Everything You Need To Know About Mouthwash

If you are brushing and flossing your teeth regularly as per your dentist’s recommendations, but still feel you are not as fresh as you can be, you should consider adding mouthwash to your oral hygiene regimen. However, buying a bottle of mouthwash is not as easy as you would probably think.

To help you make an informed choice, here is a guide containing everything you need to know about mouthwash.

If you have any pressing dental issues or questions, you can book an appointment online or contact us directly on (+356) 2125 7253 (Skyparks Business Centre, Malta International Airport), or (+356) 2155 7323 (Dingli Street, Victoria, Gozo). For international patients, it is recommended to request a free e-consultation where we can discuss your individual case and treatment options.

Why use mouthwash?

To help fight gum disease or other oral severe conditions

Gum disease is the loss of supporting structures of teeth caused by bacterial activity. Individuals with gum disease also have bad breath since the disease creates perfect conditions for bacteria to thrive. Usually, the space between the teeth and the gums is between 1 and 3mm. However, with gum disease, this space can increase to 5mm or more. An increase in this space allows bacteria to hide in even deeper places that toothbrush bristles cannot reach. Mouthwash can get to these spaces and stop or reduce gum disease and other oral conditions on their tracks. (1)

Bacteria-fighting power

Some mouthwash contains alcohol, which is deadly against bacteria. However, if you have sensitive teeth, dry mouth or sore gums, you should stay away from alcohol-based mouthwashes. (2)

An extra boost of freshness and helps eliminate bad breath

Mouthwash effectiveness can be broken down to the ingredients. Some are designed to give a fresh scent while others penetrate even deeper to kill the bacteria causing the bad breath. The result is a significant boost in oral freshness.

Help whiten teeth

Mouthwash helps to reduce and prevent tartar, gingivitis or plaque. Some mouthwash come with ingredients that help in whitening teeth.

Complements brushing and flossing

Mouthwash helps to get rid of plaque and debris stuck in areas that flossing and brushing can’t get to. Although they are not a replacement, they are a complement to these oral cleaning methods.

Types of Mouthwash

Antiseptic Mouthwashes

Antiseptic mouthwashes contain chlorhexidine at 0.2% concentration. Mouthwashes that contain this ingredient are a measuring rod of all antiseptic mouthwashes. They are great in fighting off fungi, spores, and bacteria.

Antiseptic mouthwashes are used after oral surgeries when the bacteria cannot be removed using other methods and when brushing is impossible due to pain. In addition to this, chlorhexidine mouthwashes are used to manage erosive mucosal conditions and oral ulcerations. They help prevent infections that may cause a delay in the healing process.

Plaque-inhibiting mouthwashes

These mouthwashes have a variety of active ingredients, including antimicrobials, essential oils and agents that prevent bacteria from sticking to the enamel. Different ingredients employ a different method of preventing plaque build-up.

These mouthwashes are designed to complement brushing and flossing. When used alone, their oral benefits are limited.

When used right after brushing, the active ingredients in these mouthwashes can reduce fluoride effects on teeth but improve plaque control. However, if the goal is to improve plaque control and prevent tooth cavities, it’s advisable to use the mouthwash at least half an hour after brushing.

Preventative mouthwashes

The most common type of preventative mouthwashes are those with fluoride. These help in preventing tooth decay and in some cases aid in reversing early lesions caused by caries. Preventative mouthwashes are recommended for patients above eight years who are at high risk of getting dental caries. Other individuals at high risk of developing dental caries include those who take a lot of sugar and patients undergoing some orthodontic treatment.

Other mouthwashes

There are also some mouthwashes designed to manage specific conditions, including xerostomia, which may be caused by several factors including radiotherapy, autoimmune diseases or drugs.

Mouthwashes can also be used to keep dentine hypersensitivity under wraps and whiten teeth.


Mouthwash ingredients explained

Cetylpyridinium chloride

It is an ammonium compound that helps in killing bacteria and preventing the formation of plaque. It’s excellent in getting rid of bad breath.

Delmopinol hydrochloride

This ingredient causes minimal staining and helps to interfere with plaque adherence to the enamel. It also helps to manage gingivitis.

Essential oils (e.g. thymol, menthol, eucalyptol)

These essential oils are used in alcohol-based mouthwashes for their antibacterial effects and to counter bad breath.

Heavy metal salts (e.g. zinc chloride, tin fluoride)

Heavy metal salts, like zinc chloride, help to fight bad breath; their effects last for about 12 hours.


