Mouthwash, also known as oral rinse, is a common oral hygiene product prescribed by dentists to address various oral health concerns, including bad breath and gum inflammation. While its intended use involves swishing the solution in your mouth and then spitting it out, it's not uncommon for people to accidentally swallow small amounts of mouthwash during the process. This article explores what you should know about swallowing mouthwash, its ingredients, potential effects, and alternatives.
What Does Mouthwash Contain?
Mouthwashes come in various formulations, categorized by the U.S. Food and Drug Administration (FDA) as either cosmetic or therapeutic. Cosmetic mouthwashes aim to whiten teeth, while therapeutic ones target specific oral issues like gum inflammation. Active ingredients may include cetylpyridinium chloride, chlorhexidine, essential oils, fluoride, and hydrogen peroxide, each designed to address particular oral health concerns.
Oral mouthwashes can also contain different solvents, sweeteners, preservatives, thickeners, emulsion stabilizers, fragrances, humectants, antioxidants, and even pigments to add one or multiple features to their formula. While these ingredients are designed and mixed in safe and strict measurements, ingesting large quantities of the product could lead to overdose problems and multiple complications.
Alcohol-Free vs. Alcohol-Based Mouthwashes
There are two main types of commercial mouthwashes—alcohol-based and alcohol-free mouthwashes. The first ones have alcoholic bases like ethanol, while the latter have other chemical compounds. Although alcohol-based mouthwashes are known for their wide action spectrum and aggressive cleaning properties, non-alcoholic oral rinses are gaining more popularity due to their low toxicity and less aggressive nature. Both of them have their indications and use, but alcohol-free mouthwashes are more child-friendly and safe for everyone at home.
Understanding Mouthwash Overdose
A mouthwash overdose occurs when a person ingests more mouthwash than the recommended amount, potentially leading to adverse effects. Overdosing on mouthwash can be as harmful as overdosing on medications or drugs and should be taken seriously.
Although swallowing a bit of mouthwash is expected for every commercial or natural oral irrigator during or after the rinsing process, ingesting too much of the active ingredients can:
● Irritate the digestive tract
● Induce intoxication or poisoning
● Cause other severe systemic issues.
While mouthwash overdose is typically less severe than other types of overdose—like alcohol or medications or both—, it is still a serious issue that should not be overlooked within your household.
Common Causes for Mouthwash Overdose
The most frequent cause of mouthwash overdose is unauthorized use in children. While it can accidentally happen in adults, most cases of mouthwash overdose occur in kids under 6 years of age, typically induced by intoxication due to alcoholic principles or other active components. Similarly, it can occur in mature people or individuals with certain deficiencies or disabilities that could increase the risk of accidental ingestion.
Why Kids Are More at Risk
There are two main characteristics that make children more prone to mouthwash overdose:
Children’s Weight
Kids typically have smaller bodies and, consequently, fewer pounds and mass than adults. As a result, the toxins or poisonous substances can travel through their body much faster and aggressively. Also, their developing organism and undeveloped tissues are significantly more sensitive to harmful substances, resulting in severe consequences and overall systemic affections.
Children’s Naivety
Most accidental mouthwash overdose in children occurs due to kids mistaking mouthwash for juice or other tasty beverages. This happens thanks to the minty or fruity flavors that commercial brands put on their products to make them more appealing. While this could be an advantage to make oral rinses more attractive to the little ones, it can also represent a disadvantage when dealing with younger kids.
How To Protect Your Child From Mouthwash Overdose
The first and most important recommendation is to keep any potentially harmful substance out of the reach of children and animals. Fortunately, most antiseptic mouthwashes have a safety cap that prevents smaller kids from opening them without adult supervision. Therefore, keep your mouthwash labeled and closed at all times when not in use.
Additionally, follow your dental professional instructions and recommendations, keeping mouthwash and other complementary hygiene tools within the appropriate age framework. Avoid using these products in children under 6 years to avoid accidental swallowing.
Effects of Swallowing a Small Amount of Mouthwash
Accidentally swallowing a small amount of mouthwash is a common occurrence and generally not a cause for significant concern. It may lead to minor irritation in the stomach, resulting in symptoms like diarrhea or slight nausea. This can be attributed to the fluoride component in the mouthwash, but no severe health issues are typically associated with ingesting small quantities.
However, ingesting a large amount of mouthwash is a different matter and can lead to serious consequences.
Effects of Overdosing on Mouthwash
Ingesting a substantial quantity of mouthwash warrants immediate contact with emergency services. Overdosing on mouthwash can result in various symptoms, including:
● Difficulty breathing
● Nausea and vomiting
● Convulsions
● Dizziness
● Throat pain
● Drowsiness
● Slurred speech
● Rapid heart rate
In severe cases, multiple organ failure (MOF) and even death have been reported as outcomes of ingesting a large amount of mouthwash.
Factors Influencing the Overdose Severity
The severity of the overdose depends directly on the amount of mouthwash ingested and the components in the formula.
The Amount of Mouthwash
Drinking a mouthful of oral mouthwash is not the same as swallowing an entire bottle. Therefore, the amount of product ingested is directly related to the severity of the intoxication and the treatment it would need to prevent severe consequences or save the person’s life. As a result, knowing the amount of product swallowed is crucial for healthcare providers and emergency services to respond quickly and effectively.
