The short answer
Most people who use mouthwash use it once or twice a day, after brushing and flossing. Always follow the label for your specific product. The American Dental Association (ADA) says mouthwash can be a helpful extra step, but it is not required and it never replaces brushing and flossing.
If you have to choose between mouthwash and flossing, choose flossing every time.
People reach for mouthwash for three main reasons: fresh breath, less plaque and gum irritation, and cavity protection. Each one has a different best rinse. Knowing your reason helps you pick the right product and stop wasting money on the wrong one.
Cosmetic vs therapeutic mouthwash
Not all rinses do the same job. The ADA splits them in two groups:
Cosmetic mouthwashes only freshen breath for a while and leave a pleasant taste. They do not lower your risk of cavities or gum disease.
Therapeutic mouthwashes do more. The ADA says they can kill bacteria and reduce plaque, gingivitis (early gum disease), cavities and bad breath. Rinses with fluoride help prevent or reduce tooth decay. Some therapeutic rinses need a prescription, and many are sold over the counter.
Read the label. It will tell you whether the rinse is therapeutic and what it is meant to do.
Be careful with the word "natural" or "whitening" on the front of the bottle. Those words are marketing, not a promise of medical benefit. The ADA Seal is the better guide.
How often to use it
There is no one number that fits everyone. A good rule of thumb:
Do not overdo it. Using a rinse many times a day will not clean better. Some strong rinses can irritate the lining of your mouth or change how food tastes if you use them too often.
Check the swish time on the label. Most rinses need 30 seconds to a minute to work, so a quick five-second splash does little. Use the measuring cup and do not dilute or add water unless the label says so.
- Over-the-counter rinses: once or twice a day, as the label says. Swish for the time listed, usually 30 seconds to a minute.
- Prescription rinses, like those used for gum disease: use exactly as your dentist or doctor says. Some are meant for short periods only.
- Fluoride rinses: often once a day, at a time that is not right after brushing, so they add fluoride instead of washing it away.
- Bad breath rinses: as needed, but if you need them all the time, see a dentist to find the cause.
Before or after brushing?
This is a common question. The answer depends on the rinse. Many dentists suggest using mouthwash at a different time from brushing, such as after lunch or before bed after you floss. That way the fluoride from your toothpaste stays on your teeth. If you rinse right after brushing, you may wash some of that fluoride away.
If you use a fluoride rinse, try not to eat or drink for a short while after rinsing, so it can work. Your product's label and your dentist can tell you the best timing.
Always spit out mouthwash. Do not swallow it.
If you are not sure, a good plan for most people is to use your mouthwash at a different time of day than your brushing. For example, brush and floss at night, then rinse after lunch the next day. That way you do not wash off the toothpaste fluoride, and you get a boost of protection during the day.
What mouthwash can and cannot do
Mouthwash can reach places a brush and floss might miss. That is where its benefit comes from. It can help lower plaque and gum irritation and freshen your breath.
It cannot scrub off plaque the way a brush does. It cannot clean between your teeth. It also cannot fix the cause of a bad smell. Bad breath often comes from the tongue, from food stuck between teeth, from gum disease, from dry mouth or from a problem elsewhere in the body. A rinse can cover it for a while, but the cause stays.
If your breath is bad even though you brush, floss and rinse, book a dental visit. We will check for cavities, gum disease and dry mouth. If those are fine, your doctor can look for other causes.
A small comfort: a rinse can also help in special moments, like after a dental cleaning if your gums feel tender, or when you cannot brush after a meal. In those cases a quick swish of plain water also helps, and costs nothing.
Think of mouthwash as the spray at the end of a car wash. It helps, but only after the real cleaning has been done. If the car is caked in mud, the spray alone will not fix it. Likewise, a rinse on top of plaque you left on your teeth will not do much.
Who should be careful
Children under 6. The ADA does not recommend mouthwash for kids under 6, because young children may swallow large amounts. That can cause nausea, vomiting and, for rinses with alcohol, intoxication. Supervise older kids and check the label.
People with dry mouth. Rinses with alcohol can feel harsh and dry the mouth more. Alcohol-free options exist. Ask your dentist what fits you.
People with sensitive gums or mouth sores. A strong rinse can sting. If your mouth burns after rinsing, stop and ask your dentist.
People who take medicines or have health conditions. Ask your doctor or dentist, especially for prescription rinses. Some can stain teeth or change taste for a while when used for a long time.
Pregnancy and health conditions. Most rinses are safe to use during pregnancy, but ask your doctor or dentist about prescription rinses or products that contain alcohol. If you have diabetes, a dry mouth or a weak immune system, a rinse can help or hurt depending on the type, so it is worth a quick talk.
People who just had dental surgery or an extraction. Do not swish hard in the first day or so after a tooth is pulled. Your dentist will give you directions for rinsing with salt water or a prescription rinse when it is safe.
How to pick one
Look for the ADA Seal of Acceptance. The ADA says the Seal means the product was tested and shown to be safe and effective. Then match the rinse to your need:
A simple routine that works. Brush twice a day for two minutes with fluoride toothpaste. Clean between your teeth once a day. If you want an extra step, add a rinse at a time that works for you, for example after lunch. Visit your dentist and hygienist regularly. This routine does more for your mouth than any rinse alone.
- Cavity-prone? Pick a rinse with fluoride.
- Gum irritation or plaque? Ask your dentist about an antibacterial therapeutic rinse.
- Sensitive or dry mouth? Pick an alcohol-free formula.
- Just want fresh breath? A cosmetic rinse is fine, but do not count on it for protection.
Rinse advice at KDA
Not sure which rinse is right for you? Ask us. At Kendall Dental Associates, our hygienists take an hour for routine cleanings, so there is time to look at your gums and talk about the tools that make sense for you. We have been in the Kendall Mall since 1973, at 8833 SW 107th Ave, Miami, FL 33176.
We are open Monday to Friday, 8:00 AM to 5:00 PM, with emergency care 24/7. We accept most dental insurances and most Medicare supplemental plans, and financing is available. Call 305-271-1421.
Common questions
Can mouthwash replace brushing?
No. The ADA says mouthwash is not a replacement for daily brushing and flossing.
Should I use mouthwash before or after brushing?
Many dentists suggest a different time from brushing so the toothpaste fluoride stays on your teeth. Check your product's label.
Is mouthwash safe for kids?
The ADA does not recommend it for children under 6, since they may swallow it.
What is the difference between cosmetic and therapeutic mouthwash?
Cosmetic rinses freshen breath only. Therapeutic rinses can reduce plaque, gingivitis, cavities and bad breath.
Why is my breath still bad after mouthwash?
The cause may be gum disease, cavities, a coated tongue or dry mouth. A dental exam can find out.
This article is general information, not medical advice. Your dentist will confirm what is right for you at your exam. General information checked against: mouthhealthy.org, mouthhealthy.org.