Not all mouthwashes are created equal and with so many on the market how do I know which mouthwash is the best for me? We took the Top 10 most popular mouthwashes and ranked them to make it simpler on you: ACT, Biotene, CariFree (CTx3 & CTx4), Crest Pro-Health, Hydrogen Peroxides (HPM or Peroxyl), Listerine, Peridex, Scope, Therabreath, and Tom’s of Maine.
Any other mouthwashes on the market were ruled out due to not being popular or liked among our patients. We do NOT get paid by any company to express which mouthwash is the best in any of these categories. Another study we did tested the best mouthwash by function among most available rinses on the market.
**Note that any prevention products that we sell in office are sold AT THE SAME COST WE PURCHASE THEM so if we recommend a product, it's because you really need it. Let's begin:
If you do NOT currently have any cavities and just want to prevent them, a good regimen is to first use a prescription mouthwash Peridex since it essentially resets the bacterial normal flora in your mouth. Use it for two weeks only and then use regular mouthwash thereafter. Peridex is optional.
Cavities develop predominantly when the mouth becomes acidic. Most mouthwashes are naturally acidic so even though they remove cavity-causing bacteria, most also induce the mouth’s environment to grow back that same bacteria. A more alkaline mouthwash is the most ideal for this situation after Peridex and there are only a few from these Top 10 that truly fulfill that criteria: CariFree's CTx3, Therabreath, Biotene, and ACT
If you have a lot of cavities then you need a mouthwash with a higher concentration of FDA-regulated fluoride in it. The best thing to do aside from mouthwash is come to our office to restore all those cavities. In the meantime, you could rinse initially with a CTx4 rinse. It contains bleach, which kills bad bacteria and dramatically raises your pH in your mouth. The taste is horrible but it unfortunately works. Use CTx4 for 3 months straight then reevaluate. Whether you use CTx4 or not, CTx3 or ACT mouthwashes would be the most beneficial mouthwashes to be used thereafter. Both of these have more protective fluoride properties tand are more alkaline than other mouthwashes including Crest Pro-Health and Listerine!
What kids need in their mouthwash are small traces of fluoride. The amount of fluoride in ACT is like a BB gun compared to toothpaste, which is like a shotgun. So if parents are worried about too much fluoride from combining dental products, ACT is a drop in the bucket and substantially "safe." All other mouthwashes have ingredients that kids don’t need like alcohol or dry mouth ingredients. ACT has an ideal amount of controlled fluoride and has a more tolerable, milder taste for kids. Did you know that ACT is for kids and adults too?
If you have white clouds on your teeth the best way to manage them with mouthwash is using a low-fluoride concentration mouthwash like ACT, Listerine, or Crest Pro-Health. The small amount of constant rinsing with fluoride mouthwash gives a steady flow of building blocks for your teeth to strengthen themselves. It likely will not remove the white spots—this is aided with other means (whitening and going to our office to use an abrasive pumice if necessary)—but it will strengthen your teeth around those white clouds and that is more important.
Dry mouth is a major factor in causing cavities no matter how well you care for your teeth. There is no magic bullet out there that cures dry mouth unless you were to reduce your multiple medications or cure any autoimmune diseases to name the major contributors to dry mouth. The mouthwash of choice for xerostomia (dry mouth) that the majority of our patients prefer is Biotene. Most mouthwashes are used morning and/or night. Biotene can be used throughout the day and even into the evening. Its role is to help stimulate saliva flow.
We actually don't have one brand that we recommend that is a "natural" mouthwash. For those that feel that most marketed products today are injected with toxins that destroy our bodies, Tom’s Natural Mouthwash is gluten free, metal free, vegan, all natural with no preservatives, eco friendly, organic, and the primary ingredient is water. Note that Tom’s mouthwash may have fluoride in it [gasp]. You could save yourself some money and just rinse with water from home but for those that would rather spend money instead, we recommend Tom’s. Side note: did you know that Listerine is an "essential oils" mouthwash and usually has no fluoride in it?
Best Major Tune-Up Mouthwash
Peridex
For anyone that has neglected their teeth for years and wants to get back on the wagon, you must use Peridex! Think of this mouthwash like you would do a major tuneup for your car. As you flush all your car’s fluids, this mouthwash resets the bacteria in your mouth. Use it as prescribed or you will spray paint your teeth with dark brown spots if not used properly: Rinse your mouth with 15mL 1-2x/day up to 2 weeks. Stop using that mouthwash for 3 months and redo the process over again. While not using the mouthwash during that 2.5 month break you may use any other mouthwash of your choosing. Peridex is potent enough that it normally takes the bacteria roughly 3 months to return to its original state prior to using the mouthwash.
Best for Fighting Gingivitis
Peridex
First off, 95% of the population has either gingivitis (the minor disease) or periodontitis (the major disease). These are percentages Bernie Sanders would be proud of. Note the majority of people using mouthwash are NOT saying, “I need to use mouthwash but only for gingivitis.” If gingivitis is your sole concern then use Peridex. It’s a prescription toothpaste and extremely effective. During that 2.5 month span of not using Peridex, you are welcome to use the mouthwash of your choosing. We suggest Plax IF you're just concerned with gum issues.
Best Antibacterial
Peridex
If you feel your teeth are infected, Peridex kills the bacteria that start cavities and fortifies your gums. Unfortunately, there is a different family of bacteria that propagate cavities once they’ve formed in your mouth and Peridex is much less effective against that bacteria. Peridex does have alcohol ingredients so if you have an open wound from an extraction or if you participate in AA then we suggest you refrain from using it. If you want to use a rinse after a tooth extraction, we recommend something simple like warm salt water rinses instead.
This is the most challenging to answer because halitosis is multifactorial. If this is your concern then we don't recommend a mouthwash with alcohol (Listerine or Peridex) nor one that is acidic (most of them). In reality, mouthwash in this situation is more like putting a band-aid over a large open wound. Mouthwash is thus a temporary fix over a bigger issue. Nearly all mouthwashes foot the bill of fixing bad breath temporarily. What we do recommend is fixing the source of the bad breath: get regular dental cleanings, remove cavities, use a tongue scraper, brush two times a day and especially floss, consider a waterpik, quit smoking, limit your diet from garlics, onions, tuna, etc.
CTx3, hands down, has the most beneficial ingredients packed into one mouthwash. It has a high alkaline pH that prevents bacteria from forming cavities. It has the most amount of FDA-regulated fluoride suggested in an over-the-counter mouthwash for the teeth to properly remineralize. It contains xylitol that essentially kills off the bacteria that cause cavities to form. CTx3 helps improve bad breath and it has a mild taste suitable for kids to adults without leaving a potent aftertaste.