Mouthwash is a misunderstood tool for looking after your oral hygiene.
Not everyone needs it, so you may even be wasting money if you buy it unnecessarily. And some of the manufacturer claims are over-hyped.
But mouthwash does have its uses — it can manage bad breath, ease pain and inflammation in the mouth and protect against tooth decay.
Below are my mouthwash recommendations based on my experience as a dentist and research into the various products available.
Our recommendations
Best all-round: Listerine Total Care Zero / Amazon, Chemist Warehouse / ~$10
Best budget: Oral-B Clinical Alcohol Free / Chemist Warehouse / ~$6.99
Best unflavoured: CloSYS Original Unflavored / Amazon, House of Mouth / ~$59.99
Best for bad breath: TheraBreath — Fresh Breath / Amazon, Chemist Warehouse / ~$16.49
Best for dry mouth: Biotene Dry Mouth Relief / Amazon, Chemist Warehouse / ~$16.49
10 useful things to know when choosing a mouthwash
- Mouthwash can be beneficial for those with specific dental issues, but it's not essential for everyone.
- Mouthwash is not a substitute for brushing and flossing. Physical cleaning is more important.
- Use fluoride mouthwash in addition to fluoride toothpaste to reduce decay risk.
- Alcohol-free mouthwashes are recommended over those containing alcohol.
- Consult a dental professional if you have persistent bad breath.
- Avoid using mouthwash immediately after brushing.
- Always follow the usage instructions on the mouthwash label.
- Children under six should not use mouthwash due to the risk of swallowing.
- Mouthwash is normally considered safe for people who are pregnant, but this does depend on the ingredients list.
- Consider eco-friendly mouthwash options to minimize environmental impact.
Best all-round mouthwash
Listerine Total Care Zero
Listerine is one of the most widely known mouth care brands, and can be found around the world. It is widely available in stores and online, with a range of flavours and bottle sizes.
Why we chose it
Listerine's large range can be somewhat overwhelming.
I recommend this option because it is one of their alcohol free options (many Listerine mouthwashes do contain alcohol), and has a milder mint taste. From personal testing I have found many Listerine options to be very strong!
Whilst there are many other listerine options I have picked this one specifically because it contains fluoride at 0.022%, which is at the higher end of the scale.
It has been awarded the Australian Dental Association Seal of Acceptance too.
Recommended use is 20ml twice a day. Although they recommend using after brushing, I would advise using at a separate time of day.
It comes in bottle sizes of 250ml, 500ml, 1L and has a cost of approx 40c per rinse.
Pros |
Cons |
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Contains fluoride |
Not always recycled material bottles |
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Good value for money |
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Fresh taste |
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Alcohol free, so no burning sensation |
Best budget mouthwash
Oral-B Clinical Alcohol Free
More often than not, Oral-B Clinical is one of the cheapest options on the shelf (but do compare it to others that may be on offer). It contains sodium fluoride, and the antimicrobial ingredient CPC.
Why we chose it
This option is also alcohol free, avoiding that burning sensation and any other doubts about alcohol containing mouthwashes.
Recommended use is 20ml twice daily. The bottles come as 500ml or 1L. The cost per rinse works out at 20c, which is one of the best value options out there.
There is only one favour available: Clean Mint.
Pros |
Cons |
|---|---|
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Contains fluoride |
Lack of sustainability information |
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Affordable option |
Only one flavour available |
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Alcohol free, no burning sensation |
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Widely available |
Best unflavoured mouthwash
CloSYS Original Unflavored Mouthwash
I have included this as it was the only truly unflavoured option I could find. It is expensive, though. If you simply want non-mint you could consider Listerine Lemon (view it here on Amazon), although it isn't alcohol-free.
Why we chose it
CloSYS Ultra Sensitive comes as an unflavoured mouthwash, but with a sachet available to add flavouring if you want it. As well as having no taste, there is no burning sensation as it is alcohol free.
The benefits of this mouthwash include Cloralstan, which contains chlorine dioxide to help counteract VSCs which cause bad breath. This mouthwash is also recommended if you have bad breath.
Sadly there is no fluoride in this rinse, although other CloSYS mouthwashes are available that do contain it, but which are not unflavoured.
This mouthwash is alcohol free and SLS free, and is suitable for vegans.
It is not a cheap option, but it is effective and one of the few unflavoured options available.
Pros |
Cons |
|---|---|
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Alcohol free, no burning sensation |
More expensive option |
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Option to add flavour or leave it flavour free |
No fluoride |
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Lack of sustainability information |
Best mouthwash for bad breath
TheraBreath – Fresh Breath Oral Rinse
I recommend this mouthwash as it has such positive feedback from thousands of customers. Whilst it isn’t a cheap, it's worth a go as it comes with a money back guarantee.
Why we chose it
For those who really suffer with bad breath (halitosis) this is a good option because the sodium chlorite fights the cause of bad breath, whilst the minty flavour also gives a refreshing taste.
It is also alcohol free and SLS free.
