Does Mouthwash Fix Bad Breath?

It’s the mint in your purse, the little bottle in the glove box, the swish before the meeting. It works for about as long as it takes to get across the room. Then a conversation starts, and you wonder if the smell has already come back.

Two kinds of mouthwash

The ADA² says there are two types. Cosmetic mouthrinses temporarily control bad breath and leave a pleasant taste, but have no therapeutic benefit. Therapeutic mouthrinses contain active ingredients intended to help control or reduce conditions like bad breath, gingivitis, plaque and tooth decay, and the ADA’s MouthHealthy page says they have active ingredients that kill bacteria.

The ADA’s³ bad breath page says mouthwash can help kill bacteria or neutralize and temporarily mask bad breath, but that it’s only a temporary solution. The NHS⁴ suggests trying an antibacterial mouthwash or toothpaste as one part of treating bad breath yourself.

What mouthwash doesn’t do

The ADA² says use of mouthrinse does not take the place of optimal brushing and flossing. Its MouthHealthy page says mouthwash is a supplementary tool because it can get in between teeth where brushes can’t reach, but it’s not a replacement for daily brushing and flossing.

That matters because of where the smell usually comes from. The ADA³ lists hundreds of types of bad-breath-causing bacteria that naturally live in your mouth, dry mouth, gum disease, foods like garlic, onions and coffee, smoking, and medical conditions such as sinus issues, acid reflux, diabetes, and liver or kidney disease. The NHS⁴ lists gum disease, holes in teeth, infection, fasting, dry mouth, tonsillitis and acid reflux. A rinse can’t reach any of those causes. Our articles on breath that smells even after brushing, tonsil stones and bleeding gums cover several of them.

Choosing and using it

Pick a product with the ADA² Seal. The ADA says the Seal of Acceptance indicates a product has been through scientific evaluation for the purpose claimed. Its MouthHealthy page says to look for products that carry the Seal.

Go alcohol-free if your mouth is dry. The ADA² says that for people with dry mouth, an alcohol-free rinse may be prudent, since alcohol can be drying. The NHS⁵ says the same: use alcohol-free mouthwash, because you’re more likely to get tooth decay if you have a dry mouth. See waking up with a dry mouth.

Mind the timing. The NHS⁶ says not to use mouthwash straight after brushing.

Not for young children. The ADA² says children younger than 6 shouldn’t use mouthwash because they may swallow it.

Ask your dentist. The ADA’s¹ MouthHealthy page says to talk with your dentist about if you need a mouthwash.

What helps the breath

The NHS⁴ lists the routine: gently brush your teeth and gums at least twice a day for 2 minutes with fluoride toothpaste, clean your tongue once a day with a tongue scraper or cleaner, and clean between your teeth with interdental brushes or floss at least once a day. The ADA³ adds stimulating saliva by chewing crunchy foods or sugar-free gum, cleaning dentures nightly, quitting smoking and having regular checkups. See a white tongue for tongue care.

The play

Try this: a one-week routine with a mouthwash at a different time

Brush twice a day for 2 minutes with fluoride toothpaste, and clean your tongue once.

Clean between your teeth once a day, floss or interdental brushes.

If you use a mouthwash, use it at another time of day, not right after brushing, and pick an alcohol-free one if your mouth is dry. Note whether the smell is still there by the afternoon.

When to get checked

The NHS⁴ says to see a dentist if bad breath doesn’t go away after treating it yourself for a few weeks, or if you have painful or bleeding gums, toothache, loose teeth or denture problems. The ADA³ says regular checkups let your dentist detect problems such as gum disease or dry mouth early, and that if your mouth checks out, you may be referred to your primary care doctor for underlying conditions. The ADA also says bad breath can be a warning sign of advanced gum disease.

Book an appointment if any of these fit:

• Bad breath hasn’t improved after a few weeks of a good routine
• Your gums bleed, hurt or look red and swollen
• Your mouth is dry most of the time
• You have a bad taste that won’t go away
• You rely on mouthwash all day to feel confident

The mint buys you ten minutes. A checkup finds out why you needed it.