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An image showing a comparison between two mouthwashes. On the left is a bottle of Colgate Total Advanced Pro-Shield non-alcohol mouthwash. On the right is a bottle of Listerine Total Care alcohol mouthwash. The text above reads "This or That?" and the text in the middle reads "VS".

Non-Alcohol Mouthwash vs Alcohol Mouthwash – Which is Healthier?

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Our Verdict

When comparing non-alcohol mouthwash to alcohol mouthwash, we picked the alcohol.

Why?

Note: this is a contingent choice and is applicable to most, but not all, people.

In short, there has been some concern about alcohol mouthwashes increasing cancer risk, but research has shown this is only the case if you already have an increased risk of oral cancer (for example if you smoke, and/or have had an oral cancer before).

For those for whom this is not the case (for example, if you don’t smoke, and/or have no such cancer history), then best science currently shows that alcohol mouthwash does not cause any increased risk.

What about non-alcohol mouthwashes? Well, they have a different problem; they usually use chlorine-based chemicals like chlorhexidine or cetylpyridinium chloride, which are (exactly as the label promises) exceptionally good at killing oral bacteria.

(They’d kill us too, at higher doses, hence: swill and spit)

Unfortunately, much like the rest of our body, our mouth is supposed to have bacteria there and bad things happen when it doesn’t. In the case of our oral microbiome, cleaning it with such powerful antibacterial agents can kill our “good” bacteria along with the bad, which lowers the pH of our saliva (that’s bad; it means it is more acidic), and thus indirectly erodes tooth enamel.

You can read more about the science of all of the above (with references), here:

Toothpastes & Mouthwashes: Which Help And Which Harm?

Summary:

For most people, alcohol mouthwashes are a good way to avoid the damage that can be done by chlorhexidine in non-alcohol mouthwashes.

Here are some examples, but there will be plenty in your local supermarket:

Non-Alcohol, by Colgate | Alcohol, by Listerine

If you have had oral cancer, or if you smoke, then you may want to seek a third alternative (and also, please, stop smoking if you can).

Or, really, most people could probably skip mouthwashes, if you’ve good oral care already by other means. See also:

Toothpastes & Mouthwashes: Which Help And Which Harm?

(yes, it’s the same link as before, but we’re now drawing your attention to the fact it has information about toothpastes too)

If you do want other options though, might want to check out:

Less Common Oral Hygiene Options ← miswak sticks are especially effective 😎

Take care!

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