It comes in 500ml bottles, and recommended use is to rinse with a capful and then gargle with a capful, and to do this twice daily. Unhelpfully the cap doesn’t give a measurement, but I measured it to be approx 35ml at home. This means a regular bottle would only give a 7 day supply.
It comes with a money back guarantee, so it might be worth a go if you are suffering from bad breath.
Pros |
Cons |
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Alcohol free, no burning sensation |
No fluoride |
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Different bottle size options |
More expensive option |
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Powerful taste, feels refreshing |
Lack of sustainability information |
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Money back guarantee |
Large doses for recommended usage |
Best mouthwash for dry mouth
Biotene Dry Mouth Relief
I highly recommend Biotene Mouthwash for people who experience dry mouth symptoms.
Why we chose it
A dry mouth can be sore when eating, drinking, and cleaning your teeth. Sometimes a mouthwash can provide temporary relief.
This mouthwash is not necessary for most people. It’s aim is to rehydrate the mouth, and it does this by helping to retain water and moisture on the mouth surfaces (using ingredients called humectants).
The flavour isn’t all that pleasant, from our testing, but it does provide relief for people who do suffer from a dry mouth.
There is no fluoride in this mouthwash, but it is alcohol free and pH neutral.
The bottles come in 500ml options only, and recommended dose is 15ml, up to 5 times daily, depending on how dry your mouth feels. It works out about 51c per rinse.
Pros |
Cons |
|---|---|
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Alcohol free |
No fluoride |
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Helps with things such as mouth ulcers as well as dry mouth |
More expensive option |
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Large doses for recommended usage |
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Lack of sustainability information |
Buyer's guide: most people don't need a mouthwash
Mouthwash is not necessary for most people.
Physical cleaning is most important. Brushing twice a day for two minutes with a fluoride toothpaste and cleaning in between your teeth is enough to achieve good oral health.
However, mouthwashes can be beneficial in addition to this if there are reasons why physical cleaning is not good enough, or if additional doses of certain ingredients are needed.
The advice of professional organisations around the world varies.
The National Health Service advises: "Using a mouthwash that contains fluoride can help prevent tooth decay, but don't use mouthwash (even a fluoride one) straight after brushing your teeth or it'll wash away the concentrated fluoride in the toothpaste left on your teeth."
The American Dental Association says: "While not a replacement for daily brushing and flossing, use of mouthrinse (also called mouthwash) may be a helpful addition to the daily oral hygiene routine for some people."
The Canadian Dental Association advises: "As part of your morning oral health routine, swish with an oral rinse (also known as mouthwash or a mouth rinse) once a day. This will help keep odour-causing bacteria at bay."
These people do benefit from mouthwash:
- Adults at high risk of tooth decay - to get an additional dose of fluoride
- Children over the age of six at high risk of tooth decay - to get an additional dose of fluoride
- People with sore mouths due to infection, ulcers or surgery should use mouthwash - specific ingredients can help prevent infection of open wounds and ulcers, reduce inflammation, and help manage soreness in the mouth.
- People who struggle using a toothbrush should use a mouthwash - for example people who struggle to physically clean their teeth with brushing due to disabilities. The fluoride can protect against tooth decay whilst anti-plaque ingredients can help manage the inevitable build up which can’t be removed by brushing.
- People with gum disease should use a mouthwash to help manage plaque levels.
- People with sensitive teeth - by using mouthwashes containing desensitising ingredients to help manage sensitivity.
- People with bad breath - to help mask the smell and to help manage the causes.
Choose a mouthwash with fluoride and without alcohol
Alcohol is added to mouthwash as a preservative. It has little effect on most people, other than a mild burning sensation.
But some people find the alcohol content can actually dry the mouth out and make bad breath worse. There is some conflicting evidence about whether or not alcohol in mouthwash can increase cancer risk.
Overall, there is nothing to suggest that alcohol containing mouthwashes are more effective than alcohol-free mouthwashes, so it's best to avoid it if you can.
We do recommend opting for a mouthwash with fluoride, unless you are using it for another specific purpose such as pain relief. The additional fluoride can help to prevent tooth decay.
Don't use it more than twice a day unless told to by your dentist
Most mouthwashes will give you the most benefit if they are used twice a day. You are unlikely to get any extra benefits from using it more often.
If you are using mouthwash for a specific condition, or after oral surgery, your dentist might recommend it differently - such as three or four times per day. This is for a short amount of time - normally a week or two. Follow the advice given by your dental care professional.
Here's why you should use mouthwash at a separate time to brushing
The basic message is don't use mouthwash straight after brushing. Rinsing after brushing removes the toothpaste you have just used.
Using mouthwash at a different time to brushing leaves the toothpaste contacting the teeth to allow the fluoride to have maximum benefit.
Using mouthwash before brushing has few benefits
Using mouthwash directly before brushing has very few benefits - it is, essentially, a waste of money. This is because the act of brushing the teeth will remove any ingredients left by the mouthwash.
