Mouthwash myths: what does the evidence say?

Ahead of Dentistry Show London, we explore three familiar mouthwash myths Laura Bailey and Benjamin Tighe will put under the spotlight during the LISTERINE Professional Masterclasses, and why the evidence may prompt you to think again.

Effective toothbrushing and interdental cleaning may be sufficient for some patients, while others may benefit from additional support according to their individual needs (Chapple et al, 2015).

So how do we know when to consider an adjunct, and what does the evidence tell us?

Myth: mechanical cleaning is always enough

Mechanical plaque removal remains the foundation of good oral hygiene. Chapple et al (2015) describe it as the ‘bedrock’ of successful periodontal disease management, while recognising that some patients may benefit from adjunctive agents.

The evidence for adjunctive approaches has continued to develop. A systematic review and meta-analysis found statistically significant reductions in gingival inflammation, bleeding and plaque when specific adjunctive antiseptics were used alongside mechanical plaque control compared with mechanical plaque control alone (Figuero et al, 2020).

Similarly, a meta-analysis of 29 six-month studies found that combining mechanical methods with an essential oil-containing mouthrinse provided additional improvements in plaque compared with mechanical methods alone (Araujo et al, 2015).

In practice, this means starting with effective mechanical cleaning and considering whether an evidence-based adjunct could provide additional support where appropriate.

Myth: ‘spit, don’t rinse’ means no mouthwash

‘Spit, don’t rinse’ may be familiar advice after brushing, but it can be misleading without one important qualification: ‘with water’.

Delivering Better Oral Health (2025) advises patients to spit after brushing rather than to rinse with water, to avoid diluting the fluoride concentration.

Research has also demonstrated that rinsing with a 225ppm fluoride mouthrinse significantly increased salivary fluoride levels compared with not rinsing after brushing with a 1,450ppm fluoride toothpaste (Sköld et al, 2012).

The distinction matters: the guidance relates specifically to rinsing with water, while evidence shows that a fluoride-containing mouthrinse used immediately after brushing can, at appropriate concentrations, increase salivary fluoride levels.

Myth: prevention starts with disease

The best time to support periodontal health is before disease develops. Effective daily plaque control helps maintain healthy gingiva and prevent gingivitis. If gingivitis does develop, it represents an important opportunity for early intervention (Chapple et al, 2015).

Gingivitis does not inevitably progress to periodontitis, but unmanaged gingivitis can progress in susceptible individuals. Maintaining periodontal health and managing gingival inflammation therefore form an important part of preventing periodontitis (Chapple et al, 2015).

The principle is straightforward: start with maintaining oral health, address gingivitis if it develops and reduce the opportunity for progression.

This puts the emphasis on effective self-care from health onwards, with mechanical plaque control at its foundation and evidence-based adjuncts considered according to individual patient needs.

Join the discussion

At Dentistry Show London, award-winning dental hygienist and coach Laura Bailey, and Benjamin Tighe, a tutor dental therapist at the Eastman Dental Hospital who also works in private practice, will take these and other familiar oral hygiene myths into the LISTERINE Professional Masterclasses, running throughout the show on stand D40.

Drawing on the evidence and their own clinical perspectives, Laura and Ben will consider what it means for everyday practice, including how recommendations can be tailored to individual patient needs. The sessions will also give dental professionals the opportunity to ask questions, get involved in the discussion and pick up samples from the stand.

References

• Araujo MWB, Charles CA, Weinstein RB, et al (2015) Meta-analysis of the effect of an essential oil-containing mouthrinse on gingivitis and plaque. Journal of the American Dental Association 146(8): 610–622.
• Chapple ILC, Van der Weijden F, Doerfer C, et al (2015) Primary prevention of periodontitis: managing gingivitis. Journal of Clinical Periodontology 42(S16): S71–S76.
• Delivering Better Oral Health: an evidence-based toolkit for prevention (2025) Office for Health Improvement and Disparities, Department of Health and Social Care, NHS England and NHS Improvement. Chapter 2: Summary guidance tables for dental teams.
• Figuero E, Roldán S, Serrano J, et al (2020) Efficacy of adjunctive therapies in patients with gingival inflammation: a systematic review and meta-analysis. Journal of Clinical Periodontology 47: 125–143.
• Sköld UM, Birkhed D, Ellwood R (2012) Effect of post-brushing mouthwash solutions on salivary fluoride retention – study 1. Journal of Clinical Dentistry 23(3): 97–100.

Visit LISTERINE Professional on stand D40 at Dentistry Show London this October to join a Masterclass with Laura Bailey and Benjamin Tighe and explore the evidence behind familiar oral hygiene myths.

Visit Kenvue Pro at kenvuepro.com/en-gb/brands/listerine for ongoing professional resources, samples and support.

Head to Dentistry.co.uk to complete the Digital Oral Hygiene Roadshow.

This article is sponsored by LISTERINE.

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