Can I replace toothpaste with fluoride mouthwash?

Mouthwash: how useful is it?

When does a mouthwash make sense?

Many people neglect the spaces between their teeth. Therefore, caries and periodontitis-promoting plaque often persist there. Experts see several reasons for the suboptimal cleaning of the interstices:

  • Some people shy away from the not so simple use of dental floss and interdental brushes and therefore do not use these instruments at all or too seldom.
  • Others do not consistently clean all gaps or injure the gums with too firm, jerky movements. The harmful bacteria in the mouth then penetrate the injured areas and quickly trigger inflammatory gum disease.
  • Sometimes, however, the motor skills for the correct use of dental floss and interdental brushes are simply missing, for example in old age or with physical or mental impairments.

Against this background, dentists are now advising mouth rinsing more often. This is less effective than the mechanical cleaning of the gaps. Rinsing with an antibacterial solution twice a day for around a minute in addition to brushing your teeth is better than completely doing without cleaning the spaces between your teeth.

However, an express warning should be given against excessive use of mouthwashes (more than three times a day): A Europe-wide study has provided indications that this can increase the risk of cancer in the upper respiratory tract and food tract. However, the relationships must be examined more closely.

How does a mouthwash work?

Mouthwashes are supposed to loosen the plaque on the teeth and in the interdental spaces, kill germs and thus prevent tooth decay and gum disease. But they are usually not able to do this on their own.

For effective prophylaxis, you should thoroughly clean your teeth and the spaces between your teeth every day with a toothbrush, fluoridated toothpaste and dental floss or an interdental brush. These are the recommendations of central dental institutions. Mouthwashes can only complement this basic care.

You can read here how to brush your teeth properly and the benefits of fluoridated toothpaste: How to brush your teeth properly and fluoride in toothpaste

Mouthwash and Mouthwash: What's the Difference?

Numerous liquid products for oral hygiene are available in stores. Before you decide on a remedy, you should know what the differences are:

  • Mouthwash is offered in concentrated form and used diluted in clear water. The remedies are aimed exclusively at freshening the breath for a short time - thanks to various essences, such as peppermint or menthol. However, they cannot remedy the causes of bad breath, which are usually caused by inflammatory diseases in the oral cavity. The only way to do this is to go to the dentist.
  • Unlike mouthwash, mouthwash is used undiluted. It is not primarily intended to provide fresh breath, but to loosen plaque and kill harmful germs.

Mouthwash: There Are These Different Types!

A distinction is made between caries preventing, gum care and medical mouthwash.

Caries preventive mouthwash

There are two types of mouthwash here, which are sometimes combined in one product: rinses that loosen up dental plaque so that it can be removed more easily, and solutions with additives that reduce caries such as tin fluoride or amine fluoride. The fluoride has been shown to loosen the plaque and inhibit its formation. To prevent caries, a mouthwash must contain at least 0.025 percent fluoride. It is useful for:

  • exposed tooth necks
  • elderly or disabled patients who are unable to maintain proper oral hygiene on their own
  • Patients after periodontal treatment
  • Wearers of brackets (fixed orthodontic devices) that make mechanical cleaning of the interdental spaces impossible

Gum care mouthwash

These mouthwashes contain herbs and other ingredients that have a calming effect on symptoms of inflammation. However, they do not eliminate the inflammation by themselves. Therefore, such mouthwashes are not a solution in the long run. If you have sensitive, bleeding and / or painful gums, you should see your dentist immediately instead.

However, a gum care mouth rinse is not completely ineffective:

  • The herbs contained stimulate the blood circulation in the gums and make them more resistant to bacterial inflammation.
  • Herbs and other ingredients like allantoin or vitamin A soothe irritated areas.

Before use, allergy sufferers should check carefully whether they can tolerate the contained ingredients.

Medical mouthwash

These products contain medically effective ingredients, mostly the germicidal one Chlorhexidine. In high doses (0.2 percent chlorhexidine), they are considered chemical toothbrushes that can temporarily replace mechanical tooth brushing. From a dental perspective, a chlorhexidine mouthwash is the only mouthwash that effectively fights plaque bacteria.

Be used high-dose chlorhexidine rinses for example during periodontal treatment. They are also used, for example, in the following cases:

  • after oral surgery to aid the healing process
  • during a hospital stay when careful oral hygiene is not possible
  • in patients with physical or mental impairments that are overwhelmed by mechanical teeth cleaning

Chlorhexidine does, however, with prolonged use (more than six weeks) Side effects:

  • brown discoloration of teeth and dentures
  • disturbed sense of taste

The taste sensation normalizes again after the end of the application. The dentist can remove the discoloration with a professional teeth cleaning service.

For long-term use - e.g. as a replacement for dental floss or interdental brush - dentists recommend low-dose chlorhexidine preparations. Mouth rinses with 0.06 percent chlorhexidine have proven themselves in studies. They should be used undiluted for around one minute in the morning and in the evening after eating and brushing your teeth. In particular, the spaces between the teeth should be rinsed intensively. Chlorhexidine mouthwashes are only available from pharmacies.

Mouthwash without alcohol

Most mouthwashes contain alcohol, sometimes up to 30 percent. The alcohol disinfects and preserves the ingredients.

For children, there are fluoridated alcohol-free mouthwashes that are just as effective. However, they should be used from the age of six at the earliest, when the children can reliably spit out. In this way, a fluoride overdose with white spots on the teeth can be avoided.

With a view to alcoholic users, mouthwashes and mouthwashes without alcohol are now also available for adults.

Mouth rinse - pregnancy does not speak against it

Alcohol-free mouthwashes are also suitable for pregnant women, for whom dentists expressly recommend intensive oral hygiene for periodontal prophylaxis. Because as a result of the pregnancy hormones, the tissue and thus the gums are supplied with more blood, softer and therefore more vulnerable - periodontal bacteria can penetrate more easily.

Women who consistently eliminate the harmful microorganisms significantly reduce the risk of periodontal disease during pregnancy. The additional use of a mouthwash can help with this.

According to one study, regular use of a mouthwash during pregnancy can even reduce the risk of premature birth: Pregnant women with periodontal disease are at a significantly higher risk of premature birth. A germicidal one Mouthwash lowers the number of harmful bacteria in the mouth and thus helps prevent periodontitis and its possible consequences.

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