Mouthwash is an oral hygiene product formulated for rinsing and spitting, not for internal consumption. It contains various chemicals and active ingredients intended to kill bacteria, which can become toxic when swallowed in large quantities. The severity of the reaction depends on the amount ingested, the specific formulation, and the person’s age and body weight. Children are particularly susceptible to poisoning, requiring careful monitoring.
The Primary Toxic Components
The most concerning ingredient in many mouthwash varieties is ethanol, or ethyl alcohol, which can be present in concentrations ranging from about 5% to 27%. This high alcohol content acts as a solvent and antimicrobial agent. When ingested, it is rapidly absorbed into the bloodstream, posing a serious risk of alcohol poisoning. Even small amounts of alcohol-based mouthwash, such as one ounce, can produce dangerous effects in children.
Fluoride, commonly included to strengthen tooth enamel and prevent cavities, is another component that becomes toxic when consumed in large doses. While safe in the trace amounts used for rinsing, acute ingestion of fluoride can lead to severe systemic effects. The concentration of fluoride, whether sodium fluoride or stannous fluoride, is too high for the body to process safely when swallowed.
Other ingredients, such as chlorhexidine, methyl salicylate, and various essential oils like menthol and eucalyptol, are generally present in lower concentrations. These compounds are primarily irritants, meaning they can cause distress to the digestive tract. However, the primary life-threatening concerns are related to the ethanol and fluoride content, especially in cases of large-volume ingestion.
Effects of Small, Accidental Swallowing
Accidentally swallowing a small amount of mouthwash, such as a capful during rinsing, is unlikely to cause severe toxicity in healthy adults. Symptoms are typically confined to mild, localized irritation of the gastrointestinal system. This occurs because the concentration of toxic agents is highly diluted once it reaches the stomach.
Individuals may experience an upset stomach, mild nausea, or a brief episode of vomiting shortly after the accidental swallow. A temporary burning or stinging sensation in the mouth, throat, or esophagus is also common due to the alcohol or other irritants present in the liquid. These mild effects are usually transient and resolve on their own without requiring medical intervention.
However, any ingestion should be taken seriously if it involves a child. Children have a lower body weight, making them far more susceptible to the toxic effects of even a small quantity of alcohol or fluoride. Monitoring for any symptoms is prudent, and any amount ingested by a child warrants a call to a poison control center.
Severe Poisoning Risks and Symptoms
Ingesting a large volume of mouthwash, such as half a bottle or more, presents a serious risk of severe systemic poisoning, primarily driven by the ethanol content. The high concentration of alcohol can lead to Central Nervous System (CNS) depression. This manifests as slurred speech, profound drowsiness, dizziness, and uncoordinated movement. In the most severe cases, this depression can progress to stupor, coma, and life-threatening respiratory failure.
Alcohol toxicity is especially dangerous for children, who are prone to developing hypoglycemia, or dangerously low blood sugar. This condition can lead to seizures and permanent brain damage. Beyond the ethanol, acute fluoride poisoning from a large dose can cause severe gastrointestinal distress, including abdominal pain, vomiting, and diarrhea. Fluoride also interferes with the body’s electrolyte balance, resulting in muscle weakness, tremors, and serious cardiac abnormalities, such as an irregular heart rhythm.
Immediate Action and Emergency Guidance
In the event of mouthwash ingestion, the first step is to contact a poison control center for expert guidance. In the United States, this can be done by calling the national toll-free Poison Help hotline at 1-800-222-1222. Do not attempt to induce vomiting unless specifically instructed by a healthcare professional or the poison control center.
Be ready to provide specific information to the operator. Keep the mouthwash container nearby, as the ingredients and concentrations listed on the label are necessary for determining appropriate treatment.
Information to Provide
- The person’s age and weight.
- The exact name of the mouthwash product.
- An estimate of the amount swallowed.
- The approximate time of ingestion.
Call 911 or your local emergency number immediately if the person is unconscious, has difficulty breathing, is having a seizure, or is showing signs of severe intoxication. These symptoms indicate a life-threatening emergency that requires immediate medical intervention. Stay with the affected person and monitor their condition until help arrives.