Does Mouthwash Raise Blood Pressure? | Delmarva Dental Services

Does Mouthwash Raise Blood Pressure?

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In early 2014 the press raised the question; Do Mouthwashes Raise Blood Pressure.  They quoted a 2012 European study in the Journal of “Free Radical Biology and Medicine, http://dx.doi.org/10.1016/j.freeradbiomed.2012.11.013” which found that twice daily use of a mouthwash with a particular ingredient did indeed raise blood pressure by 2 to 3.5 mm of Hg.  This minor elevation may not seem like much but a 2 mm increase in blood pressure increases the risk of death when a heart attack or stroke occurs by 7 to 10%.   

The subjects in the study rinsed with a mouthwash containing chlorohexidine.  This is an antimicrobial mouthwash that is only available by prescription in the U.S.; but can be bought over the counter in Europe.  Chlorohexidine is an antimicrobial which means it kills bacteria.  The difference between this mouthwash and most others is a unique ability to coat teeth, gums, cheeks and tongue lasting as much as 12 hours.  This is called substantivity.  Most over the counter mouthwashes do not last more than 30 minutes.  In this study chlorohexidine was used twice a day so it killed bacteria for 24 hours.  So you might think, well that’s great.  However, it kills helpful bacteria in the mouth as well as bad.  Just like when you take an antibiotic and it kills the helpful bacteria in your intestines leading to diarrhea.   In the case of blood pressure, these good oral bacteria help break down a nitrogen product that relaxes our blood vessels and lowers our blood pressure.  So, no nitrogen reducing bacteria, no relaxed blood vessels, and increased blood pressure.  Most dentists only prescribe a chlorohexidine mouthwash for brief periods of time during healing from a dental surgery or a dental infection.

In summary more studies need to be done in this area.   Before taking any prescription including a prescription mouthwash inform you’re the dentist or physician of your other medications and health issues.