Wait, can mouthwash cause high blood pressure?

Before you freak out and throw the bottle under the sink, let’s take a look at what the science actually says about this surprising discovery. Are certain people at higher risk of developing high blood pressure from mouthwash, and are the refreshing benefits of certain types of mints safer?

What does current research show?

Several studies have reported an association between mouthwash and high blood pressure. A new observational study published in Blood Pressure in 2020 found that people who used mouthwash 2 or more times a day1 had a higher risk of high blood pressure even when other risk factors (such as being overweight or heart problems) were taken into account.

Another small study in 2015 found that using an antibacterial mouthwash for just three days raised the top numberHypertensive patients around the age of 65 had a blood pressure (systolic blood pressure) of 2, but the lower number (diastolic blood pressure) was not affected.

So what’s the deal? “Healthy oral microbiome3 is associated with a healthy cardiovascular system,” Dr. John Higgins, a sports cardiologist at UTHealth Houston, told Well+Good. However, she added, mouthwashes can disrupt the balance of bacteria in the mouth and lead to complications such as high blood pressure.

Dr. Higgins says mouthwashes can kill not only bad bacteria, but also certain good bacteria that produce a natural chemical called nitric oxide. This chemical acts as a vasodilator. That is, it widens blood vessels (so more blood can flow), thereby lowering blood pressure. However, using mouthwash can theoretically wipe out good bacteria and disrupt this nitric oxide production pathway. As a result, blood pressure may be affected.

On the other hand, some studies have found no relationship at all. A 2019 study published in the journal Free Radical Biology and Medicine reported on the use of antibacterial mouthwashes. Blood pressure did not spike4 for vegetarians or omnivores (i.e. people who eat meat and plants). Another 2016 study found similar results: Rinse with antiseptic mouthwash three times a day for three days. did not affect blood pressure5 for young, healthy women.

The bottom line? Researchers have developed theories about why mouthwash use increases blood pressure, and some studies support these theories, but more research is needed to confirm the results. It is necessary.

Are certain people more at risk?

Dr. Higgins says certain people are at higher risk of developing high blood pressure from using mouthwash. This includes people who have a family history of heart disease or who currently have high blood pressure or diabetes. Age is another risk factor, Dr. Higgins noted, and most of the studies that found a link between blood pressure and mouthwashes were in older people.

Besides family history, pre-existing diabetes, and age, other risk factors for high blood pressure include:

your gender (assigned at birth) (men are more likely to have high blood pressure until age 64; women are more likely to have high blood pressure after age 65); your race (black, Hispanic, black, etc.); (racial and ethnic groups) Asian adults have higher rates of high blood pressure) Chronic kidney disease Lack of physical activity Unhealthy diet, especially one high in sodium Overweight or obesity Drinking too much alcohol Sleep apnea High cholesterol Smoking and smoking stress

Does this mean I should stop using mouthwash?

No, you don’t need to flush mouthwash down the drain just yet, says Dr. Higgins. Further research is needed to confirm whether there is a real relationship between mouthwash and high blood pressure, he added.

In the meantime, if you have pre-existing blood pressure problems (or risk factors for developing high blood pressure), you may want to play it safe. “For now, limit your use of antiseptic mouthwashes,” Dr. Higgins says. Specifically, it recommends avoiding antiseptic mouthwashes (those that kill bacteria) that contain active ingredients such as:

Will my blood pressure return to normal if I stop using mouthwash?

If your blood pressure is elevated because of mouthwash use, your blood pressure may return to a normal range when you stop using the mouthwash. The increase in blood pressure appears to be fairly short-lived, lasting only a few days to a week after exposure, Dr. Higgins said.

Keep in mind that there are several other possible reasons why your blood pressure readings may be high. To fully determine the root cause, it’s best to visit your health care provider to take your vitals and run some tests.

That said, if you’re considering ditching mouthwash and want to protect the delicate balance of your oral microbiome, Dr. Higgins recommends adding probiotics “by taking an oral probiotic supplement.” We suggest reintroducing the bacteria. Always consult your health care provider before trying any new vitamins or supplements.

Are certain types of mouthwash safer?

A clean mouth isn’t just about having fresh, minty breath. Good oral hygiene is also important for heart health. So if mouthwash is part of your daily routine, you don’t have to skip rinsing your mouth completely. “Try a natural, non-bacterial mouthwash instead,” says Dr. Higgins. Unlike antiseptic mouthwashes, natural rinses do not eradicate oral flora or interfere with nitric oxide production. In other words, they should not affect blood pressure.

So, what kind of material should I look for? Higgins says mouthwashes containing coconut oil, fluoride, salt and lemon peel oil appear to be safe. If you’re still not sure which mouthwash is right for you, talk to your health care provider or dentist. They can guide you in the right direction.