Mouthwash for gingivitis is a good first step if you have any of the early signs of gingivitis or gum disease.

You’ve likely got gingivitis if you have any of the following signs:

-Bleeding gums when you floss or brush your teeth

-Swollen gums

-Red gums

-Painful gums, especially when you chew

-Sensitive teeth from swollen gums pushed out of position while chewing

-Seeing red when you spit after brushing or flossing

-Smelly breath

Image of smiley face with green bad breath-mouthwash for gingivitis

Mouthwash for gingivitis will help with bad breath
Image courtesy of Craig Sommer DDS at

As infection increases, really bad breath starts to develop, as the infected cells that make up your gums are killed by the invading bacteria. The rotting cell proteins form a nauseating stink as putrescine and cadaverine are released. It is a stink that persists even after brushing.

Eventually the gingivitis increases, progressing to a more severe form called periodontitis where your teeth begin to loosen.

If you’re experiencing one or more of these signs chances are you’ve got gingivitis or worse and you are wondering how to treat gingivitis.

How To Treat Gingivitis

The good news is if you only have gingivitis, it is limited to an inflammation of the gum tissue that sits right around each tooth like a turtleneck. It’s not only the gum that you can see on the lip or cheek side of the teeth and tongue side of the teeth, but it’s the gum wedged in between the teeth as well.

I saw a recent article describing the cause of gingivitis as a thin layer of material that hardens on the sides of teeth at the gum line. The article seemed to imply that it was the hardened material that created the irritation to the gum tissue. But, that is not the complete problem.

What’s That Hard, Crusty Layer?

The hardened layer of material is piles of food and bacteria, known as plaque, with saliva minerals deposited within it, forming crystals. This crusty deposit, home to millions of bacteria, is now called tartar or calculus. I refer to them as barnacles. It’s like the crusty ring around pier pilings when the tide goes out.

Sure, anything hard and crusty, poking into the gum tissue long enough will irritate it and cause inflammation and bleeding. Imagine walking around with a rock in your shoe. Eventually, it will cause enough irritation and inflammation and you’ll make efforts to get rid of the rock. That doesn’t happen with teeth right away. There is no pounding against the calculus so the gingivitis problem can sneak up on you.

Since the surface of tartar or calculus is not smooth, but incredibly rough like the surface of a sponge, the bacteria numbers are enormous.  Tartar or calculus is a virtual “bacteria-magnet” protecting the bacteria from removal by tooth brushing. It is this thick bacterial shag carpet pressing against the gums that is responsible for damaging gingivitis.

If the “wrong” type of aggressive bacterial bad guys show up and takeover, you may get a fever, rotten breath and watch the gums between your teeth start to melt away.

Bacteria are definitely the bad guys.

Image of bacteria a microscopic view of bacteria similar to Those That Make Up Thick Plaque Deposits-mouthwash for gingivitis

A Microscopic View Of Bacteria Similar To Those That Make Up Thick Plaque Deposits    Courtesy of

The Best Gingivitis Treatment Requires Getting Rid Of The Bacteria Bad Guys

One way to fight the gingivitis problem is to attack the bacteria floating around with a mouthwash. Anywhere the mouthwash comes into contact with bacteria, it can help. And anywhere it doesn’t contact bacteria, it won’t help.

Can mouthwashes get to surface of plaque bacteria? Yes. How about bacteria two,  three or more layers deep? Will those bacteria be affected? Nope.

How about bacteria in the crevices on the back of the tongue? Nope.

How about bacteria inside the little turtleneck of gum tissue around each tooth? Nope.

Even the best mouthwashes have natural barriers to their effectiveness. They cannot help areas where bacteria are accumulating if they cannot reach them.

If a mouthwash cannot reach critical areas it is essentially useless.

What Does A Good Mouthwash Need To Do?

For a mouthwash to be effective against gingivitis, it needs to be effective against bacterial growth. If it doesn’t kill bacteria or prevent their growth it is  useless.

A good mouthwash needs to have staying power. Does it contain active ingredients that will hang around after the first sip of coffee or tea?

So let’s look at some of the different ways various companies have approached the solution to the bacteria problem that is gingivitis.

Animated gif showing what your teeth see when you use a mouthwash for gingivitis

Swishing and Gargling-What Your Teeth See As You Use A Mouthwash For Gingivitis.
Courtesy of: Craig Sommer DDS

Alcohol Kills Bacteria-At Least Some Of Them

As a child I remember walking into the physician’s office and remembering the distinct smell of alcohol. At that time, alcohol was everywhere present in various containers to help “sterilize” all sorts of things. Instruments, gauze swabs, thermometers, and stethoscopes all had a distinct alcohol smell or taste because that’s what was used to kill bacteria. The thermometers always tasted of alcohol.

