Which mouthwash is worth your money?

WITH 19 million fewer dental appointments in the UK last year, we all need good home dental hygiene. Mouthwashes promise to help in various ways — but can they?

MANDY FRANCIS asked Dr Uchenna Okoye, a dentist at London Smiling clinic and spokeswoman for the British Dental Association, to assess a selection, which we then rated.

TOOTH STRENGTHENER

Listerine Advanced Nightly Reset, £6 for 400ml, most pharmacies CLAIM: A zero-alcohol formula that ‘works while you sleep’ — the high level of fluoride in this remineralises (repairs and strengthens) tooth enamel, the maker says. ‘Especially effective when used morning and evening after brushing.’ EXPERT VERDICT: This mouthwash is alcoholfree, which is a good thing. Alcohol is added to some mouthwashes to create a tingling ‘clean’ feeling, but over time it can have a drying effect, which may increase the risk of mouth ulcers, gum disease and dental decay.

The tooth-strengthening claim here refers to the 450 ppm (parts per million) fluoride — double the amount in most regular mouthwashes. Fluoride is recommended by dental professionals because it can kill off some of the bacteria that cause tooth decay and, with daily use, repair and rebuild tooth enamel.

I’d suggest using this two hours after brushing. Ideally, don’t use mouthwash immediately after brushing, as it will dilute the useful amounts of fluoride from your toothpaste residue (most toothpastes contain a far more substantial 1,350 to 1,550 ppm fluoride). 7/10

BREATH FRESHENER

Ultradex Daily Oral Rinse Mint, £5.50 for 250ml, most pharmacies CLAIM: The ingredients in this are clinically proven to ‘ instantly eliminate bad breath compounds for 12 hours’. It contains chlorine dioxide (used to disinfect drinking water) and sodium monofluorophosphate (a type of fluoride). EXPERT VERDICT: The most common cause of bad breath is poor oral hygiene — if the build-up of food and debris isn’t removed daily, bacteria that produce smelly, volatile sulphur compounds (VSCs) can proliferate. These bacteria can also raise the risk of gum disease and dental decay.

Some products just mask the smell, but the chlorine dioxide and sodium monofluorophosphate work to eliminate VSCs and the bacteria that cause them. 9/10

FOR CHILDREN

Aquafresh Fruity Flavour My Big Teeth 6-8 years, £2.09 for 300ml, most pharmacies CLAIM: This fruitflavoured, sugar- free, alcohol-free mouthwash contains fluoride, offers ‘ 24- hour sugar acid protection’ and ‘gets to places where brushing misses’. EXPERT VERDICT: While fluoride can offer teeth some protection, as the instructions here make clear, this shouldn’t be considered a substitute for healthy food and drink choices, regular brushing with a fluoride toothpaste and interdental cleaning.

To make it more palatable, it is sweetened with sorbitol and sodium saccharin. But I wouldn’t recommend fruit- flavoured toothpastes and mouthwashes for children, as they can encourage a sweet tooth. Mouthwash will not remove plaque — only brushing and flossing can do that. 5/10

MOUTH MOISTURISER

Biotene Moisturising Mouthwash, £8 for 500ml, most pharmacies CLAIM: This contains glycerin, a moisturising agent that forms chemical bonds with water and locks moisture in, making it ‘an ideal oral rinse for helping provide protection against dry mouth’. EXPERT VERDICT: A dry mouth can increase the risk of dental decay and gum disease — saliva washes away food debris and acts as a buffer against the effects of acids and sugars from food and drinks. It has antibacterial properties, and the minerals in it, including calcium and phosphate, can help rebuild tooth enamel.

The glycerin in this can temporarily ease the discomfort of dry mouth — but taking regular sips of water or chewing sugar-free gum can work well, too. 7/10

ULCER TREATMENT

Gengigel Mouthrinse, £10 for 150ml, boots.com CLAIM: A specialist treatment mouthwash that ‘restores healthy gums’ and ‘can assist with’ mouth ulcers and gingivitis (inflamed gums). EXPERT VERDICT: This uses sodium hyaluronate, which can help protect sore gums and soothe inflamed tissue, including mouth ulcers and post-surgery gum trauma, by acting as a protective ‘seal’. A lot of my patients like this, and it does no harm. 8/10

TOOTH WHITENER

Janina Ultra White 24K Gold Mouthwash, £6.99 for 500ml, fragrancedirect.co.uk CLAIM: This contains antiinflammatory colloidal gold ( gold particles suspended in solution) ‘known for its regenerative and anti- inflammatory benefits’, and natural enzymes — bromelain from pineapple and papain from papaya — to whiten teeth. This product ‘helps remove stains for noticeably whiter teeth’. EXPERT VERDICT: Applied directly to teeth in a toothpaste, the enzymes in this have been shown to help remove some staining on the surface of the teeth from coffee and red wine, for example.

