"Dangers" of Listerine

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

Astros1fan

Full Member
10+ Year Member
Joined
Mar 3, 2009
Messages
147
Reaction score
1
Something that I want someone to help me out with. I've been working with a dentist for 6 months now and he doesn't like recommending Listerine to patients because he believes the alcohol in Listerine will dry out the mouth, but with long term use of Listerine he believes will cause permanent damage to salivary glands.

Now I've worked as a dental hygienist for 6 years now and I've always recommended Listerine for my perio and gingivitis patients because 1) get pretty decent results with it 2) A LOT cheaper than having patient spend $12-20 on Peridex or Perioguard (not to mention those two stain teeth after long-term use).

If someone has heard anything regarding this if it's true or not, please let me know. At least to "cure" my curiousity. Tried looking stuff up but haven't found anything and even asked a Listerine rep if they've heard anything about that, but nothing so far. Thanks a lot

Members don't see this ad.
 
There is reason behind his feeling, but I have not read any study that it damages salivary glands.

Alcohol is not what makes Listerine work. Alcohol burns your mouth not because its working, but rather that it is irritating the tissue.

Some people say we tell our patients not to drink alcohol because of the increase in risk of oral cancer and feel an alcohol containing mouthwash has a similar risk, therefore do not want the risk of a future lawsuit and do not Rx it.

So what do I do? I once recommend to my patients to use Crest Pro Health (alcohol free). The perio results were very good, but it stains the teeth like crazy! So now I tell my patients to use reduced alcohol Listerine. Biotene products are also alcohol free
 
Members don't see this ad :)
Alcohol can cause the mouth to become exceptionally dry. I'm not sure if it would cause permanent damage to the salivary glands, but it will cause the tissues to become dry and irritated. It also can cause hyperkeratosis of oral mucosa.

I usually recommend an alcohol-free mouth rinse to my patients who don't currently use a mouth rinse. Personally, I've started using ACT. But if I have a patient who likes Listerine and uses it, I tell them to continue but recommend rinsing with half Listerine and half water if they ever develop any burning sensations.
 
If you stop to think about it for a moment, the notion that Listerine somehow damages salivary glands is conceptually ridiculous. Is your boss suggesting that it somehow flows retrograde through the entire course of the parotid and submandibular ducts back into the glands? Sorry, I don't buy it.
 
Perhaps he thinks it damages the salivary gland ducts somehow, anyways, I am skeptical.

However, what I do wonder is why they add the alcohol to listerine if it doesn't do anything?
 
Maybe he means the minor salivary glands. But even then, I am skeptical any major damage could result. I thought the alcohol did have some minor antimicrobial effect. Obviously that effect is on 20-30 seconds long since as soon as you finish rinsing, the alcohol content drops and salivation washes away the residual pretty fast.
 
Perhaps he thinks it damages the salivary gland ducts somehow, anyways, I am skeptical.

However, what I do wonder is why they add the alcohol to listerine if it doesn't do anything?

I looked up information about Listerine. The active ingredients are thymol, menthol, methyl salicylate, and eucalyptol. Old Listerine (yellow one) has 26% alcohol and the new ones have about 21%. The alcohol (ethanol) serves to dissolve the active ingredients.

And yeah I don't buy it either. That's why I'm on here trying to get the facts straight.
 
I don't know about Listerine damaging salivary glands, but I would be more concerned about the potential for development of oral cancer with its high alcohol content.

Some have sought to discredit this, but the theory, and evidence exists to substantiate it, is that alcohol increases the permeability of the mucosa to known carcinogens (such as from smoking), having a synergistic effect with other known risk factors, as well as being an independent risk factor in itself. Now, it may turn out that this is only partially correct, or incorrect, but I would question whether any benefit of using an alcohol containing mouthwash would outweigh the potential risks?
 
Kerr AR, Katz RW, Ship JA.A comparison of the effects of 2 commercially available nonprescription mouthrinses on salivary flow rates and xerostomia. Quintessence Int. 2007 Sep;38(8):e440-7.

OBJECTIVE: To determine if 2 commercial mouthrinses, 1 alcohol-based and 1 nonalcohol-based, affect salivary flow and symptoms of dry mouth in nonxerostomic adults. RESULTS: There were no significant differences between groups at baseline. After 1 week of mouthrinse use, ANOVA and ANCOVA of combined data (before and after crossover) revealed no significant differences in either flow rates or VAS scores between groups (P >.05).
 
Kerr AR, Katz RW, Ship JA.A comparison of the effects of 2 commercially available nonprescription mouthrinses on salivary flow rates and xerostomia. Quintessence Int. 2007 Sep;38(8):e440-7.

OBJECTIVE: To determine if 2 commercial mouthrinses, 1 alcohol-based and 1 nonalcohol-based, affect salivary flow and symptoms of dry mouth in nonxerostomic adults. RESULTS: There were no significant differences between groups at baseline. After 1 week of mouthrinse use, ANOVA and ANCOVA of combined data (before and after crossover) revealed no significant differences in either flow rates or VAS scores between groups (P >.05).

