Rinse and Repeat? Maybe not.

Ditch the mouthwash. Why your microbes are vital to oral hygiene, heart health, and sexual performance

Since we were kids, we were taught that germs are bad. Everything from skincare to cleaning products promised to eradicate those pesky bugs. Then COVID happened and our obsession with sterilizing everything went into overdrive.

Don’t get me wrong I’m all for cleaning the seat trays on airplanes and avoiding open testers at Sephora but after two years working with a team of microbiologists at Symbiome Labs, I’ve evolved my approach to managing my own bacteria in the quest to be clean and healthy.

It turns out that not all microbes are out to make you sick — some actually exist to keep you well and most need to be in balance in order to serve a variety of vital functions.

Humans have an ecosystem of trillions of microorganisms living in and on our bodies. Disrupting your microbiome can be detrimental to your health in many ways.

So why then are we so keen on pulverizing our microbes when many exist to protect, nourish and keep the peace?

This current revelation seems to have landed antibiotics on the sh*tlist (unless you really, really need them after surgery or for a serious infection). Yet surprisingly there’s another offender in your bathroom vanity that you use daily without a second thought.

Antiseptic mouthwash. Just a harmless rinse and repeat for fresh breath? Maybe not.

Kills 99.9% of germs that cause bad breath

Who made killing all mouth bacteria part of our daily routine? Well it wasn’t a notable medical institution, it was the marketing department of Listerine. Simply by using the old Latin word “halitosis” instead of "unpleasant breath" in ads dating back to the 1920's, it turned a nuisance into a scientific-sounding, medical condition and then conveniently provided the cure — one that is estimated to scale to $6.8B in sales in 2023.¹

Marketed as a product that prevents cavities, fights gingivitis, restores enamel, and “cleans the whole mouth,” mouthwash today ranges from prescription-strength antiseptic with chlorhexidine to antibacterial or alcohol-enhanced.

Does it live up to the hype? Advances in microbiome science says no with leading biologic dentists, functional doctors, and naturopaths shifting their approach. We now know that tooth decay and gum disease are not caused by bacteria but rather the result of an imbalance in the entire oral microbiome.

“…mouthwash and other bacteria-killing options developed to prevent and heal dental disease don’t work…because they harm the most important immunity tool your oral health has: the oral microbiome.”²

— Dr Mark Burnhenne DDS

Reduces a vital molecule called Nitric Oxide

Our innocuous daily habit of swishing to “get minty clean,” can destroy the microbes that turn nitrates into nitrites which converts into nitric oxide (NO). NO is important for many critical biological functions. It acts as an anti-inflammatory, antioxidant, neurotransmitter and vasodilator — as in it relaxes and expands blood vessels to improve blood flow.

Dr Louis Ignarro’s discovery of the molecule won him the Nobel Prize in Medicine and led to the development of Viagra (which increases blood vessel sensitivity to NO). NO is critical for the below. ³

• Maintaining heart health

• Lowering blood pressure

• Regulating erectile function in men and arousal in women

• Promoting cognitive function (learning, memory and recall)

• Improving athletic performance⁴

Studies show that frequent use of mouthwash lowers NO bioavailability and is attributed to increased risk of prediabetes/diabetes and hypertension.⁵

“Because antiseptic mouthwashes eradicate the oral bacterial flora, this nitric oxide-generating pathway is abolished, which may result in nitric oxide-deficient conditions potentially leading to life-threatening complications.”

— NIH

Alters pH causing Dry Mouth

Conventional mouthwash, which contains up to 26% ethanol, can suppress saliva production leading to dry mouth. The alcohol causes an acidic change in pH which can actually worsen bad breath and tooth decay.

Studies found a temporary increase of acetaldehyde levels in saliva from the alcohol in mouthwash which may be linked to increases in oral cancer (Although there are conflicting studies, the data becomes more significant in people who also drink alcohol, smoke and have poor oral hygiene). ⁶

The take-away: Disrupting your oral microbiome in the name of dental health is counterproductive. A balance of microorganisms are needed to prevent gum disease and tooth decay as well as to perform vital functions that support your overall health.

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More effective than using mouthwash, the below tips will help you combat bad breath tooth decay and periodontal disease.

• Use a tongue scraper: Every morning scrape your tongue to remove bacteria. It will support digestive health, lessen bad breath, and may even improve ability to taste food (by removing the coating on your taste buds). Try Boka Starter Kit with a compact scraper that’s perfect for travel.

• Floss then brush: The most beneficial order is to floss first to remove trapped food and bacteria from between your teeth before you brush. Consistent flossing and brushing are the best ways to keep plaque under control.

• Spit don’t rinse: Try nano hydroxyapatite toothpaste which can help remineralize your teeth. Just don’t rinse afterwards so the formula stays on your enamel long enough to make a difference. I like Boka and Risewell.

• Limit processed food: As modern humans, our carbohydrate intake has drastically increased today compared to our ancestors. The starchy, sugary particles get stuck, ferment between our teeth causing odor and damage the enamel.

• Breathe through your nose: Mouth breathing leads to tooth decay because it dries out saliva and changes the ph levels in your mouth. Use Somnifix mouth tape at night.

If this content resonates with you, subscribe, drop a like or share with a friend who might benefit from this information. As always, please let me know how you are doing. (Thanks in advance for being an active part of this community!)

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All writing is for informational and entertainment purposes only and is not a substitute for medical advice, diagnosis or treatment.

1. Smithsonian - How Halitosis Became a Medical Condition with a “Cure”

2. Is Mouthwash Bad for You? Best Mouthwash + Risks and Alternatives - Dr Mark Burnhenne

3. The Doctor’s Farmacy - The Most Important Molecule for Health You Have Never Heard of: Nitric Oxide with Dr Louis Ignarro

4. Exercise increases systemic nitric oxide production in men - NIH

5. Over-the-counter mouthwash use, Nitric Oxide and Hypertension risk

6. Alcohol-based mouthwash as a risk factor of oral cancer - NIH