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Can you use toothpaste and mouthwash with fluoride?

The American Dental Association doesn't specifically recommend using mouthwash in your daily routine, but it does acknowledge its benefits.
The American Dental Association doesn't specifically recommend using mouthwash in your daily routine, but it does acknowledge its benefits.
Hemera/Thinkstock

As soon as we're old enough to go to the dentist, we're introduced to the American Dental Association's (ADA) fundamental rules of good oral health: Brush at least twice a day with a fluoride toothpaste; floss to clean between your teeth; eat a diet rich in fruits and vegetables; and limit sugary foods and drinks that can encourage bacteria and tooth decay [source: ADA].

But what about mouthwash? Mouthwash, sometimes referred to as mouth rinse, is a popular item in many people's medicine cabinets, but can you safely use toothpaste and mouthwash that both contain fluoride in your oral care routine to effectively prevent cavities? The ADA doesn't specifically recommend using mouthwash in your daily routine, but it does acknowledge its benefits. But first, let's look at why brushing and flossing is essential to good health.

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Your mouth is in a constant battle with bacteria. While much of the bacteria in your mouth are harmless, regular brushing, flossing and dental visits help remove the food and bacteria that can break down your teeth. Improper tooth care, however, allows for a buildup of bacteria, which lodges itself in your gums. This is known as plaque. Plaque buildup on your teeth can lead to gingivitis, or gum (periodontal) disease [source: The New York Times]. It can also lead to cavities, which can affect children, teens and adults equally.

In the 1940s, the U.S. government began allowing states to add fluoride to its water supply to compensate for areas where people were not able to get proper dental care, and about 64 percent of Americans drink fluoridated water today, but since the 1980s, dentists have noticed that children began developing white spots on their teeth, known as fluorosis, a sign of ingesting too much fluoride. In 2011, the U.S. government said it would begin recommending that states reduce the amount of fluoride added to their water supplies [sources: Hughes, NIDCR]. Due to levels of fluoride in water, toothpaste and mouthwash today, it seems that it's possible to have too much fluoride.

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While water supplies, toothpaste and mouthwash all contain fluoride, mouthwashes contain a minimal amount of fluoride and won't put your fluoride intake over the top [source: ACT]. Mouthwash can bring additional benefits to preventing both cavities and bacteria-induced gingivitis, but given the variety of mouthwashes available, it can be tough to figure out which one is best for you. Here's a breakdown [sources: Haiken, Seward]:

  • If you want to simply freshen your breath, try a basic mouthwash that has a low alcohol content. The main ingredients in these are chlorine and zinc, which combat bad breath bacteria for a short period of time.
  • If you're looking for a stronger mouthwash to help protect you from gum disease and plaque buildup, you want an antibacterial mouthwash; these are higher in alcohol content and also contain ingredients such as eucalyptol and menthol.
  • If your water supply isn't fluorinated, mouthwashes that contain fluoride can coat your teeth after rinsing and help strengthen your tooth enamel.
  • If you already have gingivitis, your dentist can prescribe a mouthwash that contains chlorhexidine, the strongest ingredient to fight gingivitis-causing bacteria. These rinses can only be prescribed by a dentist and are not available over the counter.
  • You can find, or even make at home, mouthwash made with all natural ingredients and are alcohol-free. These rinses contain essential oils such as peppermint oil, astringents such as aloe vera, and baking soda. Their effectiveness to fight cavities is not proven, but it's a natural alternative to other rinses.

The ADA does not recommend mouthwash or rinses for children younger than age 6 because many of them contain alcohol. Children are more prone to swallow mouthwash instead of just swishing it around and spitting it out. Another concern is that mouthwash may stunt the natural ability of saliva to help wash bacteria away from teeth. Since alcohol is a drying agent, using an alcohol-based mouthwash will actually dry out your mouth. This can prevent your mouth from producing saliva, and the cycle of natural antibacterial removal is stopped [source: 1-800-Dentist]. Ask your dentist which toothpaste and mouthwash combination will be the most beneficial for your mouth.

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Sources

  • 1-800-Dentist. "Mouthwash." (Sept. 2, 2011) http://www.1800dentist.com/dental-encyclopedia/mouthwash
  • ACT. "Fluoride. Alcohol. And Your Patients." (Sept. 2, 2011) http://www.actfluoride.com/professional/alcohol.html
  • American Dental Association. "Oral Health Topics: Brushing your teeth (Cleaning Your Teeth and Gums." (Aug. 29, 2011) http://www.ada.org/5624.aspx?currentTab=1
  • Haiken, Melanie. "Which Mouthwash Should You Use?" Real Simple. (Sept. 2, 2011) http://www.realsimple.com/health/preventative-health/dental/which-mouthwash-should-you-use-00000000010464/index.html
  • National Institute of Dental and Craniofacial Research (NIDCR). "Community Water Fluoridation by State." (Sept. 2, 2011) http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/WaterFluoridation/CommunityWaterFluoridationState.htm
  • The New York Times. "Periodontitis." (Aug. 30, 2011) http://health.nytimes.com/health/guides/disease/periodontitis/background.html
  • Hughes, Bill. "U.S. says too much fluoride in water." USA Today. Jan. 7, 2011. (Aug. 28, 2011) http://www.usatoday.com/yourlife/health/medical/2011-01-07-too-much-fluoride_N.htm
  • Seward, Elizabeth. "Use These All Natural Homemade Mouthwash Recipes." Planet Green. Sept. 25, 2008. (Sept. 6, 2011) http://planetgreen.discovery.com/food-health/homemade-natural-mouthwash.html

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