Recent research indicates that the use of antiseptic mouthwash may increase blood pressure by disrupting the oral bacteria responsible for converting dietary nitrates into nitric oxide. According to a 2024 meta-analysis, individuals who use these products two or more times daily may see an average increase of 2 millimeters of mercury (mmHg) in their blood pressure readings.
The human body relies on oral bacteria, particularly those found on the tongue, to convert nitrates from vegetables like spinach, lettuce, and cabbage into nitrites, which the body then processes into blood-pressure-lowering nitric oxide.
How mouthwash affects blood pressure
Antiseptic mouthwashes function by killing oral bacteria, which inadvertently halts the transformation of dietary nitrates into nitrites. Bob T. Rosier, a scientist at the Spanish research organization Fundación Fisabio, explains that this process is essential for cardiovascular health. Once nitrites enter the digestive system and bloodstream, they are converted into nitric oxide, a compound that acts as a vasodilator to expand blood vessels and lower systemic blood pressure.
What the data shows
Scientific investigations have established a link between oral hygiene products and systemic health markers over several years. A 2024 meta-analysis published in the Journal of King Saud University identified a significant association between the habitual use of antiseptic mouthwash and an elevated risk of hypertension. This finding stands in contrast to a 2018 review in the journal Cell Metabolism, which highlighted the positive cardiovascular and metabolic benefits of dietary nitrates, including improved endothelial function and antidiabetic effects. Additionally, a 2017 study published in the journal Nitric Oxide: Biology and Chemistry reported an association between regular mouthwash use and a higher risk of developing prediabetes and diabetes.
While the 2 mmHg increase cited in recent studies is statistically significant, the broader clinical context suggests that lifestyle factors—such as physical activity and diet—likely play a more substantial role in blood pressure regulation than oral hygiene choices alone. Consumers should prioritize maintaining oral health while being mindful that not all mouthwash formulas act identically on the oral microbiome.
Is mouthwash still recommended?
Experts suggest that individuals do not need to abandon oral hygiene, but rather shift their approach. Bob T. Rosier advises against the excessive use of antibacterial mouthwashes. Chilean dental surgeon Alexis Araya notes that many patients prioritize mouthwash over fundamental habits like consistent physical exercise and healthy nutrition. Furthermore, Araya points out that mouthwash is often ineffective for those with periodontitis, as the liquid cannot penetrate the periodontal pockets where harmful bacteria reside.
What may happen next
Researchers involved in the 2024 meta-analysis have stated that further studies are required to confirm the depth of the relationship between mouthwash and hypertension. In the interim, consumers may see a shift in product labeling as manufacturers offer more options that avoid alcohol or target specific bacteria without disrupting the beneficial oral microbiome. It is likely that clinical guidance will continue to emphasize mechanical cleaning—such as brushing twice daily and flossing—as the primary method for maintaining dental health without impacting systemic blood pressure.
Frequently Asked Questions
Does brushing my teeth cause high blood pressure?
No. According to Bob T. Rosier, brushing teeth does not increase blood pressure and remains a recommended practice to perform twice daily.
Can I still use mouthwash?
Yes, but experts advise against the excessive use of antibacterial versions. Consumers can choose products that do not contain alcohol or that are formulated to avoid disrupting the oral microbiome.
Is mouthwash effective for treating gum disease?
According to Alexis Araya, mouthwash is not effective for treating periodontitis because it cannot reach the deep periodontal pockets where the bacteria causing inflammation and bone resorption are located.
Do you plan to check the ingredients of your oral care products to see if they contain antibacterial agents?
