Mouthwashes and their Limitations and Risks

Mouthwashes and their Limitations and Risks

It’s true that mouthwashes fight plaque-causing bacteria and provide fresh breath. Studies have proven the effectiveness of mouthwashes that dentists around the world recommend its use. However, there are many types of mouthwashes available on the market, and they have their specific use, limitations and risks. Let us delve into them so you'd know which one to get on your next trip to the grocery or pharmacy.

Limitations and Risks of Different Types of Mouthwashes

1. Cosmetic mouthwash

Cosmetic mouthwashes do not contain an active ingredient to help fight bacteria in the mouth. It temporarily masks bad breath; think of eating mints but only in liquid form and without the calories. Some whitening mouthwashes are also considered cosmetic because they do not offer any therapeutic use.<


Some whitening mouthwash may increase tooth sensitivity and produce soft tissue irritation due to peroxide or alcohol content.

2. Therapeutic mouthwash

Therapeutic mouthwashes are classified into two: over the counter (OTC) and prescription mouth rinse.

a. OTC therapeutic mouthwash

A mouthwash falls under the category of therapeutic if it contains active ingredients clinically proven to kill plaque-causing bacteria targeting the root of halitosis, gingivitis, tooth decay and gum disease. Active ingredients are defined as the component responsible for providing the therapeutic claims of the product. Some common active ingredients included in mouth rinses are:

* Cetylpyridinium chloride (CPC)

CPC is a broad-spectrum antimicrobial agent to support oral health, proven effective in fighting plaque-formation and gingivitis. Its mode of action is to damage the protective barrier of the bacteria leading to its death.

Side effects

Some side effects of using CPC-containing mouth rinse are taste alteration and teeth staining.

* Hexetidine

0.1% hexetidine is classed as a safe broad-spectrum oral antiseptic to fight bacteria and fungi. It inhibits the growth of gram-positive and gram-negative bacteria by interfering with vital metabolic processes. Hexetidine mouthwash is proven effective in reducing gingival bleeding, inflammation and plaque buildup. Hexitidine also has an antifungal property, making it effective against mouth sores.


Some side effects of using 0.1% hexetidine mouthwash are the change in taste, teeth stains and hardened dental plaques.

* Fluoride

Fluoride is an effective agent in preventing caries. Its mode of action is to avoid the loss of minerals, promote mineralisation, and strengthen the teeth. Fluoride is a standard component in therapeutic mouthwash in the form of 0.2% sodium fluoride, proven effective in reducing cavity formation.


Too much fluoride can make the teeth brittle. It is possible to have too much fluoride with the use fluoridated water, fluoride-containing toothpaste, and fluoride mouthwash.

* Peroxide

Hydrogen peroxide is a common ingredient due to its bleaching and antimicrobial property. The peroxide content present in common brands are low, ranging from 1.5% to 3%. At this range, minimal side effects are observed, making it safe for daily use.

Side effects

Hydrogen peroxide can produce a mild burn sensation in the mouth.


Commercial mouthwashes contain a safe amount of hydrogen peroxide. This ensures the safety of the consumers. The health risk of using hydrogen peroxide mouth rinse comes from improper dilution and self-made mouthwash. High concentration and prolonged use of hydrogen peroxide mouthwash may result in soft tissue necrosis.

b. Prescription therapeutic mouthwash

Chlorhexidine is the preferred therapeutic mouthwash in treating gum diseases. It eliminates and prevents the growth of bacteria in the mouth and aids in gum healing and sores. Highly effective and fast-acting, killing bacteria in 30 seconds. It has substantial adherence properties on soft tissues, making it an efficient preventive and therapeutic agent against harmful pathogens.

Side effects:

Some side effects of chlorhexidine are teeth stain, change in taste and hardened tartar. In some rare cases, chlorhexidine may cause allergic reactions and soft tissue irritation. Chlorhexidine is also reported to damage the cells that are responsible for healing, prolonging the restoration time.


More than two weeks of use of chlorhexidine mouthwash can result in oral microbiome disruption. This can lead to increased saliva acidity due to an imbalance in the amount of bacteria and disruption of microbial processes. Our teeth weaken in the presence of an acid, promoting demineralisation. Another risk of having an imbalanced oral microbiome is the risk of developing oral diseases like periodontitis. Oral microbiome is also essential for the immune system and digestion.

3. Specialised mouthwash + PDT system

Specialised mouthwashes contain photosensitisers used together with light. Photosensitisers (a special dye) are light-sensitive agents that attach themselves to the target bacteria's protective wall. Upon light exposure, the dye absorbs the light stimulating it to an excited stage. It then releases the absorbed light by producing heat or produces high-energy oxygen that ruptures the protective covering of the bacteria, eliminating them simultaneously. Unlike mouthwashes that affect a wide range of bacterial strains, the PDT system is highly focused, only targeting the effect on teeth and the gumline and leaving the rest of the oral cavity unaffected. This ensures that the normal flora of the mouth remains undisturbed, restoring a balanced oral microbiome.

Side effects:

The light therapy system is proven safe. The maximum side effect would be a warm sensation during application.

General Mouthwash Precaution

Children 6 years and below should not use mouthwash unless prescribed by a dentist. The limitation is set due to the likelihood of ingesting a large amount of liquid due to their undeveloped swallowing reflex that may cause nausea and vomiting.

Bottom Line

Mouthwashes only serve as additional support in oral hygiene. It is vital to brush and floss in between teeth regularly. Choosing the most effective and safe oral aftercare is essential in keeping a healthy mouth. Keep yourself updated on new products that can help you take better care of your oral health.

Lumorinse mouth rinse is the most potent mouthwash solution that targets plaque-producing bacteria. It is a part of the Lumoral system to effectively prevent the development of gum inflammation, periodontitis and cavity formation. Furthermore, it removes teeth stains with continued use.

Visit our website to learn more about the benefits of using Lumoral. For more information, please contact us at Or click the button below to buy one now.