9 Toxic Ingredients Found In Your Mouthwash… Are You Accidentally Ruining Your Teeth?

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9 Toxic Ingredients Found In Your Mouthwash
Photo © Andrey Popov – fotolia.com

According to statistics from the World Health Organization, 60 to 90 percent of school-aged children and close to 100 percent of adults have dental caries. When dental caries are left unmanaged, a person can develop periodontal disease, which leads to tooth loss and affects 15 to 20 percent of middle-aged adults all over the world. With nearly all of the population experiencing poor oral health, dental hygiene is a must. Moreover, we must all be wary of the products we use when we brush our teeth or wash our oral cavity. [1]

Because brushing your teeth only cleans a small percentage of your mouth, a lot of dentists will recommend you to use mouthwash regularly. Using mouthwash helps keep your entire mouth clean. However, there are different kinds of mouthwash with various ingredients that can do more harm than good. Keep in mind that some chemicals can be dangerous to your oral health.

1. Alcohol

If you’re into skincare, you will often hear advice to avoid alcohol-containing products because it dries up your skin and can make it prone to damage. The same applies to the sensitive tissue inside your mouth. Not only does alcohol dry out your mouth, it also kills all the bacteria in your mouth – good and bad. This is bad because this messes up the natural equilibrium of the good bacteria in the oral cavity. [2]

A study published in 2009 focused on the growing concern that alcohol-containing mouthwashes could contribute to the development of oral cancer. While the alcohol itself doesn’t increase the risk for oral cancer, research has found that ethanol oxidizes into acetaldehyde, which is a toxic metabolite and is known to increase a person’s risk for oral cancer. The study found that use of alcohol-containing mouthwash increases levels of salivary acetaldehyde beyond safe levels – and that repeated use of alcohol-containing mouthwash could indeed increase oral cancer risk. [3]

2. Artificial Dye

The use of dyes in various cosmetic products has long been the topic of controversy over safety issues. Various studies have shown that certain dyes can cause cellular toxicity if a person is exposed to them enough. While the results of Yuen, et. al.’s study in 2009 revealed that dyes were technically safe, the results also revealed that repeated exposure could have toxic consequences. In fact, a 2013 publication revealed that we are repeatedly exposed to dyes through various cosmetic products – mouthwashes included. [4][5]

3. Benzalkonium Chloride

Benzalkonium chloride is a known preservative and antiseptic, used in various medicinal products like eye drops. However, it is also a known allergen, meaning products containing them have to clearly print them on the label because exposure can cause severe adverse effects. The CDC actually reports the following signs and symptoms if you are exposed to dangerous levels of benzalkonium chloride: difficulty breathing, skin damage, blurred vision, abdominal pain, nausea and vomiting, and diarrhea. An in vitro study on benzalkonium chloride actually found it exhibited antiestrogenic activity, meaning it could also cause problems with your body’s hormones. [6][7]

4. Cetylpyridinium Chloride

The same study that focused on benzalkonium chloride also focused on cetylpyridinium chloride (CPC), which is an antiseptic ingredient in mouthwash. The researchers found conclusive evidence that CPC causes problems with cellular function, specifically mitochondrial inhibition — wherein CPC disturb cellular ability to produce energy. Similar to benzalkonium chloride, cetylpyridinium chloride also exhibited significant antiestrogenic activity. [7]

5. Chlorhexidine

If you have problems with oral health, particularly if you are plagued with oral infections, you will be familiar with chlorhexidine mouthwashes. Chlorhexidine is a very popular antiseptic agent in mouthwashes and solutions and is typically prescribed to prevent oral infections if you are at risk for them. However, various studies have shown that using chlorhexidine can actually worsen your oral health if you use it excessively (or if you don’t have any oral health problems, infection or otherwise). A study on mouthwash containing chlorhexidine and persica found that it caused cellular toxicity, which can be a risk factor for cancer. [7]

6. Hexetidine

Like chlorhexidine, hexetidine is an effective antiseptic that can prevent oral infections or manage a currently occurring one. However, prolonged use of hexetidine can also cause adverse effects like worsening xerostomia (dryness of the mouth); this is especially true if you use hexetidine mouthwashes for more than two weeks. Mild irritation has been seen in some people but with no toxic effect – but this is only true if you don’t use hexetidine regularly. [8][9]

