Mouthwash Usage and… Heart Attacks?

There’s a lot of talk about the gut microbiome and its relation to our immune system, mental health, and health status at large. In reality, the gut microbiome is just one of many microbiomes that we have. We also have an oral microbiome, a skin microbiome, a nasal microbiome, an ear microbiome, and so on. As we have come to learn, the proper balance of bacteria in each microbiome is extremely important when it comes to maintaining health, preventing disease, and correcting issues that have already manifested. 

Much like how antibiotics cannot tell the difference in our gut between good and bad bacteria and just wipe it ALL out, mouthwash works in the same way. It kills the bacteria in our mouths, but also the beneficial bacteria. This is problematic because these beneficial bacteria are what help us fight off gingivitis, cavities, and bad breath (to put in context: over 50% of US adults have gingivitis, and most of us use regular mouthwash which will exacerbate the problem). 

If you have ever been to a biological or holistic dentist, they likely tested the pH of your saliva. Knowing the pH of saliva is important because one of the functions of saliva is to aid in the remineralization process by depositing nutrients like magnesium, hydroxyapatite, phosphorus, and vitamin K2, vitamin D, and calcium onto the teeth. In addition to killing off beneficial bacteria, using mouthwash substantially disrupts the mouths natural production of saliva and thus affects the ability of saliva to protect against cavities. 

Perhaps the most concerning risk factor of all, is the ability of mouthwash to significantly increase heart attack risk. This happens because the antiseptic properties in mouthwash kill off the beneficial bacteria in the mouth which produce a chemical called nitrite. Nitrite helps keep our blood vessels dilated so the pressure doesn’t get too high and blood can easily pass through. Why does this matter? About 1 in 3 adults in the US have high blood pressure and don’t even know it. Even worse, 2 out of 3 people on hypertension medications do not have their blood pressure adequately controlled. One study showed that the mouthwash caused nitrite production in the mouth to fall by over 90% and blood nitrite to fall by 25%. The changes in blood pressure were noticeable within only ONE day of using the mouthwash twice per day. Imagine the effects that may ensue by using mouthwash daily for years!

For these reasons, I generally do not recommend mouth washes that contain harsh antimicrobials that wipe out all bacteria such as 

1. Alcohol based washes

2. Chlorine dioxide containing washes

3. Chlorhexidine washes

4. Washes that contain formaldehyde

(These are problematic for everyone - but especially for patients that have a history of heart disease or hypertension!)

For other healthier ways to support fresh breath, I have several recommendations:

1. Use a natural mouthwash such as Lumineux which can be bought easily on Amazon (Be careful not to buy any old ‘natural’ mouthwash, though. Many still contain alcohol or other ingredients which will disrupt the oral microbiome): Click here for a trusted brand.

2. Purchase a tongue scraper. Studies show using a tongue scraper daily for just a week reduces levels of certain bacteria that cause bad breath. One of my favorites is a stainless steel pack of two for only a few bucks (once you try tongue scraping, you will never stop doing it!): Click here

3. Eat a healthy diet that supports an optimal oral (and gut!) microbiome. This excludes foods with phytic acid (wheat, corn, etc), simple carbs (like pasta, breads, white rice), sugary foods and drinks, dried fruit, and acidic drinks.

4. Use an oral probiotic. For 15% off my favorite trusted oral probiotic, click here. Anecdotally, this product helps with recurrent sore throats, strep infections, and sinus and ear problems as well as being a proven bad breath aid and helping in cavity protection. If you haven’t done so already, you will be prompted to make a free account before you can check out. The product’s name is OralProbio and it will come up under my favorites. 

To see my other oral care favorites such as toothpaste made with nano hydroxyapatite (the mineral that makes up teeth), healthy chewing gum which uses xylitol, an antimicrobial which acts against bad bacteria, and more, click here.

For access to 15% off practitioner-only professional-grade supplements from over 300 different brands, click here.

To schedule a free, 15-minute consult, click here.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4838534/

https://pubmed.ncbi.nlm.nih.gov/9526927/

https://pubmed.ncbi.nlm.nih.gov/25506416/

https://www.sciencedirect.com/science/article/pii/S0891584912018229

https://www.nhlbi.nih.gov/health-topics/high-blood-pressure

https://pubmed.ncbi.nlm.nih.gov/16032940/