Mouthwash is an oral hygiene product specifically formulated for swishing and then spitting out, designed to reduce plaque, freshen breath, and sometimes deliver therapeutic agents like fluoride. It is not intended for consumption, and swallowing a substantial amount, even accidentally, can pose a serious health risk. Ingesting this product can lead to immediate and severe systemic reactions, making it a common household source of accidental poisoning, especially for young children.
Toxic Components in Mouthwash
The primary danger in many commercial mouthwashes comes from the high concentration of ethanol, which is a type of alcohol. Many popular formulations contain ethanol levels that range from approximately 5% up to 27% by volume, a concentration often higher than that found in beer or wine. For a small child, even a moderate amount of mouthwash can deliver enough ethanol to induce alcohol poisoning because their smaller body mass cannot process the substance quickly enough.
Another substance that becomes harmful upon ingestion is fluoride, which is included to strengthen tooth enamel and prevent decay. While fluoride is safe and beneficial in the trace amounts found in a typical rinse, swallowing large quantities can trigger acute fluoride toxicity. Ingested fluoride can react with stomach acid to form hydrofluoric acid, causing immediate gastrointestinal irritation. The estimated toxic dose for an average person is low, with symptoms often appearing after ingesting only 3 to 5 milligrams per kilogram of body weight.
A third source of toxicity comes from antimicrobial compounds, often including essential oils like eucalyptol, menthol, and thymol. These oils are highly concentrated phenolic compounds that act as irritants and can cause systemic poisoning if absorbed in large doses. Ingesting these compounds can cause severe irritation to the lining of the stomach and the esophagus.
Immediate Health Consequences of Ingestion
The physiological effects following the ingestion of toxic mouthwash components can manifest rapidly, particularly concerning the central nervous system (CNS). The rapid absorption of ethanol leads to intoxication, causing symptoms such as slurred speech, confusion, and a noticeable loss of coordination. In severe cases, high blood alcohol concentration can suppress the CNS to the point of causing respiratory depression and lead to coma.
A particularly concerning metabolic consequence of ethanol ingestion, especially in children, is severe hypoglycemia, or dangerously low blood sugar. Ethanol interferes with the liver’s ability to produce glucose, a process that children’s bodies rely on more heavily than adults. This drop in blood sugar can happen quickly and may result in seizures or permanent neurological injury if not treated immediately.
The phenolic compounds and high alcohol content also cause intense gastrointestinal distress almost immediately. Symptoms typically include significant nausea, persistent vomiting, and sharp abdominal pain as the irritants inflame the stomach lining. In massive ingestion cases, the absorption of phenolic compounds can result in severe metabolic acidosis, potentially leading to multiorgan system failure.
Necessary Emergency Response
If a known or suspected ingestion of mouthwash has occurred, the immediate action is to contact Poison Control. The national hotline, 1-800-222-1222, is available 24 hours a day and provides expert guidance tailored to the specific product and the amount ingested. It is imperative to call even if the person appears to feel fine, as symptoms of toxicity can be delayed.
When awaiting instructions from a medical professional, it is important not to attempt to induce vomiting. The corrosive or irritating nature of the ingredients means that forcing them back up the esophagus can cause a secondary injury. Instead, medical personnel will likely ask for the exact name of the product and an estimate of the quantity consumed to determine the level of risk.
If instructed to seek hospital care, the treatment will focus on supportive measures while the body processes the toxins. Medical staff will closely monitor the person’s breathing, heart rate, and blood glucose levels. Interventions may include administering intravenous fluids and glucose to counteract hypoglycemia and manage dehydration from vomiting.