Saw that one too, but I didn't post it because it's not an assessment of long-term effects.
 
Alcohol can cause the mouth to become exceptionally dry. I'm not sure if it would cause permanent damage to the salivary glands, but it will cause the tissues to become dry and irritated. It also can cause hyperkeratosis of oral mucosa.

I usually recommend an alcohol-free mouth rinse to my patients who don't currently use a mouth rinse. Personally, I've started using ACT. But if I have a patient who likes Listerine and uses it, I tell them to continue but recommend rinsing with half Listerine and half water if they ever develop any burning sensations.

It really depends on what type of issues the patient has. ACT is a Fluoride containing rinse. If my patient has perio issues, but is caries free, i'm NOT going to recommend ACT. Instead I would recommend Listerine as long as the pt isn't xerostomic or has a past hx of EtOH abuse.

I've never heard or read anything in the literature about Listerine causing damage to salivary glands. That claim is ridiculous and any dentist preaching it is not practicing EBD. Personally, I see no problem with listerine.
 
Last edited:
So what do I do? I once recommend to my patients to use Crest Pro Health (alcohol free).

Regarding Crest Pro Health TOOTHPASTE, I noticed that stannous flouride is used. Whatever "whitening" agent they've added in the toothpaste serves only to counteract the stannous fluoride (I would imagine). I have a feeling the mouthrinse does the same.

If a patient asked for a nonalcohol rinse, I'd recommend ACT Rinse, though it probably won't kill germs as much as ACT Restoring, which has 11% alcohol, but still less than Listerine.
 
Not a dentist, but I came across this thread when I was researching Listerine for another reason.

From what I know ethanol breaks down cell walls of bacteria. Whether it does that or not at the level present in Listerine, I don't know.

Ethanol is also a penetration enhancer. I would guess it serves some purpose in delivering the essential oils through the biofilm matrix.

What is somewhat interesting is that only the versions of Listerine with ethanol are ADA approved for treating gingivitis and reducing plaque. Does this mean the company that makes Listerine hasn't done the studies on their other products or that they have and they didn't pass? I don't know. But it's interesting.

I only use original Listerine to clean my toothbrush (pour Listerine on it, then rinse it with water before using), and in my mouth if I have any bleeding after flossing. But if I do use it in my mouth (for 1 minute) I rinse well with water afterward. It's a disinfectant. I don't see much point in leaving it lingering in the mouth. I then use use a higher ph xlitol/fluoride mouthrinse (CariFree) which I spit out but don't rinse. Listerine has a fairly low ph which I don't think is a great idea to leave on the teeth overnight, let alone its effect on mucosa.
 
Something that I want someone to help me out with. I've been working with a dentist for 6 months now and he doesn't like recommending Listerine to patients because he believes the alcohol in Listerine will dry out the mouth, but with long term use of Listerine he believes will cause permanent damage to salivary glands.

Now I've worked as a dental hygienist for 6 years now and I've always recommended Listerine for my perio and gingivitis patients because 1) get pretty decent results with it 2) A LOT cheaper than having patient spend $12-20 on Peridex or Perioguard (not to mention those two stain teeth after long-term use).

If someone has heard anything regarding this if it's true or not, please let me know. At least to "cure" my curiousity. Tried looking stuff up but haven't found anything and even asked a Listerine rep if they've heard anything about that, but nothing so far. Thanks a lot

Your dentist is shooting from the hip - ask him/her if he has any evidence to back this claim up (I would bet he/she has NONE whatsoever), because that would be a huge scandal considering the enormous numbers of people that use this product. Always ask for well supported, (i.e. randomized, controlled, preferably double blinded, preferably human) published scientific studies!!

Also, don't make assumptions without proof: "I think A does this, therefore B is also possible"
 
Last edited:
the alcohol does not do direct damage. its used to dissolve the active ingredients in listerine (all those oils ... which DO work btw).

does alcohol effect mucosa and cause damage .. yes. will a 30+ sec swish of the stuff give you cancer?? I'm stacking my chips on the NO. the folks claiming Etoh will give your pt's cancer are the once observing their alcoholics pounding a case a night.

if you're that concerned .. rx the listerine that is etoh free, or use another mouth wash that does not contain etoh. there are plenty of them!

edit.. no, mouth wash does not effect salivary gland function. its a topical agent at best.
 
the alcohol does not do direct damage. its used to dissolve the active ingredients in listerine (all those oils ... which DO work btw).

does alcohol effect mucosa and cause damage .. yes. will a 30+ sec swish of the stuff give you cancer?? I'm stacking my chips on the NO. the folks claiming Etoh will give your pt's cancer are the once observing their alcoholics pounding a case a night.

if you're that concerned .. rx the listerine that is etoh free, or use another mouth wash that does not contain etoh. there are plenty of them!

edit.. no, mouth wash does not effect salivary gland function. its a topical agent at best.

Also, wasn't the connection between oral cancer and EtOH found in those patients that smoked as well? Tobacco + EtOH = deadly combination
 
Top