daily but the American Dental Association recommends you to floss once daily and brush twice a day.
However, there is no harm in flossing twice daily until you are doing it correctly and gently without using much vigorous force.
Other FAQs about Mouthwash that you may be interested in.
Can mouthwash replace brushing
Does Listerine cause sore throat?
References:
Farah CS, McIntosh L, McCullough MJ. Mouthwashes. Aust Prescr 2009;32:162-4.
Hujoel, P. P., et al. “Dental flossing and interproximal caries: a systematic review.” Journal of dental research 85.4 (2006): 298-305.
Sambunjak, Dario, et al. “Flossing for the management of periodontal diseases and dental caries in adults.” Cochrane Database of Systematic Reviews 12 (2011).
Kaur, P., Singh, H., Khatri, A., & Aulakh, K. S. (2015). Evaluation and comparison of short term side effects of 0.2% and 0.12% chlorhexidine mouthwash. Journal of Advanced Medical and Dental Sciences Research, 3(3), 26.
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Chlorhexidine, (2021)
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