Now, we know that alcohol is not 100% effective at killing bacteria. It kills off a number of bacteria and perhaps a few of the cells lining your mouth as well.

It doesn’t really “sterilize” anything, but it disinfects, or reduces the bacteria count to some degree. The distinction is important. Even so, it’s commonly used in mouthwashes today.

The CDC, or Centers for Disease Control says a 10 minute exposure to alcohol (ethanol), in water at concentrations from 50% to 95% is a disinfectant against bacteria. Any lower concentrations, or shorter times reduce the effectiveness of the bacteria killing effect.

Alcohol, even at ideal concentrations, will not affect bacteria hiding as spores (dangerous) and will also not penetrate multiple protein layers. If there is surface debris, alcohol cannot penetrate it to get to the underlying bacteria.

It never reaches the deeper bacteria hiding under plaque deposits, or inside the turtleneck areas of your gums.

To help a mouthwash be as effective as possible against gingivitis, brush away as much plaque as you can before using it, since it only affects surface bacteria.

Could My Favorite Alcoholic Beverage Work As A Mouthwash?

Your favorite beverage would have to have a minimum effective alcohol concentration between 50% and 95%  to be considered a bacterial disinfectant. That is 100 proof to a searing 190 proof.

Most beverages top out at 40% alcohol or 80 proof before dilution with ice or mixers.

I would not recommend that you try to use alcoholic beverages as a mouthwash substitute even though manufacturers of mouthwash add it to their products.

One reason alcohol is added is the “bite” mouthwashes have when used. The alcohol content makes mouthwashes seem “strong,” but they still may not have the desired effect you are hoping for, namely killing bacteria.

Another reason alcohol is added is to dissolve other active ingredients or to keep them in solution or separating into two layers in the bottle.

Check out the labels on any of your mouthwashes and examine the alcohol content.

Why Is Alcohol In Mouthwashes A Concern?

It’s well known today that the consumption of alcoholic beverages on a regular basis leads to an increase in the risk of oral cancer. So suspicion was raised as to whether there is also an increased risk of oral cancer in individuals using alcohol containing mouthwash.

Completed studies did indeed show an increased risk for oral cancer among users of alcohol containing mouthwashes, even among those who do not smoke.

The take home lesson is alcohol in your mouthwash increases your oral cancer risk.

So even though alcohol may be effective at killing some of the bacteria that can cause gingivitis, there may be a better way.

How About Using Essential Oils In Mouthwashes?

You are probably aware that some essential oils have been shown to be very effective bacteria fighters. Several of these phenol based essential oils are combined with alcohol to produce one of the most popular commercial mouthwashes sold in America today, Listerine.

image of essential oils, the active ingredient in a mouthwash for gingivitis

Essential Oils Are Very Effective In A Mouthwash For Gingivitis
Courtesy of: Craig Sommer DDS and

Even though, Listerine has an alcohol content of 21%, or 42 proof, it lists the alcohol as an inactive ingredient. As was mentioned earlier it’s used primarily to keep the essential oils from from separating into two layers, a water layer and an oil layer.

Vodka, whiskey and rum are common alcoholic beverages that typically contain 40% alcohol or 80 proof. When comparing mouthwashes to alcoholic beverages that range from 3.2% to as high as 70%, the alcohol content, while not insignificant, does little to kill bacteria.

When tested in one study, Listerine had a greater effect on reducing the inflammation associated with gingivitis than it had on the actual amount of plaque thickness. It seems that with regular use, one or more of the oils acted directly to reduce the inflammation in the gums themselves.

This is not a surprise due to the chemical similarity to aspirin of some oils.

Listerine’s active phenolic oil ingredients are listed as:

  • Eucalyptol [Eucalyptus oil] 0.092%
  • Menthol [Peppermint oil] 0.042%
  • Methyl salicylate [Wintergreen oil] 0.060%
  • Thymol [Thyme oil] 0.064%

Listerine, in another separate study, helped reduce plaque by 52% more than only brushing and flossing.

The take home lesson is that it may not be the alcohol that is the most important consideration for bacteria reduction. It is likely the essential oils that have an affinity for oral tissues including gum tissue. The longer they stick around the more effective they can be.

