Public Health

What is the Best Mouthwash for Cavity Prevention?

Blanche Palasi
Blanche Palasi19 May 2023

With many mouthwash options available, choosing the best mouthwash to prevent cavities may be challenging. The best mouthwashes – for example, ACT (fluoride), Crest (CPC), and Biotene (glycerin) Mouthwashes – protect teeth from decay and cavities and often contain vital ingredients to prevent deterioration.

Best Mouthwash Options for Cavity Prevention

When selecting a mouthwash to supplement your oral hygiene routine, look for key ingredients to prioritize teeth enamel and bacteria prevention. These are some of the best anti-cavity mouthwashes according to dentist recommendations and the mouthwashes’ ingredient list. Most come in various flavors, are alcohol-free, and have a high fluoride concentration and other teeth-protecting ingredients.

Active Ingredients in Mouthwashes to Prevent Cavities

The two main types of mouthwashes are cosmetic and therapeutic. Cosmetic mouthwashes are used to freshen breath, while therapeutic mouthwashes contain active ingredients to treat and prevent dental issues. To choose the best mouthwash, check the label to ensure it contains necessary cavity-preventing ingredients.

Pros and Cons of Dental Active Ingredients 

Active IngredientProsCons

Strengthens enamel and protects against tooth decay

Beneficial for those with high risk of cavities

Found in most toothpastes and mouthwashes

Safe and effective for daily use

Toxic if overused

If used in large amounts, can cause teeth staining


Effective antibacterial and anti-inflammatory agent for gum disease

Prevents plaque buildup and gingivitis

Used to prevent bacteria after tooth scaling and root planing procedures

Available by prescription only for gingivitis

May caused decrease taste sensations and burning

Can discolor teeth and mouth

Cetylpyridium Chloride (CPC)

Prevents plaque biofilm accumulation

Reduces risk of virus infections through gums

Mouth irritation

Temporary staining of teeth

May promote tartar formation on teeth


Prevents maturation of gum disease and tooth decay

Helpful for dry mouth and after periodontal treatments 

May be hard to find in mouthwashes



The most essential ingredient to look for in mouthwashes is fluoride. According to the American Dental Association (ADA), fluoride helps promote remineralization in teeth and reduce tooth decay. Fluoride also strengthens enamel after exposure to acidic foods and drinks. This halts the natural accumulation of plaque and loss of minerals on the teeth, which cause cavities. Using a fluoride-containing mouthwash replenishes these lost minerals and overall strengthens the teeth.

Incorporating a fluoride mouthwash into your dental routine can fight cavity-causing bacteria, reducing and slowing the growth of cavities. In addition to these benefits, fluoride also prevents gum disease and gingivitis.


Chlorhexidine is an antiseptic and disinfectant to help the growth of bacteria. Chlorhexidine is used in mouthwashes to prevent plaque accumulation. A research study published by the Journal of Dentistry found that chlorhexidine’s anti-microbial effects are effective against many bacteria, fungi, and viruses that cause many oral diseases. Chlorhexidine mouthwashes are not available over-the-counter and require a prescription from your dentist. 

Cetylpyridium Chloride

Similar to fluoride and chlorhexidine, cetylpyridinium chloride is an anti-microbial ingredient that works against oral bacteria and dental plaque. Cetylpyidinium chloride is known to prevent the maturation of bacteria, stopping bacteria growth that causes cavities. It is also protective against gum disease and bad breath.

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Finally, look for a mouthwash that is designed explicitly for cavity prevention. Xylitol is a plant-based sweetener that prevents tooth decay by creating a neutral pH, inhibiting the growth of bacteria on your teeth. It is also helpful in strengthening weakened enamel and renewing calcium-deficient spots. 


Many mouthwashes contain alcohol to kill bacteria and are often accompanied by a burning sensation. Alcohol-free mouthwashes are recommended because they do not weaken your enamel and are less likely to irritate your gums. Alcohol in mouthwashes can also cause mouth dryness; saliva is essential for clearing bacteria away, and overuse of alcohol-based mouthwashes can lead to increased cavities. 

Best Overall: ACT Anticavity Fluoride Mouthwash

This mouthwash contains 0.05% fluoride to strengthen tooth enamel and prevent cavities. It is alcohol-free and comes in several different flavors, including Arctic Blast, cinnamon, and mint. Children ages six and up can use the Kids' version available in easy-squeeze dosage cups. 

Best for Sensitive Gums: Listerine Total Care Zero Anticavity Mouthwash 

Listerine’s Anticavity mouthwash is also alcohol-free and contains 0.02% fluoride. It also contains essential oils, such as eucalyptol and menthol, to help freshen breath. Although the fluoride concentration isn’t as high compared to other mouthwashes, it has a less intense minty flavor for those with sensitive gums. 

Best for Gingivitis: Crest Pro-Health Advanced Mouthwash

In addition to having 0.02% fluoride, this popular Crest mouthwash also includes cetylpyridinium chloride (CPC), an antiseptic ingredient used to help to kill cavity-causing bacteria and fungi in your mouth. CPC aids in plaque-induced gingival infections and gingival inflammation. In addition to maintaining good oral health and reducing bacteria, recent studies show that CPC can prevent the transmission of viruses in illnesses like herpes simplex virus, hepatitis B, and some coronaviruses. 

Best for Dry Mouth: Biotene Dry Mouth Gentle Oral Rinse

A common complication of dry mouth is cavities, as saliva is necessary to resist acid and tooth decay. Dry mouth, or xerostomia, can also leave you more prone to bad breath, stickiness in your mouth, and changes in your sense of taste. Chronic dry mouth is common, especially in older adults, and can strain oral hygiene. The effects of glycerin in this Biotene mouthwash last for up to four hours after use. Although it does not contain fluoride, this moisturizing oral rinse has CPC and xylitol for more anticavity protection.

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Alcohol-free Mouthwashes

Many mouthwashes contain alcohol to kill bacteria and are often accompanied by a burning sensation. Alcohol-free mouthwashes are recommended because they do not weaken your enamel and are less likely to irritate your gums. Alcohol found in mouthwashes can also cause mouth dryness; saliva is essential for clearing bacteria away, and overuse of alcohol-based mouthwashes can potentially lead to increased cavities.

Frequently Asked Questions about Anticavity Mouthwashes

Navigating which mouthwash to get and finding the right ingredients to prevent cavities may be intimidating. However, here are some frequently asked questions to ensure you get the complete anticavity protection of your mouthwash.

Should I Rinse After Using Fluoride-Containing Mouthwashes?

Contrary to popular belief, it is advised not to rinse your mouth, eat, or drink for 30 minutes after using a fluoride mouthwash. Rinsing with water can prematurely wash away the fluoride. For maximum cavity protection, fluoride should remain in the mouth, allowing time to sit and remineralize the enamel.

In addition, fluoride is a main ingredient in many toothpastes. Rather than using mouthwash immediately after brushing, it is recommended not to rinse your mouth immediately after spitting. If you use a fluoride-containing mouthwash, you can use it at a separate time of brushing.

What Causes Cavities?

According to the Cleveland Clinic, 80% of Americans have at least one cavity before their mid-30s. Your teeth can decay because of various factors and lifestyle habits. Cavities are formed when acids break down your teeth’s enamel and typically worsen when left untreated. You dentist can help you identify cavities during your routine dental exam or teeth cleaning. You are most at risk for developing cavities if you have any of the following:

  • Bacteria in your mouth from eating and drinking excess sugar
  • Dry mouth, sometimes caused by certain conditions or medications
  • Gum disease
  • Family history of tooth decay
  • Poor dental hygiene
  • Teeth grinding

How Often Should I Use Fluoride Mouthwash?

Mouthwashes with fluoride are typically used once or twice a day. They are commonly used at bedtime to allow the fluoride to sit overnight. It is important not to overuse mouthwashes that contain stannous fluoride and CPC as they can cause stains that are difficult to remove. In addition, mouthwash is not recommended for children under six years of age to prevent overuse of fluoride and swallowing the mouthwash.

Blanche Palasi

Blanche Palasi is a 2024 PharmD. Candidate currently attending St. John's University. A Queens native, she is passionate about helping patients identify and navigate social determinants of health.