Flossing vs. Mouthwash…What Really Works?
The beginning of most dental checkup appointments is an assessment of your homecare routines. If I had a dollar for every time I asked about flossing and heard the response “I don’t really floss, but I use mouthwash”, I’d seriously retire.
Let me be clear….Mouthwash does not replace flossing. Ever. Nothing replaces the manual removal of bacteria.
Now you know the verdict, but here’s why.
One of the most important things to consider is that rinses are only effective up to 2mm below the gumline. Recall when your dental hygienist is measuring your gum health and they’re calling out “3-2-3…3-2-3…4-3-3…”? Even if you don’t remember this process, this is how we measure (in millimeters) the depth of the tissue around each tooth and subsequently check the health of the underlying bone. Very rarely are there patients who only have 2’s and 1’s. I can’t even recall any patient in the last 7 years that would fit that criteria. So, if you’re only using mouthwash, you are missing the base of the pocket, thereby leaving millions of bacteria completely undisturbed and able to continue causing damage to your gums.
Another point of interest is that bacterial colonies are not penetrated by over-the-counter mouth rinses. Plaque that adheres to the tooth surface is an incredible organism, and is extremely protective of the bacteria it houses. Mouth rinses may be able to soften the bacteria on the outside of the plaque barrier, but they’re not able to penetrate the colonies living within it. Colonies of bacteria, not just bacteria itself, is the danger to oral health. Trace amounts of bacteria on their own do not pose significant risks to your gum tissue and teeth, but well established colonies of them do. Only flossing can break up the microcosm that houses bacterial colonies, thereby making them ineffective and removing the risk.
And lastly, if you’ll notice, the recent commercial ads in regards to a well known producer of mouthwash have changed quite a bit. In 2005, a judge in New York ruled against Listerine for making false claims surrounding the efficacy of its products, stating the clinical research did not support the claim that the mouth rinse was “just as effective as flossing”. He found that Listerine’s ads could actually pose a public health risk by turning people away from flossing. This finding by the courts prohibits Listerine from making this claim publicly now.
Nothing replaces good oral hygiene, so be wary when seemingly “easy” shortcuts make their way onto the dental aisle at the grocery store. Always be sure to ask your dental providers before you try any new products so that they can assess what your needs are and how to best meet them.
- Paige Tscherpel, RDH, BSDH
Consulted Sources Include: