Location
Suwanee, GA
Start Date
6-5-2025 1:00 PM
End Date
6-5-2025 4:00 PM
Description
Introduction
The human microbiota, including bacteria, fungi, archaea, and viruses, is a diverse and dynamic community of microorganisms that maintains both systemic and oral health. This population regulates immune response, prevents pathogen colonization, and facilitates metabolic processes such as nitrate reduction. Oral microbiota are distinct from gut microbiota but are interconnected through microbial translocation and inflammatory signaling, disruption of this balance is linked to various diseases, including cardiovascular conditions. Emerging evidence suggests that antibacterial mouthwash use may reduce nitrate-reducing bacteria, impairing nitric oxide (NO) production, a key molecule in vasodilation and blood pressure regulation. Understanding this relationship is crucial in assessing the long-term cardiovascular impact of antibacterial-based mouthwashes.
Methods
A literature review was conducted using PubMed, with keywords such as “Oral Microbiota and Antibacterial Mouthwash.” Studies ranged from 2014 to 2025. Inclusion criteria focused on studies evaluating antibacterial-based mouthwash effects on oral microbiota and excluded studies involving non-antibacterial mouthwashes, non-English publications, participants under 18 years of age, and studies with confounding medical conditions affecting normal flora were excluded. Variables such as mouthwash frequency, population, and blood pressure changes were used. Initially, 39 studies were identified; 34 were excluded based on criteria, resulting in five relevant articles. The Downs and Black risk of bias assessment tool was applied to evaluate study quality.
Results
Of the five included studies, multiple findings indicated a potential link between antibacterial mouthwash use and elevated blood pressure. Bondonno et al. (2014) reported an increase in systolic blood pressure after three days of antibacterial mouthwash use. Joshipura et al. (2019) identified a higher risk of hypertension in participants using mouthwash twice or more daily. Conversely, Babbateen et al. (2019) found no significant blood pressure change following single-use mouthwash exposure, suggesting sustained use may be required to observe notable effects. These studies collectively highlight that frequency and duration of antibacterial mouthwash exposure may influence blood pressure outcomes, likely by altering NO bioavailability through nitrate-reducing bacteria depletion.
Discussion
The reviewed studies indicate that frequent antibacterial mouthwash use may increase blood pressure due to reduced NO production. Joshipura et al. (2019) demonstrated a strong association between routine mouthwash use and higher hypertension risk, while Bondonno et al. (2014) showed acute systolic pressure increases with short-term use. These findings align with the understanding that NO plays a critical role in vascular relaxation. While Babbateen et al. (2019) found no immediate changes with single-use exposure, this suggests that cardiovascular effects may be cumulative with continued use. These findings emphasize the importance of balancing bacterial reduction with preserving beneficial nitrate-reducing species.
Conclusion
The findings support that regular antibacterial mouthwash use may contribute to increased blood pressure by reducing nitrate-reducing bacteria and limiting NO production. Frequent exposure should be approached with caution, especially in individuals at risk for hypertension. These findings highlight the need for increased awareness of the systemic effects of antibacterial mouthwash and underscore the importance of further research to fully understand its cardiovascular impact.
Embargo Period
5-28-2025
Included in
Health complications of antibacterial-based mouthwash on oral microbiota: literature review
Suwanee, GA
Introduction
The human microbiota, including bacteria, fungi, archaea, and viruses, is a diverse and dynamic community of microorganisms that maintains both systemic and oral health. This population regulates immune response, prevents pathogen colonization, and facilitates metabolic processes such as nitrate reduction. Oral microbiota are distinct from gut microbiota but are interconnected through microbial translocation and inflammatory signaling, disruption of this balance is linked to various diseases, including cardiovascular conditions. Emerging evidence suggests that antibacterial mouthwash use may reduce nitrate-reducing bacteria, impairing nitric oxide (NO) production, a key molecule in vasodilation and blood pressure regulation. Understanding this relationship is crucial in assessing the long-term cardiovascular impact of antibacterial-based mouthwashes.
Methods
A literature review was conducted using PubMed, with keywords such as “Oral Microbiota and Antibacterial Mouthwash.” Studies ranged from 2014 to 2025. Inclusion criteria focused on studies evaluating antibacterial-based mouthwash effects on oral microbiota and excluded studies involving non-antibacterial mouthwashes, non-English publications, participants under 18 years of age, and studies with confounding medical conditions affecting normal flora were excluded. Variables such as mouthwash frequency, population, and blood pressure changes were used. Initially, 39 studies were identified; 34 were excluded based on criteria, resulting in five relevant articles. The Downs and Black risk of bias assessment tool was applied to evaluate study quality.
Results
Of the five included studies, multiple findings indicated a potential link between antibacterial mouthwash use and elevated blood pressure. Bondonno et al. (2014) reported an increase in systolic blood pressure after three days of antibacterial mouthwash use. Joshipura et al. (2019) identified a higher risk of hypertension in participants using mouthwash twice or more daily. Conversely, Babbateen et al. (2019) found no significant blood pressure change following single-use mouthwash exposure, suggesting sustained use may be required to observe notable effects. These studies collectively highlight that frequency and duration of antibacterial mouthwash exposure may influence blood pressure outcomes, likely by altering NO bioavailability through nitrate-reducing bacteria depletion.
Discussion
The reviewed studies indicate that frequent antibacterial mouthwash use may increase blood pressure due to reduced NO production. Joshipura et al. (2019) demonstrated a strong association between routine mouthwash use and higher hypertension risk, while Bondonno et al. (2014) showed acute systolic pressure increases with short-term use. These findings align with the understanding that NO plays a critical role in vascular relaxation. While Babbateen et al. (2019) found no immediate changes with single-use exposure, this suggests that cardiovascular effects may be cumulative with continued use. These findings emphasize the importance of balancing bacterial reduction with preserving beneficial nitrate-reducing species.
Conclusion
The findings support that regular antibacterial mouthwash use may contribute to increased blood pressure by reducing nitrate-reducing bacteria and limiting NO production. Frequent exposure should be approached with caution, especially in individuals at risk for hypertension. These findings highlight the need for increased awareness of the systemic effects of antibacterial mouthwash and underscore the importance of further research to fully understand its cardiovascular impact.