This process has been hammered into our minds by almost every top dental product manufacturer on the market, especially Listerine. It’s definitely one of the most popular and well marketed germ fighting rinses ever known man and people love it. What makes it so great? Well, according to their ads, Listerine kills 99% of germs that cause bad breath. It tastes great! It comes in a handful of beautiful eye catching colors, each with a unique purpose that are sure to appeal to the public. How could we go wrong with so much awesomeness? Wouldn’t every dental hygienist promote such a bacteria destroying tool?
I’m one of the few people that cringes when patients ask me if they should use Listerine. To me, it’s not a simple yes or no answer and here’s why:
- High Alcohol Content. Many of the Listerine choices have a lot of alcohol. There is 26.9% in the original formula and around 22% in the mint option. Keeping my average patient in mind, I wouldn’t recommend this for children, recovering alcoholics, the geriatric population or anyone that is dealing with a dry mouth brought on by age, medications, or medical conditions that have caused a limited amount of saliva in the mouth. (They have developed an alcohol free variation just to be fair.)
- Overrated. I can’t tell you how many times I’ve asked a patient how often they floss their teeth and the response I get is, “..not as much as I should but I use Listerine which kills most the germs in my mouth.” This statement drives me bananas! First of all, my question wasn’t answered. Secondly, this proves that the general public tends to think that using a swish will rid them of harmful periodontal disease causing germs that live deep below the gums. Many of the sneaky pathogens that live in hard-to-reach nooks and crannies can in fact be killed by an antibacterial, but when germs die, they don’t necessarily detach from their surface and get rinsed down the drain. More often than not, they stick to whatever they were living on and calcify into tartar. The tartar (also known as calculus) can now only be removed by your dental hygienist. In the meanwhile, it acts like a nice textured surface for more live bacteria to hang on and around. I always feel like I’m doing damage control from the television ads about how awesome Listerine is for everyone. It’s just not true.
- Some germs are okay. You know how we are always taught to keep the gut in check by using probiotics? There’s also a healthy balance of good and bad bacteria that we need to maintain in our mouths and there are 200-500 species of bacteria in the average human mouth at any given time. Although S. Mutans and P. Gingivalis are on the most hated list, other oral bacteria are actually good at controlling the bad ones. Listerine doesn’t target specific types of germs. Instead, it kills on contact and has no preferential treatment. An interesting article by Scientific America (click here) talks about controlling bad breath by keeping healthy bacteria happy.
So, maybe I’m not giving you the answer you were looking for, but my personal opinion is that you should always remove the gnarliest of germs by brushing and flossing really well first and then pick the right rinse one for your unique situation. For patients that are at high risk for decay, I recommend a rinse that has a prescription level of fluoride. For those that have extreme dry mouth, I recommend products like Biotene. For low risk patients that are healthy, I usually suggest they leave their toothpaste on to soak in and skip the rinsing… at least at night. Read all about that explanation here.