Your mouth contains a delicate balance of both good and bad bacteria. Bad bacteria are at the root of tooth decay, gum disease, and many other dental problems. Good bacteria are working to keep your teeth strong and healthy.

When the bad bacteria begin to overwhelm the good, you may start having more problems in your mouth. Killing off the bad bacteria can help maintain a more healthy balance in your mouth.

Furthermore, some mouthwashes offer additional benefits—mouthwashes with fluoride may help to strengthen tooth enamel and fight tooth decay. Cetylpyridinium chloride is an ingredient that targets the bacteria that cause bad breath. Potassium nitrate can reduce tooth sensitivity to cold. Carbamide peroxide or hydrogen peroxide can help whiten teeth over time for a more movie-star smile. But see the caveats below. Read the ingredients label and seek information on unfamiliar ingredients.

One study demonstrated that long-term routine use of conventional mouthwash is associated with an increased risk of hypertension (high blood pressure).
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People who used mouthwash twice per day had a higher incidence of hypertension (with an incidence ratio of 1.85) compared to less frequent users, even when controlling for multiple confounders such as age, sex, smoking status, and physical activity. Non-users of mouthwash had the lowest incidence of hypertension.

Research has demonstrated the link between the oral microbiome and levels of nitric oxide (https://pubmed.ncbi.nlm.nih.gov/28353075/). Antibacterial mouthwash is known to disrupt the oral microflora, and reduce overall levels of microbes in the mouth. However, the impact of mouthwash on overall long-term health had yet to be determined, except in small short-term trials associating mouthwash with a reduction in salivary and plasma nitrate and nitrite (https://pubmed.ncbi.nlm.nih.gov/25359409/).

This landmark study demonstrated that extended disruption of the oral microbiome by mouthwash lead to long-term effects on cardiac health through disruption of bacterial nitrate reduction pathways responsible for generating nitric oxide. This study also lays a foundation for engineering the oral microbiome in the management of hypertension. Maintaining a healthy oral microbiome is a key component of cardiac health.

Certain mouthwashes, including Chlorhexidine, have been found to lead to tooth staining with frequent use (https://pubmed.ncbi.nlm.nih.gov/22957711/). So be sure to follow instructions from your dental provider on proper usage to avoid any complications.