Mouthwash is a common part of many daily hygiene routines, often used for fresh breath or to combat gum disease. However, an emerging area of scientific inquiry is exploring a potential connection between regular mouthwash use and cardiovascular health. This article examines the biological processes and current scientific understanding of this link.
The Oral Microbiome’s Role in Health
The mouth harbors a complex community of microorganisms known as the oral microbiome. Some of these bacteria play a beneficial role in health by converting nitrates, found in vegetables, into nitrites.
These nitrites are then processed in the body, particularly in the stomach, to produce nitric oxide (NO). Nitric oxide is a signaling molecule that helps relax and widen blood vessels, a process known as vasodilation. This process is important for regulating blood pressure and supporting cardiovascular health.
How Mouthwash Affects Oral Bacteria
Certain mouthwashes, especially those with broad-spectrum antimicrobial agents like chlorhexidine or high alcohol levels, can disrupt the oral microbiome. These ingredients kill or inhibit a wide range of bacteria, reducing harmful types but also eliminating beneficial ones.
The elimination of these beneficial bacteria, such as Rothia mucilaginosa, Haemophilus parainfluenzae, and Neisseria species, reduces the mouth’s ability to convert nitrates into nitrites. This disruption decreases the body’s natural nitric oxide production. Studies show even a single use of conventional antiseptic mouthwash can reduce nitric oxide production for up to 12 hours.
The Connection to Blood Pressure and Heart Health
Current research suggests a potential association between regular use of certain mouthwashes and effects on blood pressure and cardiovascular health. Studies observe that antibacterial mouthwash can significantly reduce the increase in plasma and saliva nitrite concentrations following nitrate intake. This reduction in nitrite can blunt the blood pressure-lowering effects of dietary nitrates.
Some research indicates that regular use of specific mouthwashes, such as those containing chlorhexidine, may lead to increases in systolic and diastolic blood pressure. For example, one crossover study showed that a 7-day period of chlorhexidine mouthwash use reduced oral nitrite production by 90% and plasma nitrite levels by 25%, correlating with a 2 to 3.5 mmHg increase in systolic and diastolic blood pressure. While these findings suggest a link, it is important to understand that research is still evolving, and more long-term studies are needed to establish a definitive cause-and-effect relationship.
Important Considerations for Mouthwash Use
Given the ongoing research, individuals may wish to consider certain aspects of their mouthwash use. Discussing mouthwash habits with a dentist or doctor is advisable, particularly for those with existing cardiovascular conditions or high blood pressure. These professionals can offer personalized guidance based on individual health needs.
For daily oral hygiene, alternatives to broad-spectrum antiseptic mouthwashes include consistent brushing, flossing, and tongue scraping. Incorporating a balanced diet rich in nitrates, found in vegetables like beetroot, spinach, arugula, and celery, can also support the body’s natural nitric oxide production. In some cases, a dental professional may prescribe specific therapeutic mouthwashes for particular oral health conditions, and these should be used as directed.