Alcohol vs. Alcohol-Free Mouthwash: What's the Difference?

Alcohol vs. Alcohol-Free Mouthwash: What's the Difference?

 Whitney DiFoggio MA, RDH
Written by Whitney DiFoggio MA, RDH🔬 Evidence Based
Alcohol vs. Alcohol-Free Mouthwash: What's the Difference?

Is mouthwash with alcohol bad for your mouth? When it comes to alcohol vs. alcohol-free mouthwash, there are advantages to both. If you aren’t one to typically read the labels on your oral care products, alcoholic mouthwash makes up a fairly large percentage of what you’ll find in the drugstore or supermarket. But as more people seek an alcohol-free alternative, holistic and “all natural’ rinses are popping up left and right.

You might be asking, “Why does mouthwash have alcohol in it in the first place?” There are two reasons. One, it has antibacterial properties (that’s why they make hand sanitizer out of the stuff.) Two, the alcohol helps suspend the other important ingredients, which are usually essential oils. The latter reason is one of the most important ones, as the alcohol helps extend the shelf life of the rinse (up to 2-3 years in most cases.) People who don’t use mouthwash very often may prefer to purchase one with alcohol, as they can keep it longer and use it as needed.

Is Alcohol Or Alcohol-Free Better?

Is mouthwash with alcohol bad for you or worse than using an alcohol-free version? Depending on what you’re trying to do, the answer can be yes or no. For some people, yes, alcoholic mouthwash can be worse. In other cases, it’s better.

Ultimately you need to work closely with your dentist and hygienist to decide whether alcohol vs. alcohol-free mouthwash is right for your situation. Even then, your needs and oral health status can change over time. It’s common to see the need to change out certain oral care products as your lifestyle, health, and overall medical conditions shift throughout the years. Your teeth and gums are just one factor in choosing your oral care products.

Alcohol-Based Mouthwash

Alcoholic mouthwash has been used for at least a couple of centuries. Word on the street is that it’s been an active ingredient for managing oral bacteria since the 18th century when it was discovered by none other than the “father of modern microbiology,” Anton van Leeuwenhoek. By the late 1800s, Listerine was developed and is still popular today. Listerine was initially used for two main purposes: mouthwash and a surgical antiseptic. Most people are familiar with the burning sensation that alcohol causes. And if you’ve been around long enough, you also remember the potent taste of the original, yellow-colored Listerine solution. Fortunately, there are a lot of other flavor options today!

If you’re looking for a proven mouthwash with alcohol, one of the best things to do is look for the ADA seal of acceptance. As long as the bottle has the ADA seal, it’s been proven to show evidence of both safety and effectiveness for what it’s marketed as. Such as plaque and gingivitis control.

As with any oral care product, make sure you’re not ingesting the mouthwash. There’s a reason why they don’t hand out alcoholic mouthwash to certain populations, as it could potentially be abused. Simply rinse with it as directed, spit it out, and go on your way.

Alcohol-Free Mouthwash 

Alcohol-free mouthwash is important in a lot of situations. For one, people who have dry mouth because of things like medication use or cancer therapy don’t need an alcoholic rinse drying out their mouth. People with burning mouth syndrome can’t and shouldn’t use alcoholic mouthwash. There have even been cases where people abused it because of alcohol dependency. Having an alcohol-free alternative is safer for families with small children or who fit any of the previous-mentioned scenarios.

Most effective alcohol-free mouthwashes are those for sensitive or dry mouths, bad breath, and for people who want to increase their fluoride exposure. Typically, they will have an essential oil blend or be specifically for enamel strengthening. These types of mouthwash can be used regularly for long-term purposes, as they are both gentle and effective.

On the other hand, if you’re using mouthwash to help address active gum disease, you might find that it takes slightly longer to see the same antimicrobial effects from a non-alcoholic rinse as you would an alcoholic alternative. Fortunately, as long as it contains some of the same therapeutic ingredients—such as essential oils—you can still benefit from healthier bacterial levels without the risk of burning or dry mouth symptoms. It’s also safe for kids who might need to rinse because of problems with allergy-induced halitosis.

Is Alcohol-based Mouthwash Bad For You?

There are a few instances where using alcoholic mouthwash is not recommended. Here are some common examples:

People with a history of alcoholism, alcohol dependency, or recovering alcoholics.

  • Individuals with dry mouth/xerostomia.
  • Persons undergoing cancer therapy.
  • Small children who might ingest the mouth rinse.
  • Individuals prone to thrush or who are immunocompromised.

