Is antimicrobial mouthwash safe long term?
The oral cavity is the home of about 700+ different microbial species. Among those, a handful that is potentially pathogen plays a role in disease. When a shift happens in the ideal composition, e.g. because of inadequate personal oral hygiene or a diet high in sugar, bad bacteria thrive.
It’s well known that the overuse of wide-spectrum antibiotics is responsible for serious health issues. Most notably an increase in resistant bacteria, that’s responsible for hundreds of thousands of deaths every year. Moreover, it disrupts the healthy microbiome all over the body that might be a risk factor in several chronic conditions.
There might be the case that the overuse of antiseptic mouthwash carry negative effects, too. By causing dysbiosis (shift in the composition) in the oral microbiota that may increase the risk of other health issues orally and in the rest of the body.
Several studies have shown that frequently using antiseptic/ antimicrobial mouthwash is suppressing beneficial bacteria as it’s indiscriminate and hence easily cause further imbalances.
The explanation is that these chemicals target a broad range of bacteria. Most of those species are considered beneficial. Eliminating parts of the ecosystem from the oral cavity gives chance to more opportunistic pathogens to overpopulate the environment causing a less healthy, new order.
When antibiotics are overused or not properly used, dosed, certain bacteria are not completely eliminated. Repeating exposure increase the risk of developing resistant populations.
In some sense, strong antimicrobial mouth rinses can be considered as wide-spectrum, non-specific drugs. In the past these products even contained alcohol and other harsh chemicals. It’s now known as harmful, increases the risk of cancer, and got banned.
Shifts in the oral flora may lead to the most common chronic diseases on Earth, cavities (dental decay), gum disease (periodontal disease), and bad breath (halitosis).
Yet, the oral microbiota in a well-balanced state plays a critical role in maintaining not just oral but general health. Helpful bacteria in the mouth can protect against diabetes and obesity, including microbes which help the body produce nitric oxide (NO), which regulates blood pressure and insulin levels.
Research brings into focus the interconnected nature of the body. Oral health is a fundamental component of general health. For example, gum disease has systemic effects that are measurable beyond its clinical symptoms in the mouth.
Recent studies discovered other mechanisms of how disruptions of the oral microbiota by using an antiseptic mouthwash, may lead to an increased risk of diabetes or an increase in blood pressure. NO is produced by the oxidation of L-arginine (a dietary amino acid) by enzymes produced by beneficial probiotic bacteria.
Arginine is an important ingredient in Natorally Dental Probiotic Mouthwash.
NO acts as a regulator in many areas from vessels to metabolism. Antiseptic mouthwash causes a reduced level of NO that is associated with insulin resistance as well as adverse cardiovascular effects such as hypertension and impaired vascular function.
Another issue is when mouthwash is used at the wrong time, right after brushing with fluoridated toothpaste.
Usually, toothpaste contains around 1450 ppm fluoride, whilst mouthwashes less or none. Fluoride locally considered to be beneficial in counteracting the caries-causing effects of lifestyle and diet, and quickly washing it off may disrupt the benefits.
Dental probiotic mouthwash has a potentially better role in daily oral hygiene. When used at the right time these products may help re-balancing the oral microbiome and maintain a healthy state.
Further read and references:
https://www.nature.com/articles/sj.bdj.2018.1020
https://www.sciencedirect.com/science/article/abs/pii/S1089860317301532?via%3Dihub
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794079/
https://www.nature.com/articles/s41415-019-0036-x
https://www.dentalherb.com/blog/whats-wrong-with-an-alcohol-based-mouthwash/
https://www.telegraph.co.uk/science/2017/11/22/mouthwash-may-kill-beneficial-bacteria-mouth-trigger-diabetes/