Surprise! Did you know that some mouthwash stains teeth? In addition to having to worry about picking the best toothpaste, now we have to worry about our mouthwash, too! If you’re not used to reading labels for ingredients like cetylpyridinium chloride or chlorhexidine gluconate, you’re about to become a mouthwash ingredient connoisseur. Why? Because some of them can cause superficial staining on your tooth enamel. Knowing what to look for can help you avoid unnecessary frustration and discoloration.
Generally, mouthwash stains teeth in a relatively small percentage of people. Most tooth stain comes from lifestyle factors such as things we eat, drink, or tobacco use.
Anything that would stain your grandmother’s favorite white tablecloth will also stain your teeth. Things like tomato sauce, red wine, coffee, tea, soda, berries, curry…you get the picture. Our teeth are naturally porous, so it’s normal for stain deposits to accumulate over time. The more often you eat or drink those things, the heavier stain buildup you’re going to get.
Some people also pick up random stains from things like vitamin and mineral supplements or even swimming in a chlorinated pool. If you have kids who spend lots of time at the pool or you’re a competitive swimmer, there’s a chance you’ll see some stains on your teeth after a few months.
But (there’s always a but, isn’t there?) some people are an exception to the rule…
Some types of mouthwash stains teeth because of an ingredient called cetylpyridinium chloride (CPC). Cetylpyridinium chloride doesn’t cause everyone’s teeth to stain but can affect an extremely small percentage of people (close to 3%). Enough to need to know it’s a problem, but probably not have to worry about it actually affecting you.
CPC is one of three primary antimicrobial ingredients used by popular mouthwash brands. The other two are essential oils and chlorhexidine.
Essential oils are one of the other main ingredients in popular over-the-counter mouthwash brands. The oils that are chosen work as natural antiseptics to help reduce oral bacteria levels. The downside is that sometimes they’re also mixed with ingredients that contain alcohol (to help stabilize the mixture for a longer shelf life and serve as an antimicrobial agent.) But alcohol can contribute to dry mouth, so some people have to rule it out. Essential oils are commonly found in mouthwash brands like Listerine, among others.
Side note: You can also make your own essential oil mouthwash if you want to, by placing a couple of drops of the right types of oils into a small cup of water.
Occasionally, dentists will need to prescribe certain mouthwash solutions to use on a limited basis. In most cases, they don’t want you using it for more than about two weeks. These prescription mouthwash blends contain an ingredient called chlorhexidine gluconate (CHX) that is an extremely strong antimicrobial. Typically, you’ll use the mouthwash in conjunction with periodontal disease treatments and deep cleanings, to help get chronic infections under control.
Depending on how extensive your oral infection is, your dentist may have you rinse with the chlorhexidine or just apply it to a specific area with a cotton swab or toothbrush.
The bad thing about chlorhexidine gluconate is that it’s known to cause tooth stains in most people. That’s one reason why you don’t want to use it longer than a couple of weeks. If you do, you’re almost 100% guaranteed to get mouthwash teeth stains. By the time you probably start to notice any stains, it will be time to stop using the prescription.
You may be thinking “but I’m only using half of the bottle!” That’s ok. Store it in the back of the refrigerator so that you have it several months down the road if you experience any more flare-ups. Otherwise, you can discard it. Don’t stick to the mindset of, “I need to use all of this so that it doesn’t go to waste.”
Chlorhexidine gluconate is not in over-the-counter mouthwashes, so you don’t have to worry about it being an ingredient in commercial products. If you’re getting it from your dentist’s office or they write you a prescription, they will make sure that you remember to only use it for a couple of weeks maximum.
The final top three antimicrobial ingredients in mouthwash is cetylpyridinium chloride. This agent is used in popular mouthwash brands like:
Here’s where things get a little tricky. Why these mouthwash solutions work great for a lot of people, there’s a small fraction of the population where the mouthwash stains teeth after using it on a repeated basis. Not everybody sees this happen, but enough do to where it’s a known issue that occasionally pops up among dental patients.
Unless you’re using a prescription chlorhexidine gluconate (CHX) mouthwash, staining is highly uncommon with most mouthwash. For the few people at risk of cetylpyridinium chloride stain, the best thing to do is to stop using that type of mouthwash and switch to one without cetylpyridinium chloride listed as an ingredient. That way you can keep the stain to a minimum before it gets too bad. Since so many of brands are available without this ingredient, finding an alternative should be easy to do.
The easiest way to get rid of stains from mouthwash is to schedule a cleaning with your hygienist. They can easily polish off those superficially extrinsic stains in just a few seconds. Otherwise you might want to try using a different whitening mouthwash and/or toothpaste and/or whitening strips to see if you can lift the stains yourself. Just be sure to only use over-the-counter products as directed!
Since the risk of mouthwash staining teeth is pretty low, you can generally use any over-the-counter rinse that you prefer. The main trouble-makers tend to be the prescription mouthrinses, and those should only be used on a limited basis.
When you can, try to pick out a mouthwash that has fluoride listed as an ingredient. Not all of them do. Fluoride is effective at preventing tooth decay, remineralizing weak enamel, and also combatting sensitivity. But if you’re looking at other ingredients that might be linked to staining, it’s easy to overlook whether or not there’s fluoride in them too.
Switching to a whitening mouthwash can help with superficial tooth staining to an extent. In most cases, they help you keep your smile the color it currently is, rather than whitening it more. So if you’re drinking coffee or tea, whitening mouthwash essentially lowers your risk of getting new tooth stain accumulation. Oddly, some of those whitening rinses can cause stain on their own part, because certain ones do contain cetylpyridinium chloride. Just pay attention to your teeth and if you notice any new staining in a couple of weeks, swap it out for one that doesn’t have cetylpyridinium chloride in it at all.
Using mouthwash is an add-on to your brushing and flossing routine. It doesn’t replace either one. In fact, mouthwash works even better when you’ve used it after brushing and flossing because the rinse can have better contact with all of your tooth surfaces (there isn’t any plaque or food in the way.)
If you’re choosing the wrong mouthwash for what you need, you’re still getting the benefits of an antiseptic or fluoride, but you also inadvertently put yourself at a minor risk for dry mouth or stain if you’re not checking the labels. When in doubt, always ask your dentist or dental hygienist.
Most antiseptic mouthwash blends contain one of three ingredients: cetylpyridinium chloride, chlorhexidine gluconate, or essential oils. All of them work as antimicrobials to help kill germs. However, cetylpyridinium chloride and chlorhexidine gluconate are both known to cause occasional staining. Always use oral care products as directed and if you notice stain buildup, talk to your dentist. Chances are, they can polish it right off your teeth!
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