ORCID
- Zoë Brookes: 0000-0002-8096-6256
Document Type
Article
Abstract
This narrative review describes the oral microbiome, and its role in oral health and disease, before considering the impact of commonly used over-the-counter (OTC) mouthwashes on oral bacteria, viruses, bacteriophages, and fungi that make up these microbial communities in different niches of the mouth. Whilst certain mouthwashes have proven antimicrobial actions and clinical effectiveness supported by robust evidence, this review reports more recent metagenomics evidence, suggesting that mouthwashes such as chlorhexidine may cause “dysbiosis,” whereby certain species of bacteria are killed, leaving others, sometimes unwanted, to predominate. There is little known about the effects of mouthwashes on fungi and viruses in the context of the oral microbiome (virome) in vivo, despite evidence that they “kill” certain viral pathogens ex vivo. Evidence for mouthwashes, much like antibiotics, is also emerging with regards to antimicrobial resistance, and this should further be considered in the context of their widespread use by clinicians and patients. Therefore, considering the potential of currently available OTC mouthwashes to alter the oral microbiome, this article finally proposes that the ideal mouthwash, whilst combatting oral disease, should “balance” antimicrobial communities, especially those associated with health. Which antimicrobial mouthwash best fits this ideal remains uncertain.
DOI Link
Publication Date
2023-01-01
Publication Title
International Dental Journal
Volume
73
Issue
Supp 2
ISSN
0020-6539
Acceptance Date
2023-08-21
Deposit Date
2023-11-27
Embargo Period
2023-11-28
Funding
The authors have not received any commercial sponsorship directly or indirectly for this review. The narrative review reflects the authors opinions based on evidence considered of the active ingredients of the more widely available mouthwashes. The authors views should not necessarily be interpreted as the views of their faculties, universities, or associated organisations.
Keywords
Mouthwash, Chlorhexidine, Oral microbiome, Bacteria, Resistance
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
First Page
74
Last Page
81
Recommended Citation
Brookes, Z., Teoh, L., Cieplik, F., & Kumar, P. (2023) 'Mouthwash Effects on the Oral Microbiome: Are They Good, Bad, or Balanced?', International Dental Journal, 73(Supp 2), pp. 74-81. Available at: 10.1016/j.identj.2023.08.010
