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One type of product possibly sitting in your bathroom may affect more than your smile
By: Mary Gillis
Mouthwash is a bathroom staple in many households, but risks tied to these minty antimicrobials could do more harm than good—harm that extends beyond a person’s pearly whites, according to a new comprehensive study.
While the number of ingredients and their concentrations vary among mouthwash brands, scientists have concluded that some ingredients in these oral hygiene products are linked to side effects ranging from minor skin irritation and headaches to life-threatening conditions like heart problems and cancer.
Researchers in Turkey examined 45 mouthwash formulas used by 17 commercial brands found in the five largest chain stores in Istanbul.
They found 31 out of the 45 formulas (over 68 percent) contained glycerin, associated with kidney and liver deterioration, 29 (over 64 percent) included the known carcinogen sodium saccharin, and 28 (about 62 percent) contained propylene glycol—a chemical linked to organ failure when used in large doses.
Despite its link to tooth decay, the antiseptic chlorhexidine gluconate was included in 7 of 45 formulas. Other ingredients, such as the plaque-reducing agent cetylpyridinium chloride and acid orange 7 dye, can cause tooth discoloration and staining.
“The limited array of mouthwashes found on store shelves poses a concern for both oral and public health,” study authors wrote in the International Dental Journal. “Furthermore, the intricate composition of these products, consisting of numerous ingredients with the potential for adverse effects, warrants serious attention.”
Are These Chemicals Also Found in Toothpaste?
According to a paper published in the Bosnian Journal of Basic Medical Sciences, the answer is yes. Mouth rinses practically have the same composition as toothpaste. Some overlapping chemicals include:
Abrasives that remove substances on tooth surfaces without scratching them.
Binders that prevent the product from drying out.
Solvents that dissolve ingredients so they can be mixed. Water makes up the majority of solvents, but alcohol is also used in mouth rinses.
Foaming agents that enhance the cleaning effect and remove dirt.
Flavoring agents that eliminate unpleasant smells and provide a refreshing taste. Examples include spearmint, peppermint, and eucalyptus.
Coloring agents like titanium dioxide, which is used to make toothpaste white.
Preservatives that prevent the growth of microorganisms.
Is Mouthwash a Substitute for Toothpaste?
According to the American Dental Association (ADA), mouthwash is not meant to substitute toothpaste but is a valuable addition. Swishing and gargling can help reach areas that are sometimes hard to reach with a toothbrush.
There are two main types of mouthwash: therapeutic and cosmetic. Therapeutic mouth rinses are available both over-the-counter (OTC) and by prescription and help control plaque, gingivitis, bad breath, and tooth decay. Cosmetic mouthwashes temporarily control bad breath but are not meant to eliminate plaque, gingivitis, or tooth decay.
Warnings, Recalls, and Other Risks
Several warnings and recalls have been released over the past decade regarding the dangers of mouthwash.
In 2017, the U.S. Food and Drug Administration (FDA) issued a warning about a rare but severe allergic reaction to the antiseptic chlorhexidine gluconate used for gum disease. According to the warning, chlorhexidine gluconate may cause wheezing and difficulty breathing, face swelling, hives, severe rashes, and shock, a life-threatening condition that occurs when blood flow is reduced.
In 2020, pharmaceutical repackaging company Lohxa issued a voluntary recall of a batch of chlorhexidine gluconate oral rinse due to potential contamination with the bacteria Burkholderia lata. The recall of the defective product has since been terminated.