From the Guidelines
Mouthwash is generally not unhealthy for the heart when used as directed, and there is no direct evidence linking mouthwash use to cardiovascular risks. The provided evidence from the American Heart Association [ 1 ] discusses the risks associated with alcohol consumption, but it does not specifically address the use of mouthwash. Most commercial mouthwashes are safe for regular use and do not pose direct cardiovascular risks. However, some research suggests that certain antibacterial mouthwashes containing chlorhexidine or those that kill a broad spectrum of oral bacteria might temporarily reduce nitric oxide production in the mouth.
- Key points to consider:
- Nitric oxide helps blood vessels dilate and maintain healthy blood pressure
- Beneficial oral bacteria convert dietary nitrates into nitrites, which the body then converts to nitric oxide
- Strong antiseptic mouthwashes might disrupt this pathway, but the effect is typically short-lived
- For most healthy individuals, occasional mouthwash use or using alcohol-free or more targeted formulations presents minimal cardiovascular concern. If you have existing heart conditions or blood pressure issues, consider discussing your mouthwash use with your healthcare provider, who might recommend specific types or usage patterns that won't interfere with your cardiovascular health.
From the Research
Mouthwash and Heart Health
- The relationship between mouthwash use and heart health is a topic of interest, with some studies suggesting a potential link between the two.
- A study published in 2020 found that frequent use of over-the-counter mouthwash was associated with an increased risk of hypertension, independent of major risk factors for hypertension and several other potential confounders 2.
- The study, which followed 540 participants over a period of three years, found that people who used mouthwash twice a day or more had a higher incidence of hypertension compared to less frequent users.
Potential Mechanisms
- The exact mechanism by which mouthwash use may contribute to hypertension is not fully understood, but it is thought that the antibacterial properties of mouthwash may alter the oral microbiome, leading to changes in nitric oxide production and blood pressure regulation 2.
- Other studies have found that mouthwash use can have both positive and negative effects on oral health, with some mouthwashes containing ingredients that can help reduce plaque and gingivitis, while others may contain alcohol or other ingredients that can have negative effects on the oral mucosa 3, 4, 5.
Safety of Mouthwash Use
- The safety of mouthwash use has been evaluated in several studies, with some finding that mouthwash use can be beneficial for oral health when used properly and in moderation 3, 5.
- However, other studies have raised concerns about the potential risks of mouthwash use, including the potential for oral cancer and other adverse effects 4.
- A study published in 2019 found that a chlorhexidine-fluoride mouthwash was effective in reducing plaque and gingivitis, and did not appear to have any significant negative effects on tooth discoloration or other oral health parameters 6.