Best Mouthwash For Gingivitis- The “A” List

A best mouthwash for gingivitis should accomplish at least three things.

  1. Kill bacteria directly
  2. Prevent the buildup of plaque
  3. Reduce bacterial toxicity

What are essential oils capable of accomplishing?

Essential oils have the ability to kill bacteria by damaging their cell wall or membrane. Its hard for bacteria to survive if essential oils dissolve the bag that contains the guts of the bacteria. If the cell wall is damaged, the guts spill out everywhere. No more bacteria.

Essential oils also interfere with the bacterial enzymes that are essential for  survival allowing bacteria to behave like bacteria. It stops them dead in their tracks.

Another requirement for a mouthwash to be on the A-list would be it disrupts the accumulation of plaque, upon which new plaque grows. This would also cut down on tartar and calculus buildup. Essential oils do just that. They prevent bacteria from sticking together and building layer upon layer clumps that serve as the foundation for new tartar or calculus buildup.

A good mouthwash would also slow the multiplication of bacteria. Bacteria increase in number by dividing, one into two and then two into four, etc. They have the power to number in the millions in a few short hours.

Essential oils gum up that multiplication process too. High fives for essential oils.

In addition, essential oils extract endotoxins from bacteria. Endotoxins are toxic products produced by bacteria that are responsible for much of the havoc that bacteria wreak. No poisons, no problem.

Therefore, a best mouthwash for gingivitis “A”-list should definitely include essential oils. Why?  They are very effective without causing undue harm. They have staying power because they have an affinity for live tissues.

Can I Make My Own Natural Mouthwash For Gingivitis?


Do your own research of course as I cannot advocate specific advice. Look for food grade, or approved for internal use essential oils. Most are concentrated and could irritate sensitive oral tissues if not diluted.

A popular one I use in my office is made from a combination of spearmint oil, peppermint oil and almond oil. They are diluted in what I believe is fractionated coconut oil. Talk with your dentist or physician for specific advice.

image of essential oil bottles- Essential Oils Are A Main Effective Ingredient Of Mouthwash for Gingivitis

Essential Oils Are A Main Effective Ingredient Of Mouthwash for Gingivitis
Courtesy of: Craig Sommer DDS

A few drops in a couple of ounces of water make a fine mouthwash with potent effects on a number of bacteria according to a university study.

I have been using a citrus oil blend with peppermint oil diluted with fractionated coconut oil for years.

A periodontist, gum specialist, friend of mine looked for live bacteria using plaque samples from my gums. He placed the sample on a glass slide for examination on a phase contrast microscope. There were no live, problem causing bacteria. In fact there were no live bacteria at all.

Just to be safe though, explore these options under the guidance of your holistic dentist.

Are Prescription Based Mouthwashes Better?

There are conventional prescription based mouthwashes that are very effective against oral bacteria.

Two particularly good prescription mouthwashes that block bacteria growth completely are: 1) a chlorhexidine (CHX) 0.5%-cetylpyridnium 0.5% mixture and 2) octenidine dihydrochloride.

I know the names are a bit intimidating, but your dentist and pharmacist will know exactly what they are, if your dentist prescribes them.

The mode of action is similar to that of the essential oils in that they cause the cell wall of bacteria to rupture spilling the contents of the cell, destroying the bacteria.

These prescription mouthwashes have been recommended for use both pre- and post-surgically to drastically reduce the bacteria count to promote healing.

They have also been proven to be effective against gingivitis. One of the reasons they are effective is that they persist after use. They have staying power, one of the key attributes of a good mouthwash for gingivitis.

All Mouthwashes Have Limitations

  • If you use mouthwashes to fight gingivitis, be aware that they all have limitations.They are limited in effectiveness against anything other than surface bacteria.
  • They will work best after plaque is completely removed by excellent tooth brushing.
  • The alcohol is not an effective ingredient.
  • Mouthwashes will never get into the turtleneck of gum tissue around each tooth where problem bacteria reside.
  • Mouthwash never gets into the crevices between the teeth where bacteria hide.
  • Mouthwashes never get to the bottom of the deep crevices on the back of the tongue that harbor huge quantities of bacteria.

The best plus for mouthwashes is that they will make your breath smell better for a little while if you have morning mouth and stinky breath.

Unfortunately they are not a panacea. They just can’t make up for haphazard dental hygiene so do your best to be careful, complete and consistent with your home care efforts. Regular visits will allow your dentist to evaluate your efforts, provide some coaching to improve them, and remove plaque and the tartar or calculus that you missed, the barnacles, remember?