While we’re on the topic, it’s worth mentioning that there is some debate that using alcoholic mouthwash could increase a person’s chances of developing oral cancer. According to the ADA, there’s no sufficient evidence to support this theory. That being said, we do know that increased alcohol intake (adult beverages, etc.) is linked to a higher rate of oral cancer. If someone wanted to be especially careful about the potential risk of developing oral cancer, they may want to talk to their dentist about how frequently they use an alcoholic mouthwash. Using it periodically as needed should be just fine. If you are concerned about oral cancer, please consult with your dentist.

Some people find that using an alcoholic mouth rinse isn’t as helpful for bad breath as a non-alcoholic mouthwash is. Since the alcohol can dry their mouth out, it may cause an imbalance in certain bacteria (in this case, odorous ones) instead of making the situation better.

If rinsing with alcoholic mouthwash burns too bad or makes your mouth dry, consider using an alternative. Remember, you don’t have to rinse with mouthwash to keep your teeth and gums healthy. Therapeutic rinses are just another way to up your oral hygiene game and enjoy fresher breath.

Is Mouthwash With Alcohol More Effective? 

While alcohol is certainly effective as an antimicrobial agent, it’s not your only option for choosing a good mouthwash. Truth is, one of the other main ingredients you need for killing off oral bacteria is essential oils. Combining the essential oils with an alcoholic rinse makes the overall product more potent.

Non-alcoholic mouthwash with essential oils is also effective. It just might take a little longer to see the antimicrobial results if you compare it to an alcoholic blend. Some people even prefer to make their own DIY essential oil mouthwash at home by adding a few drops of their choice food-grade essential oil to a cup of water. Do your research though because certain oils are better than others. If you’re using mouthwash specifically for bad breath, then a non-alcoholic option may be your best choice.

Good Vs. Bad Mouth Bacteria 

At any given time, your mouth is coated in a combination of both “good” and “bad” bacteria. Just like your GI tract, your mouth needs good bacteria to help break down food for digestion. But overgrowth of any type of bacteria can lead to tartar buildup, halitosis, and gum disease.

To keep oral bacteria in balance, daily brushing and flossing are a must. After that, you can use mouthwash to help swish away any loose residue or gargle to get the germs at the back of your throat.

The bad thing about using too much alcoholic mouthwash on a frequent basis is that it can kill off more “good” bacteria than you want it to. Yes, it’s killing the bad germs too. But if all of the good bacteria are suppressed, it can predispose you to oral yeast infections such as thrush.

Should You Use Mouthwash Before Or After Brushing?

For mouthwash to be effective as an antimicrobial agent, you need to use it after brushing and flossing. That way it can target and rinse away any loose bacteria that are remaining inside your mouth. It won’t work as well if you’re rinsing before you brush and floss, because it can’t necessarily penetrate the plaque buildup. This is especially important if you’re using a fluoride mouth rinse. Since you want the fluoride to penetrate your enamel, it’s important that you thoroughly brush your teeth before using it.

Which Mouthwash Do Dentists Recommend Using?

Your dentist or dental hygienist may recommend mouthwash as an add-on to your brushing and flossing routine. Remember, rinsing doesn’t replace brushing or flossing; you still need to physically remove the dental plaque first. But a mouthwash can help you manage issues like halitosis, dry mouth, stain, or bleeding gums when used with your other hygiene techniques.

All of that being said, there is no perfect mouthwash for everyone. Some are contraindicated for certain individuals. You’ll want to talk to your dental team about selecting the best mouthwash (with alcohol or without) for your unique smile. For example, you don’t want to use alcoholic mouthwash if you have a dry mouth or are undergoing cancer therapy, because it can dry your tissues out further or cause burning mouth syndrome. At the same time, you don’t want to use a dry mouth rinse if you don’t have xerostomia. And get this, some whitening mouthwashes will even make certain people develop dental stains. Your dentist and hygienist can help you navigate the decision process!

So Which Is The Best Mouthwash?

There’s no right or wrong answer when you’re choosing between alcohol vs. alcohol-free mouthwash. Everyone’s situation is different. If you have a dry mouth or sensitive gums, a non-alcoholic version will be gentler. But if you’re targeting bleeding gums and gingivitis, you’ll probably see quicker results from an alcohol-based blend such as Listerine. Always check for an ADA seal on the bottle. But most importantly, be sure to ask your dentist or dental hygienist which one is best for you.

 Whitney DiFoggio MA, RDH
Written by Whitney DiFoggio MA, RDH"Teeth Talk Girl," is a registered dental hygienist. She started her dental health journey on YouTube, educating the public through videos.
Last updated onNovember 19, 2022Here is our process

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