Can using a mouthwash replace flossing?

Dentists and hygienists get this question all the time.

Can I just rinse with a mouthwash instead of flossing?

We'll, we hate to be the bearer of bad news but the answer is no. Mouth rinses are not an effective alternative to using dental floss.

Why not?

Their ineffectiveness boils down to this.

  • Flossing involves the mechanical debridement (scraping) of tooth surfaces.
  • Using a mouth rinse does not.
Wrap the dental floss up against the side of the tooth.

Mechanical cleansing is important.

Just like a toothbrush whose bristles scrub the exposed surfaces of teeth to remove plaque and debris, dental floss is a tool that's used to scrape these same items off those areas where a brush can't reach.

[That's why proper technique involves holding floss up against the side of a tooth and sliding it along its full length (even below the gum line) and not just in and out of the contact area where two teeth touch.]

Why isn't mouthwash as effective?

Some oral rinses may be able to soften up plaque (make it less adherent) and/or kill microorganisms but neither of these effects is fractionally as effective as flossing. Only mechanical debridement (scrubbing and scraping) can adequately remove dental plaque from a tooth's surface.

Mouthwash is not the best choice for soaking dentures.

The problem with rinses.

The comparative ineffectiveness of oral rinses has to do with the nature of dental plaque.

  • Although a layer of plaque may be quite thin, it's remarkably protective to the bacteria that live within it.
  • Antibacterial rinses may have an effect on the bacteria that live on the surface of plaque but will have a very limited effect on those within it.

Why flossing is better.

In comparison, scrubbing dental plaque off a tooth's surface by flossing breaks apart the bacteria's microcosm. They must then start from square one in rebuilding their colony. (It's only bacterial colonies that cause damage to teeth and gums. Small, isolated numbers of bacteria pose little threat to oral health.)

There's even a court case that concluded that mouthwash isn't as effective as flossing.

In January 2005, Southern District of New York Judge Denny Chin issued a finding that enjoined Pfizer, Inc. (the makers of Listerine Antiseptic Mouthwash) from making the claim in their advertising that the use of their oral rinse is "as effective as floss."

Judge Chin stated that he found the clinical studies on which this claim had been staked were flawed and did not support the advertised statement. He also felt that Listerine's ads could pose a public health risk, from the standpoint that they might convince consumers that they did not need to floss daily.

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