However, it’s unlikely these enzymes will be quite as effective in a mouthwash that is designed to be rinsed around the mouth and then spat out. Brushing twice a day with toothpaste will remove surface stains more efficiently.

Colloidal gold is thought to have anti-inflammatory properties, but the amount here is more likely to just add temporary, cosmetic ‘glitter’ to your smile. The particles are unlikely to cause any harm, as most of the gold will be spat out after rinsing anyway. 4/10

ENAMEL-BOOSTING

Regenerate Enamel Science Advanced Foaming Mouthwash, £10 for 50ml, most pharmacies CLAIM: This ‘restores tooth enamel . . . reverses erosion and prevents further damage’, says the maker — you spray the alcohol-free foam directly into the mouth, where it releases bubbles that reach between the teeth and around the mouth. ‘ Effective cleaning for antibacterial action.’ EXPERT VERDICT: This is part of a range of dental-care products that have been formulated to help reverse early, invisible stages of erosion and regenerate enamel mineral if used regularly.

The small container is easy to carry and use on the go — which is great for a quick rinse after snacking.

The ingredients are not so very different from most normal bottle mouthwashes, but the foam delivery will help to dislodge food debris from between the teeth and give a more concentrated blast of cleansing and protective ingredients. It will also help the fluoride in here ‘stick’ to the teeth better than a liquid would, so it can fight bacteria and help to remineralise enamel. 8/10

‘OIL PULLING’

Georganics Oil Pulling Mouthwash Activated Charcoal, £6.90 for 100ml, georganics.com CLAIM: This is an alternative to conventional mouthwash. Swish 1-2 tsp of this blend of organic virgin coconut oil and activated charcoal powder through the teeth for five to 20 minutes to pull out bacteria and debris. ‘Cleansing, plaque-reducing. Removes stains.’ EXPERT VERDICT: Oil pulling is an ancient way to clean teeth and gums. There is no real harm or risk associated with swishing oil through your teeth, and this mouthwash could be used — like any other — as a way to remove food debris during the day, if you have the patience to do it for the recommended five to 20 minutes!

Coconut oil is rich in lauric acid, which has antibacterial and antiinflammatory properties. However, there is very little evidence to back up the belief that ‘ pulling’ helps manage plaque. I’m wary of products containing charcoal, too, as it can be quite abrasive. 2/10

FOR BLEEDING GUMS

Corsodyl Original Mouthwash, £5 for 300ml, most pharmacies CLAIM: This contains the antibacterial agent chlorhexidine digluconate, is ‘clinically proven to help treat the early signs of gum disease’, and can ease mouth ulcers and assist recovery from dental surgery. EXPERT VERDICT: This is an effective short-term treatment for the early signs of gum disease, but it is best used on the advice of a dental professional and should only be used for two weeks at a time, as antimicrobial ingredients such as chlorhexidine can stain teeth and may temporarily irritate the mouth. You could try rinsing with 1 tsp of salt dissolved in a cup of warm water as a less aggressive alternative. 6/10

ECO TABLETS

Brushd Lemon Mouthwash Tablets, £5.49 for 120 tablets, brushd.co.uk

CLAIM: ‘An eco-friendly alternative to plasticbottled mouthwashes’, these tablets — which you dissolve in water — are mostly sodium bicarbonate with natural flavouring, preservative and colour.

EXPERT VERDICT: Alcohol and fluoride-free, these tablets come in a refillable glass jar.

Sodium bicarbonate — aka baking soda — is a mildly alkaline salt, which will increase the pH in the mouth, helping to suppress some of the acid- producing bacteria that can damage the teeth. Being alkaline, it will also help to freshen breath but contains no fluoride or active ingredients.

It is a more environmentally friendly way to rinse away food particles and freshen breath, but little else. 3/10