Using mouthwash after brushing creates a fluoride wash-out
Research has shown that using a non fluoride or low fluoride mouthwash after brushing reduces the anticaries benefit of toothpaste. This is a wash-out effect.
To prevent this wash out, wait at least half an hour after brushing before using mouthwash.
However, there are a limited number of studies showing that mouthwash with a high enough fluoride content might not have a negative effect if used straight after brushing. A mouthwash containing a minimum of 100ppm fluoride "should not interfere with the toothpaste's anticaries protection".
Ingredients in mouthwash and toothpaste can react with each other
The other reason to leave it at least 30 minutes after brushing to use a mouthwash is because some ingredients in mouthwash can interact with some toothpastes. This makes the mouthwash less effective.
Some toothpaste ingredients (like calcium hydroxide or aluminium hydroxide) can form a complex with fluoride ions, which will reduce the effectiveness of a mouth rinse.
Two studies looked at two specific ingredients: Chlorhexidine and CPC. Both remove less plaque if used in a mouthwash directly after using a toothpaste containing SLS, as a result of ionic interactions.
Even though some higher fluoride mouthwashes will not have a wash out effect if used straight after brushing, if these mouthwashes also contain chlorhexidine or CPC then they will not be as effective due to chemical reactions.
This is why it is best to use mouthwash at a different time of day.
Don’t rinse with water after brushing either
Rinsing your mouth with water after brushing your teeth rinses off the toothpaste you have used.
Before modern toothpaste was invented, gritty pastes made from ingredients such as eggshells and urine were used to cleanse the teeth. This is why it was common to rinse after brushing.
However modern toothpaste doesn’t contain these harmful or unhygienic ingredients. It is totally safe to leave on your teeth. In fact, it has many beneficial ingredients. Avoid rinsing to avoid washing these off before they can have maximum benefit.
People who rinse with water after brushing have more tooth decay than people who don’t.
5 interesting things about mouthwash from scientific studies
Clinical trials have extensively tested various products and ingredients under different scenarios. Here's what the research says:
1. Mouthwash prevents tooth decay
Using a fluoride mouthwash reduces the risk of tooth decay (Marinho et al).
This is when it is used in addition to brushing with a fluoride containing toothpaste. It is estimated that correct use of mouthwash decreases decay risk by 26% more than toothpaste alone (however dentist applied fluoride gel has even better outcomes).
2. Mouthwash reduces levels of plaque
Some ingredients are able to act directly on dental plaque. This complex film on the teeth is made up of bacteria, their waste products, and food debris from the mouth.
3. Mouthwashes improve gum health
The fact that mouthwashes reduce plaque levels seems to also cause an improvement in gum health.
A 2015 publication by A Jose and team found "Chlorhexidine mouthrinse with or without alcohol as an adjunct to brushing with regular fluoride toothpaste significantly reduces bleeding scores, plaque and gingival inflammation compared to brushing alone."
This better gum health is also found with other ingredients, with a Brazilian study finding that CPC and zinc lactate containing mouthwashes providing "significantly greater reductions in Plaque, Plaque Interproximal, Gingival, Gingival Severity, and Gingival interproximal index after 4 and 6 weeks of product use".
4. Mouthwashes can help manage bad breath
Mouthwash can mask bad breath temporarily. The strong mint flavours cover up the smell of bad breath.
Some mouthwashes contain ingredients to soak up VSCs, the chemicals that cause bad breath for some people. These types of mouthwashes are one method to help manage bad breath.
Research supports the use of a number of different mouthwashes containing different combinations of ingredients, with them all being more effective than not using a mouthwash.
Bad breath often has an underlying cause such as gum disease or tooth decay. Medical conditions like reflux can also cause bad breath, so it is important to talk to a medical or dental professional if this is an ongoing issue.
5. Essential oil mouthwash may be beneficial
There is some evidence to support the use of essential oil containing mouthwashes as being beneficial for oral health. One study showed essential oil mouthwash is more effective than floss at removing plaque from between the teeth.
What would be the best to use for an 82 year old woman who’s mouth is raw and the roof of her mouth bleeds ? She also has bels palsy and was wondering if this would contribute to this , thank you
Hi Carloyn, I would recommend she sees a dentist or doctor if this is an ongoing problem. I cannot give advice specific to someone without assessing them first, but please read on for some general tips: - If she finds mouthwash too irritating, she doesn't have to use one. Toothbrushing with toothpaste normally gives enough fluoride to protect against toothpaste. - If she wants something to help the healing process she can try the home remedy of warm salty mouthwashes. - Short term use of chlorhexidine or peroxide containing mouthwashes are a good option to prevent infection of big open patches in the mouth, though these are only recommended for a week or too, until the patches have healed. These are available over the counter and in chemists. - If she would like something to help relieve the pain, there are specific numbing mouthwashes like Cepacaine. You will normally need to go to a chemist for these. There are other options also available on prescription from a doctor or dentist. They will also be able to assess whether or not the Bell's Palsy in contributing to the sore mouth. Gemma