Mouthwash is an oral hygiene product formulated for topical use, intended to be swished and then spit out. It delivers active ingredients that freshen breath, reduce plaque, and fight bacteria on the teeth and gums. While safe for the oral cavity, the formulation contains substances that can be toxic when processed by the digestive system and absorbed into the bloodstream. Therefore, mouthwash should never be swallowed, as the concentration of its chemical components is potentially hazardous upon ingestion.
Toxic Ingredients and Their Function
The primary ingredients that make mouthwash dangerous to swallow are concentrated ethanol and fluoride compounds. Ethanol (ethyl alcohol) is often included as a solvent for essential oils and for its antimicrobial properties. The concentration of ethanol in some mouthwashes can reach 27% by volume, comparable to or higher than many distilled alcoholic beverages.
The presence of large amounts of ethanol poses a significant risk of rapid intoxication upon ingestion, especially in children, due to quick absorption in the stomach. Sodium fluoride is another substance of concern, added to strengthen tooth enamel and prevent decay. While beneficial in small, topical doses, concentrated fluoride is a known toxin when swallowed in large quantities.
Other ingredients contribute to the toxicity profile, including surfactants and essential oils like eucalyptol and menthol. Surfactants are detergents that help disperse components but can cause significant gastrointestinal irritation when ingested. Methyl salicylate, a flavor agent in some formulas, can also be toxic, particularly to young children, if a substantial amount is consumed.
Physiological Effects of Ingestion
Ingesting a significant amount of mouthwash can lead to harmful physiological effects stemming from the concentrated ingredients. The high concentration of ethanol can quickly cause alcohol poisoning, resulting in symptoms like drowsiness, slurred speech, and dizziness. A more serious concern, especially in children, is central nervous system depression, which can cause slowed breathing, uncoordinated movement, and hypoglycemia.
Fluoride toxicity primarily targets digestive and systemic functions. Excessive fluoride irritates the stomach lining, leading to severe gastrointestinal distress, including nausea, vomiting, and abdominal pain. Systemically, an overdose can disrupt electrolyte balances, potentially causing muscle weakness, tremors, and cardiac irregularities.
For small, accidental sips, the effects are typically mild and localized, such as a brief upset stomach or temporary nausea. Swallowing a larger volume, especially by a child, significantly increases the risk of severe, systemic effects requiring urgent medical intervention. Non-alcohol components, such as surfactants and essential oils, primarily cause irritation and discomfort in the throat and stomach.
Emergency Response to Swallowing Mouthwash
The appropriate response depends on the amount ingested and the patient’s symptoms. If only a small, incidental amount was swallowed, such as a single mouthful or less, the immediate action should be to rinse the mouth thoroughly with water. Monitor for mild and temporary symptoms like an upset stomach, which should resolve quickly.
For a large ingestion, or if a child has consumed any amount, immediate action is necessary. The primary step is to call the national Poison Control Center hotline for expert guidance. Do not attempt to induce vomiting unless specifically instructed by a healthcare professional, as this can worsen irritation or lead to aspiration.
When contacting Poison Control or seeking medical attention, be prepared to provide details about the type of mouthwash, the estimated amount swallowed, and the time of ingestion. If severe symptoms occur, such as difficulty breathing, convulsions, extreme drowsiness, or loss of consciousness, immediate emergency medical attention is required. Having the mouthwash bottle available is helpful for medical staff to determine the exact ingredients and concentration.