What Makes A Good Mouthwash?

Let us begin with your mouth, an orifice we generally think of as a polite conversational instrument, a conduit for pasta, proclamations and the odd ill-judged gin.

But this shimmering cavern is, in fact, a densely populated metropolis of microorganisms: billions of them, gossiping, breeding, squabbling and negotiating invisible truces. More than 700 kinds of bacteria alone are registered as residents.

And the first of them arrive before you’ve even had the chance to develop an opinion on anything. Mother gifts them to you in a primal handover, our earliest inheritance, and arguably more influential than the family china.

As you grow, the neighbourhood changes. Diet, poor decisions, kisses you regret, kisses you don’t, a lifetime’s sampling of drinks and nibbles, each adds new tenants to the microbial borough. Some unpack and stay; others are shown the door by your immune system with the efficiency of a nightclub bouncer who’s already had his tea.

This lively ecosystem is your oral microbiome: a heaving, microscopic society of the good, the bad, the opportunistic and the downright antisocial. The key, as it is with all societies, is balance. Diet, nutrition, lifestyle, these are your zoning laws, your building regulations, your parliamentary debates.

How Plaque Forms: The Biofilm Begins

Which leads us, inexorably, to plaque. That adhesive filth, that sticky municipal graffiti tagging the enamel surfaces of your teeth. It forms whenever bacteria mix with the sugars and starches of the things you like to eat, so yes, always. A few of the resident species are real thugs, capable of considerable damage, and once they outnumber the good citizens, the trouble begins.

So you clear away the plaque, of course, but you also tend to the fragile ecology that governs it.

Oral hygiene is no small matter. Gum disease has been linked to heart valves misbehaving, blood sugar wobbling, blood vessels sulking, and even the health of unborn children. It seems absurd that something as simple as an inflamed gum could send memos to distant organs, but the body is a labyrinth of secret passageways.

News travels. Trouble follows.

The Great Swishing Delusion

And into this anxious landscape strides mouthwash, wearing a cape stitched from television jingles and promising miraculous freshness in thirty seconds flat.

Advertisers insist it is the sovereign remedy, minty sanctification for the modern mouth. But the truth is more melancholy. Many commercial rinses contain chemicals so aggressive they’d feel at home stripping Victorian paintwork.

Chlorhexidine kills bacteria with the enthusiasm of an invading army, good ones, bad ones, anything foolish enough to stand in its path. Alcohol dries the mouth, parabens meddle with systems they have no business in, and the result can be more ulcers, worse breath, and even increased risks of serious disease.

Mouthwash to avoid    

Whilst on the subject you may have seen a TV ad where a woman’s teeth fall out of her mouth into her hands.  Of course it’s a bad dream.  Then as she brushes her teeth blood comes out of her mouth.  Were you shocked?  Could blatant scaremongering have been the purpose behind the ad for Corsodyl?  The tagline is “Because losing a tooth in real-life is worse than a bad dream.”

In 2011, a  verdict of ‘death by medical misadventure’ was recorded at Brighton County Court after a patient died from anaphylactic shock after using Corsodyl mouthwash administered to her in a dental practice.   

Before you reach for the neon-blue potion, it’s worth remembering that the very best mouthwash is already in residence: your own saliva, given that your mouth is already healthy.

Expertly formulated by millions of years of evolution, available in unlimited daily refills, and, here’s the delight, swallowing it helps your immune system. Hard to find a commercial rival that’ll brag about that.

Of course, humanity has a long and eccentric history of rinsing its mouth with things. The Chinese were swirling mouthwashes as early as 2700 BC. Ayurvedic practitioners prescribed them for gum disease.

The Romans, never shy of a bit of vinegar and sulphurous salt, rinsed and scrubbed like dental drill sergeants. The Greeks preferred olive leaves, oil, milk, wine, and the peelings of pomegranates.

North American Indians worked with plant-based rinses such as Coptis Trifolia. And in the 18th century, Europe saw fit to gargle with urine-based mouthwash. It was a different time. Or at least one hopes so.

In comparison, your own saliva begins to look like refined French champagne.

For those the habit of using a commercial mouthwash every morning or before a date night, with the stoic determination of someone convinced suffering equals cleanliness, that needn’t be you. Nature offers botanicals and homemade rinses that freshen breath better than the fluorescent chemical brews lining supermarket shelves, and without the unpleasant association with oral cancer that many commercial concoctions now carry.

And while we’re at it, don’t forget your tongue. It isn’t an innocent bystander. It is a bustling multistorey car park of bacteria, a velvety microbial bus station. A daily scrape is not optional. It is civic duty.

Meanwhile, now and then a miracle mouthwash pops up that is said to dismantle the biofilm or some other wonderful effects. If true, it would be a revelation, though one always keeps a sceptical eyebrow raised at miracles. If you’re looking for a well-tested and affordable mouthwash, just use Celtic sea salt in warm, filtered water.

Until then, keep your microbiome amicable, your tongue tidy, your diet defensible, and remember: a well-managed mouth is less a battlefield than a beautifully run city.

Feed its citizens well, don’t poison them, and they’ll serve you for life.