Alcohol free mouthwash is better for some things and not others. It is usually gentler, the NHS recommends it if you have a dry mouth, and most people prefer the taste. On the other hand, one recent review found that alcohol free essential oil mouthwashes removed slightly less plaque than versions with alcohol. Here is what the evidence says on each point.
Comfort
Comfort is the main reason people switch. A paper in the British Dental Journal, reported in 2010, listed a burning sensation, a dry feeling in the mouth and mouth pain among the problems some people have with alcohol based rinses. If a mouthwash makes you want to spit it out early, you are less likely to use it for as long as the label says, or at all.
Dry mouth
The NHS advice for people with a dry mouth is to brush twice a day and use an alcohol free mouthwash, because a dry mouth makes tooth decay more likely. NHS hospital leaflets on dry mouth go further and tell patients to avoid alcohol, including alcohol based mouthwashes. If you have a dry mouth, for example as a side effect of medication, alcohol free is the clear choice.
Plaque and gums
This is where alcohol has a small edge. A 2024 systematic review in the International Journal of Dental Hygiene compared essential oil mouthwashes with and without alcohol. The versions with alcohol reduced plaque slightly more, while the results for gum bleeding and gingivitis were similar. The studies were mostly small. The authors still saw alcohol free rinses as a reasonable recommendation, because people preferred their taste and so may be more likely to keep using them.
Does alcohol in mouthwash cause cancer?
You may have read that it does, so it is worth being accurate. Some researchers have raised concerns, and one large pooled analysis of studies found a small association between mouthwash use and cancer of the throat area, without separating mouthwashes with and without alcohol. Systematic reviews have not established that mouthwash is an independent cause of cancer, and Cancer Research UK has said there is no credible evidence of a link. Where a possible association has been seen, it has mostly been in people who also smoke or drink. Choosing alcohol free is a sensible preference, but it is not a way to avoid a proven risk.
Alcohol and alcohol free mouthwash compared
| Alcohol free | With alcohol | |
|---|---|---|
| Comfort | Usually gentler, with no sting | Some people find it burns or dries the mouth |
| Dry mouth | Recommended by the NHS | NHS leaflets advise avoiding it |
| Plaque | Slightly less reduction in one 2024 review of essential oil rinses | Slightly more reduction in the same review |
| Gums | Similar results for bleeding and gingivitis | Similar results for bleeding and gingivitis |
| Taste | Preferred by most people in the studies reviewed | Stronger taste |
| Cancer | No proven link either way | No proven independent link |
Which should you choose?
If you have a dry mouth, find alcohol based rinses unpleasant, or simply prefer a milder taste, alcohol free is the better choice for you. If you are mainly after the biggest possible reduction in plaque and you are comfortable with alcohol based rinses, the evidence suggests a small advantage for them, although good brushing and cleaning between your teeth matter far more than either.
If you want a mouthwash that is free from both alcohol and fluoride, that is exactly what No Fluo is. It is made with peppermint, tea tree, spearmint and lemon oils, and it is designed to freshen your mouth and leave it feeling clean.
Safety: do not swallow. No Fluo contains tea tree oil, which is harmful if swallowed. Rinse and spit it out, and keep the bottle out of reach of children.
Frequently asked questions
Does alcohol free mouthwash work?
Yes, for what most people use mouthwash for, such as freshening the mouth. A 2024 review found alcohol free essential oil rinses gave similar results to versions with alcohol for gum bleeding, although slightly less plaque reduction.
Why is alcohol free mouthwash recommended for a dry mouth?
A dry mouth makes tooth decay more likely, and the NHS recommends an alcohol free mouthwash as part of looking after your teeth if you have one. NHS hospital leaflets also advise avoiding alcohol, including alcohol based mouthwash.
Is mouthwash with alcohol bad for you?
It is not proven to be harmful for most people. Some people find it stings or dries the mouth. Reviews have not shown it to be an independent cause of cancer, and Cancer Research UK has said there is no credible evidence of a link.
Is alcohol free mouthwash safe for children?
Check the label for the minimum age, supervise children and make sure they spit it out. Some mouthwashes, including those with tea tree oil, are harmful if swallowed.
Related guides
- Best alcohol free mouthwash in the UK
- Alcohol free mouthwash: No Fluo
- How to use mouthwash correctly
- All guides
Sources for this page
- NHS: Dry mouth
- Royal Berkshire NHS Foundation Trust: Dry mouth leaflet, 2024
- Dentistry.co.uk, 2010, reporting a British Dental Journal paper on alcohol free rinses
- van Swaaij and others, International Journal of Dental Hygiene, 2024, summarised by DrBicuspid
- Wilson and Conway, summary review of the INHANCE pooled analysis, Evidence-Based Dentistry, 2016
- Ustrell-Borràs and others, systematic review of alcohol based mouthwash and oral cancer, 2020
- Cancer Research UK: Does mouthwash cause cancer? (reviewed 2020)