Many individuals use mouthwash as a routine part of their oral hygiene, aiming for fresh breath and a cleaner mouth. However, a growing body of research suggests a potential connection between certain mouthwashes and changes in blood pressure. This article explores how commonly used mouth rinses might influence your cardiovascular health, focusing on the scientific mechanisms involved and offering practical advice for maintaining oral hygiene without unintended systemic effects.
Mouthwash’s Impact on Blood Pressure
Mouthwash can affect blood pressure by disrupting the delicate balance of microorganisms in the mouth, known as the oral microbiome. This disruption particularly impacts beneficial bacteria that play a role in converting dietary nitrates into nitric oxide (NO). Foods like leafy green vegetables contain nitrates, which are absorbed and then secreted into saliva. Once in the saliva, specific oral bacteria, including genera such as Veillonella, Actinomyces, Haemophilus, and Neisseria, convert these nitrates into nitrites.
These nitrites are then swallowed and converted into nitric oxide in the stomach. Nitric oxide is a signaling molecule that helps relax and widen blood vessels (vasodilation), facilitating smoother blood flow and maintaining healthy blood pressure levels. When certain mouthwashes kill these beneficial bacteria, the production of nitric oxide can decrease, which may lead to blood vessels constricting and, consequently, an increase in blood pressure. Studies have shown that the regular use of some antibacterial mouthwashes can lead to elevated blood pressure and reduced levels of nitrite in both saliva and plasma.
Key Mouthwash Ingredients to Consider
Certain ingredients in mouthwashes can disrupt the oral microbiome and affect blood pressure. Broad-spectrum antiseptic agents are a concern as they eliminate beneficial nitrate-reducing bacteria non-selectively. Chlorhexidine is one such antiseptic, found in prescription-strength and some over-the-counter mouthwashes. Studies indicate that using chlorhexidine mouthwash twice daily for a week can significantly increase systolic blood pressure and reduce oral nitrite production by a substantial margin, sometimes up to 90%.
Cetylpyridinium chloride (CPC), another antiseptic, also reduces oral bacteria and can increase systolic blood pressure. High alcohol content in mouthwashes is problematic, as it can dry out the mouth and disrupt the oral microbiome. These ingredients interfere with the natural nitrate-nitrite-nitric oxide pathway, potentially contributing to higher blood pressure. Even a small increase in blood pressure, such as 2-5 mmHg, has been linked to an increased risk of cardiovascular events.
Maintaining Oral Health While Managing Blood Pressure
Prioritizing mechanical cleaning is the most effective approach to oral hygiene for those concerned about mouthwash’s impact on blood pressure. Brushing teeth twice a day with fluoride toothpaste and flossing daily are fundamental practices that remove plaque and food particles without disrupting the beneficial oral microbiome. These mechanical methods are effective in preventing cavities and gum disease.
If a mouthwash is desired, opting for alcohol-free or fluoride-only formulations may be a safer choice, as these are less likely to interfere with nitric oxide production. Natural alternatives, such as coconut oil-based rinses or salt water gargles, might offer antimicrobial benefits with a gentler impact on oral bacteria. Individuals with pre-existing hypertension or those on blood pressure medication should be mindful of mouthwash choices and consult a healthcare professional or dentist for recommendations.