The effectiveness of mouthwashes in the treatment of halitosis is rather debated, mainly due to possible methodological errors in the published studies and to conflicts of interest deriving from research funding by manufacturing companies.
If the brush acts mechanically through the rubbing action of the bristles, the mouthwash intervenes mainly chemically. In fact, the mechanical washing action of rinses could also be obtained using simple tap water, so the alleged additive advantages of mouthwashes would derive from their particular chemical composition.
The active ingredients contained in mouthwashes can be of different types; some, like chlorhexidine, possess a certain antiseptic action, useful for directly reducing the bacterial load of the microbial flora. Other products - like most of the commercial mouthwashes available at the supermarket - only perform an action of masking the smell, thanks to the content of aromatic substances such as menthol; the efficacy of these products is clearly short-lived and even - although essential oils have some antibacterial activity - those with an alcohol base may worsen halitosis due to their dehydrating effect.
Other substances contained in mouthwashes - such as zinc salts - are able to neutralize the volatile sulfur compounds responsible for the odor.
Antiseptic agents, such as triclosan, cetylpyridinium chloride and chlorhexidine, are slightly more effective, but have side effects; Chlorhexidine, in particular, tends to stain the teeth and for this reason products are available in spray against halitosis to be applied directly on the surface of the tongue, thus reducing the contact of chlorhexidine with the teeth.
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