This ingredient protects you from bacterial infection. The enzyme attacks the protective bacterial walls and causes the bacteria to burst open from internal pressure.


This is an extract from the root of Sanguinaria Canadensis. It is known for its anti-plaque properties and helps in reducing gingivitis and plaque.

Sodium benzoate

This ingredient is added to mouthwashes to freshen the mouth.

Sodium bicarbonate

This ingredient comes at a substantially low price and helps to prevent infections, cavities, pain, and other tooth issues. (3)

Sodium chloride

Sodium chloride retards bacterial growth and helps to relieve swelling after oral surgery.


This ingredient is effective against bacteria as well as some protozoa and fungi. It is used in antiseptic mouthwashes.

Best Mouthwashes for Children

Regardless of the mouthwash you choose, there are several things you ought to bear in mind when selecting one for your child.

Pick an alcohol-free mouthwash

Alcohol is present in a variety of mouthwashes designed for adults. And while these mouthwashes are great against bacteria, they are not suitable for kids; this is because children tend to swallow mouthwashes (even when you tell them not to), and alcohol isn’t good for them (even in small amounts), for this reason, it is essential to stay away from alcohol-based mouthwashes.

Certified & Approved

The mouthwash you choose should be approved by the dental quality assurance body, such as the American Dental Association (for the US). Any mouthwash with the ADA seal has been tested to be safe and effective for its target market.


The mouthwash you choose for your kid should have a nice flavour. Most kids don’t love mint. Many kid-friendly types of mouthwash have flavours that appeal to kids like bubble gum. Regardless of the flavour you choose, the mouthwash will still achieve its goal – a clean and fresh mouth.

Best mouthwash if you are prone to cavities

The best mouthwash to prevent dental cavities is one that contains Cetylpyridinium chloride, essential oils, lysozymes, and sodium chloride. These ingredients help prevent bacteria and consequently contribute to preventing cavities.

How to Use a Mouthwash Properly

Do you do it before or after brushing?

You can use your mouthwash before or after brushing. Using it before can help to lift the plaque from the enamel and ensure a thorough clean when you brush. On the other hand, flossing can help remove food debris between the teeth which will give your mouthwash an easier time getting rid of the debris.

However, if you wish to retain the benefits of fluoride from your toothpaste, then you should use the mouthwash before you brush and floss your teeth, or at least half an hour after.

How many times a day?

Most mouthwash brands and dentists recommend that you use the solution twice in 24 hours.

Use the right amount

Most mouthwashes come with directions on how much should be used. However, dentists recommend using about 20ml, which translates to about four teaspoons.

Swish like you mean it

Close your mouth and swish the mouthwash vigorously to force it between the teeth.


You should not swallow the mouthwash. The fluoride used in these products could be toxic when swallowed in large amounts. If your kid uses adult mouthwash, you should supervise them to ensure they spit it out.

Wait 30 mins before eating,  drinking or smoking; this will allow the active ingredients more time to work.

Mouthwash FAQ

Which type of mouthwash has the most fluoride?

Fluoride helps in killing bacteria. As such, they are mostly contained in anti-bacterial mouthwashes than in other types.

Which type of mouthwash does not stain teeth?

Most mouthwashes contain cationic antiseptics, polyvalent metal salts, and phenolic stain teeth. To prevent this, choose teeth whitening mouthwashes as these don’t stain your teeth.

Is mouthwash good for canker sores?

Yes. Antibacterial mouthwashes help to prevent periodontal diseases as well as ease canker sores by killing bacteria in the area. These bacteria irritate the sores.

Which type of mouthwash is best for braces?

Fluoride mouthwashes are best for braces. They help to prevent cavities and white spots while freshening your breath.

Mouthwashes are complementary to flossing and brushing your teeth. They are a great way to prevent bad breath, cavities, and gum disease. However, you should be careful to use them as prescribed by the dentist.

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Savina Clinic – Dental & Implantology Centres are friendly, state-of-the-art practices in Malta and Gozo dedicated to comprehensive quality dental care. Savina Dental is an innovative dental practice in Malta and prides itself on the high-quality customer service, low waiting room times, attention to detail and the advanced dental technology at their disposal.

Joseph Xuereb
Principal Dental Surgeon & Owner of Savina Dental Clinics, Dr Joseph Xuereb BChD (Hons), MFGDP(UK), MGDS RCS(Eng), FFGDP RCS(UK), FICD is a general dental practitioner with a special interest in Implant and Restorative Dentistry. Dr Joseph & the teams' full biographical information can be found here.