7. Methyl Salicylate

Methyl salicylate adds the iconic tingling sensation or “minty-ness” in mouthwashes – but it too must be used sparingly. In studies that focus on methyl salicylate toxicity, this ingredient has been found to cause severe vomiting and other gastrointestinal problems when ingested, which can develop into multi-organ failure if a person is repeatedly exposed to this ingredient. These studies focused on the topical use of methyl salicylate – how worse would the effects be in products that are taken orally like mouthwashes? [10][11]

8. Methlyparaben

With more and more people demanding safety from cosmetic companies, there has been a worldwide movement against the use of parabens. You will often hear the term “paraben-free” from various products and that is supposed to entice you to purchase it over paraben-containing products. However, this negative light on parabens, which are used as preservatives, is not without merit. Parabens have been linked with the development of cancer, specifically breast cancer. Mouthwashes also contain parabens in order to prolong their shelf-life, however, this ingredient has been shown to increase your risk of cancer as well. In fact, parabens have been proven to cause worsening of breast cancer by promoting the migratory and invasive activity of cancer cells. [12][13]

9. Triclosan

For people who experience fungal infections, triclosan is quite effective in managing them; oral fungal infections are typically treated with triclosan-containing mouthwash. However, repeated exposure to triclosan and abuse of this antiseptic can cause allergic reactions or allergic disease. Bertelsen, et. al. in 2013 found that high concentrations of triclosan cause allergic sensitizations among Norwegian children. The FDA has actually released safety warnings on triclosan, citing studies that found the antiseptic to cause hormonal problems (specifically with a decrease in thyroid hormone levels), and an increased risk for skin cancer, although the latter studies are still on-going. [14][15]


[1] World Health Organization. Oral health. https://who.int/oral_health/publications/factsheet/en/

[2] American Dental Association. Mouthwash. https://ada.org/en/member-center/oral-health-topics/mouthrinse

[3] Lachenmeier, D., et. al. (2009). Salivary acetaldehyde increase due to alcohol-containing mouthwash use: A risk factor for oral cancer. https://onlinelibrary.wiley.com/doi/10.1002/ijc.24381/full

[4] Yuen, D., et. al. (2009). Comparison of the In vitro Safety of Intraocular Dyes Using Two Retinal Cell Lines: A Focus on Brilliant Blue G and Indocyanine Green. https://sciencedirect.com/science/article/pii/S0002939408006892

[5] Lucova, M., et. al. (2013). Absorption of triphenylmethane dyes Brilliant Blue and Patent Blue through intact skin, shaven skin and lingual mucosa from daily life products. https://www.ncbi.nlm.nih.gov/pubmed/23127598

[6] Centers for Disease Control and Prevention. Benzalkonium chloride. https://www.cdc.gov/niosh/ipcsneng/neng1584.html

[7] Datta, S., et. al. (2017). In Vitro Evaluation of Mitochondrial Function and Estrogen Signaling in Cell Lines Exposed to the Antiseptic Cetylpyridinium Chloride. https://www.ncbi.nlm.nih.gov/pubmed/?term=benzalkonium+chloride+toxicity+mouthwash

[8] Chevalier, M., et. al. (2015). Antiseptic mouthwashes could worsen xerostomia in patients taking polypharmacy. https://www.ncbi.nlm.nih.gov/pubmed/25601200

[9] Toxicology Data Network. Tricaprylin. https://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+7828

[10] Parker, D., et. al. (2004). The analysis of methyl salicylate and salicylic acid from Chinese herbal medicine ingestion. https://www.ncbi.nlm.nih.gov/pubmed/15107154

[11] Muniandy, R. & Sinnathamby, V. (2012). Salicylate toxicity from ingestion of traditional massage oil. https://www.ncbi.nlm.nih.gov/pubmed/22922924

[12] Darbre, P. & Harvey, P. (2014). Parabens can enable hallmarks and characteristics of cancer in human breast epithelial cells: a review of the literature with reference to new exposure data and regulatory status. https://www.ncbi.nlm.nih.gov/pubmed/25047802

[13] Khanna, S., Dash, P. & Darbre. P. (2014). Exposure to parabens at the concentration of maximal proliferative response increases migratory and invasive activity of human breast cancer cells in vitro. https://www.ncbi.nlm.nih.gov/pubmed/24652746

[14] Bertelsen, R., et. al. (2013). Triclosan exposure and allergic sensitization in Norwegian children. https://www.ncbi.nlm.nih.gov/pubmed/23146048

[15] US Food and Drug Administration. 5 Things to Know About Triclosan. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm205999.htm

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