The Type of Active
Different active components can have diverse effects in your organism. Alcoholic components, for instance, like ethanol, can cause severe intoxication and poisoning symptoms like dizziness, nausea, vomits, diarrhea, and even coma. Other substances like fluoride can cause severe digestive issues and dental and skeletal diseases over time, such as fluorosis. Therefore, knowing the type of ingredients in your mouthwash, or at least knowing the label of the product, can save you a lot of crucial time when facing a mouthwash overdose.
Poisonous Ingredients in Mouthwash
What is Poison?
A poison is every substance that may cause harm, damage, lesion, or disease when in contact with the human organism, compromising its function or overall life. A poison can be a chemical liquid compound like chlorine or a conventional over-the-counter drug. While many chemical compounds and substances could be considered poisons for the human body, they have proven to be effective in preserving, cleaning, disinfecting, sterilizing, and even treating conditions and diseases with the right dosage—the key is to use the appropriate amount and follow the expert's instructions to avoid accidents.
Most cases of poisoning occur inside conventional homes as a result of ingesting daily products that may appear harmless, such as cosmetics, cleaning products, prescription drugs, expired food, or, in this case, oral rinse. Also, it happens more frequently in children and elderly population due to their predisposition towards distraction and oblivion.
Potential Harmful Ingredients in Commercial Mouthwash
Certain ingredients in mouthwash can contribute to harmful effects following an overdose. These include:
● Chlorhexidine gluconate
● Ethanol (ethyl alcohol)
● Hydrogen peroxide
● Methyl salicylate
However, it is crucial to understand that these substances are not harmful in their optimal conditions and in their appropriate dosage. In fact, most of these compounds are highly valuable elements in oral hygiene and therapy to fight harmful microorganisms and bacteria in your mouth.
Treating a Mouthwash Overdose
Emergency services are equipped to manage individuals who have ingested excessive amounts of mouthwash. Treatment typically involves:
1. Administering intravenous fluids to dilute the mouthwash concentration in the body.
2. Providing respiratory support if the patient experiences breathing difficulties.
3. Administering appropriate medications to address symptoms.
Hospitalization duration depends on the quantity and concentration of swallowed mouthwash, but lengthy stays are generally not expected when timely treatment is administered.
At-Home Measures While You Wait for Emergency Services
Knowing how to act when an accident like this occurs is essential to reduce complications and prevent severe consequences. Any accident or emergency at home requires quick response and basic knowledge to prevent damage but also avoid common mistakes. Following, you have a list of what to do and what to avoid after a mouthwash accidental overdose:
What to Avoid?
● Avoid drinking acidic liquids like vinegar or lemon, as they can worsen the irritation or even increase the chemical reaction in your stomach.
● Don’t induce the vomit, but don’t stop it either if it occurs spontaneously.
● Do not auto-medicate.
What to Do?
● Drinking a cup of water or milk can help dilute toxins and delay their effects.
● Contact emergency services as soon as possible while knowing what you or your child ingested to facilitate medical response and treatment. You can also call poison control.
● Check the amount of mouthwash ingested and the type of active ingredient and inform it to the authorities.
An Alternative to Mouthwash: The Water Flosser
Parents and individuals concerned about accidentally ingesting mouthwash may seek alternatives for oral hygiene. One effective alternative is using a water flosser, which utilizes a stream of water to clean teeth and gums thoroughly. Water flossers can reach areas that mouthwash can and are a valuable option to consider.
FAQs About Mouthwash Ingestion
Is alcohol-free mouthwash safer to swallow?
Although alcohol-free mouthwash is generally less harmful if swallowed accidentally, it’s still not meant for human consumption. Some alcohol-free mouthwashes contain fluoride or other active ingredients that can cause mild stomach upset or toxicity in large amounts. Thus, always follow the directions on the label and avoid swallowing any mouthwash.
How can I prevent accidental ingestion of mouthwash?
Always use the recommended mouthwash amount, swish carefully, and spit it out completely. For children, use a child-safe, alcohol-free mouthwash under adult supervision. Also, consider using a dental water flosser like Oclean’s oral irrigator if you're concerned about ingestion.
Can I replace mouthwash with something else?
Yes! You can replace commercial oral rinses with water flossers, healthy Xylitol chewing gum, or natural rinses. However, keep in mind that none of these tools can replace an excellent toothbrushing and flossing technique.
In Conclusion
Accidentally swallowing a small amount of mouthwash during oral hygiene routines is typically not a cause for concern. However, ingesting a substantial quantity of mouthwash can result in severe consequences and should prompt immediate contact with emergency services.
To prevent such emergencies, individuals may explore alternatives like water flossers, which offer effective oral hygiene without the risk of accidental ingestion.
References
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2. Radzki, D., Wilhelm-Węglarz, M., Pruska, K., Kusiak, A., & Ordyniec-Kwaśnica, I. (2022). A Fresh Look at Mouthwashes-What Is Inside and What Is It For?. International journal of environmental research and public health, 19(7), 3926. https://doi.org/10.3390/ijerph19073926
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4. Shulman, J. D., & Wells, L. M. (1997). Acute ethanol toxicity from ingesting mouthwash in children younger than 6-years of age. Pediatric dentistry, 19(6), 404–408.
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