Mouthwash is designed to freshen breath and help reduce plaque or gingivitis. While intended for rinsing and spitting, ingesting mouthwash can pose serious health risks. The various ingredients, though beneficial for oral health when used topically, are not meant for consumption and can lead to toxicity.
Hazardous Mouthwash Ingredients
Mouthwash can be dangerous when swallowed due to several ingredients that are toxic in significant quantities. High concentrations of ethanol, often ranging from 5% to 27%, are present in many mouthwashes. Ingesting large amounts of this alcohol can lead to symptoms similar to alcohol poisoning.
Fluoride is another common ingredient, added to strengthen tooth enamel and prevent decay. Swallowing too much fluoride can result in fluoride toxicity.
Essential oils are also frequently found in mouthwashes for their antiseptic properties and flavoring. These plant-derived compounds, when ingested in large volumes, can contribute to severe health issues.
Cetylpyridinium chloride (CPC) is an antimicrobial agent used to reduce plaque and gingivitis. Ingestion of large quantities can cause gastrointestinal irritation. The combined effect of these ingredients, particularly ethanol and phenolic compounds like those found in some essential oils, can overwhelm the body’s systems if swallowed.
What Happens After Ingestion
The effects of mouthwash ingestion can vary from mild discomfort to severe, life-threatening conditions. Even a small accidental swallow might lead to mild stomach upset, nausea, or vomiting. These symptoms often resolve on their own.
Larger ingestions, however, can result in more serious consequences. Ethanol in mouthwash can cause central nervous system (CNS) depression, leading to drowsiness, dizziness, confusion, impaired coordination, and slurred speech. In severe cases, it can depress breathing, lower body temperature and blood pressure, and even lead to unresponsiveness or coma.
Fluoride toxicity can manifest as nausea, vomiting, abdominal pain, diarrhea, and in more severe instances, electrolyte imbalances, seizures, or cardiac irregularities. Phenolic compounds and other ingredients can contribute to metabolic acidosis, a dangerous imbalance in the body’s acid-base levels, and potentially lead to multi-organ system failure. Children are particularly vulnerable to mouthwash poisoning due to their lower body weight, increasing their risk of severe symptoms like hypoglycemia (low blood sugar) or convulsions.
When to Seek Urgent Medical Care
Immediate action is necessary if someone has ingested mouthwash, especially if a large amount was swallowed or if symptoms develop. Contacting Poison Control is the first step for guidance; call the national Poison Help hotline at 1-800-222-1222 for free, expert, and confidential advice 24/7.
It is important to have specific information ready when calling, including:
The person’s age, weight, and current condition.
The exact name of the mouthwash product, its ingredients and strength if known.
The estimated amount swallowed.
The time of ingestion.
Seek emergency medical attention immediately if the person collapses, experiences a seizure, has trouble breathing, or cannot be awakened. Do not attempt to induce vomiting, as this can cause further injury or complications.
Keeping Mouthwash Safe
Preventing accidental ingestion of mouthwash is important, particularly in households with children. Always store mouthwash securely out of reach and sight, ideally in a locked cabinet. Many mouthwash products come with child-resistant caps, which should always be used and properly secured after each use.
Carefully read and follow the product labels, using mouthwash as directed for rinsing and spitting. Emphasize to all household members that mouthwash is not for swallowing. For individuals concerned about accidental ingestion, such as those with young children or a history of alcohol misuse, alcohol-free mouthwash formulations are available and can be a safer alternative.