Is Chlorine Dioxide Safe in Mouthwash?


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Chlorine dioxide (ClO2) has been used in various industries due to its exceptional disinfecting and oxidizing characteristics. One of its applications that has been a subject of discussion is its use in dental health products, more specifically in mouthwash. This article will delve into the safety and efficacy of chlorine dioxide in mouthwash, drawing on scientific research, dental statistics, and expert opinions.

What is Chlorine Dioxide?

Chlorine dioxide is a chemical compound that has been utilized for its disinfecting properties in numerous sectors such as water treatment, food processing, and medical sanitation. As an oxidizing agent, it has the ability to kill microbes, control odors, and break down volatile sulfur compounds (VSCs), which are often the cause of bad breath.Chlorine Dioxide raw materials

In the realm of oral health, chlorine dioxide has been incorporated into mouthwashes due to its aforementioned properties. It is believed to combat oral bacteria, neutralize bad breath, and contribute to overall oral hygiene. However, its safety and effectiveness have been questioned and scrutinized over the years.

Chlorhexidine vs. Chlorine Dioxide

Chlorhexidine (CHX) mouthwashes, often recommended by dentists to decrease bacteria in the mouth, also have their share of disadvantages. Long-term use can lead to significant teeth staining and increased tartar levels. Conversely, mouthwashes with chlorine dioxide present a safer and more beneficial alternative.

Chlorine dioxide is an oxidizing gas that dissolves in water, reacting with bacteria and fungi, rendering them inactive. This makes it an effective purifier in public drinking water and an excellent ingredient for mouthwash. Mouthwash with chlorine dioxide eliminates harmful bacteria that cause plaque and bad breath, keeping our smiles healthy and our breath fresh.

Here are some more benefits of using mouthwash with chlorine dioxide:

  1. Same disinfecting power as chlorhexidine: Chlorine dioxide reduces the bacteria that cause plaque and bad breath without the unpleasant side effects of CHX, such as teeth staining and bitterness. More dentists are now using chlorine dioxide for pre-procedural rinses because patients prefer it, and it’s just as effective at reducing bioaerosols.
  2. Works better than alcohol: Unlike alcohol, which dries out the mouth and worsens breath, mouthwash with chlorine dioxide oxidizes sulfur compounds, providing long-lasting freshness without dryness.
  3. Safe for long-term use: Chlorine dioxide mouthwash is non-toxic and can be used long-term without unwanted side effects like tissue sloughing, teeth staining, or tartar buildup.

Benefits of Chlorine Dioxide in Mouthwash

Antimicrobial Action

Chlorine dioxide is a potent antimicrobial agent, capable of eliminating a wide array of microorganisms, including bacteria, viruses, and fungi. Dental plaque, a biofilm that accumulates on the teeth, is primarily composed of bacteria. The antimicrobial action of chlorine dioxide can effectively control and reduce the microbial population in the oral cavity, thereby helping in the prevention of dental caries and periodontal diseases.purple Chlorine Dioxide mouthwash

Neutralization of Bad Breath

Bad breath, or halitosis, is often caused by volatile sulfur compounds (VSCs), which are produced by bacteria in the mouth. Chlorine dioxide has been shown to oxidize these VSCs, neutralizing bad breath effectively. A study conducted in 2010 found that mouthwashes containing chlorine dioxide significantly reduced VSC concentrations, resulting in improved breath quality.

Safety Concerns and Controversies Surrounding Chlorine Dioxide

Despite the potential benefits, the usage of chlorine dioxide in mouthwashes has been controversial due to safety concerns. Some of these concerns have arisen from its industrial uses, where it is handled as a hazardous material due to its strong oxidizing properties.

Oral Tissue Irritation

The potential for chlorine dioxide to cause oral tissue irritation is a significant safety concern. While low concentrations of chlorine dioxide have been deemed safe for use in mouthwashes, higher concentrations could potentially irritate the oral mucosa, leading to discomfort or even oral health complications. It is therefore crucial that commercial dental products containing chlorine dioxide adhere to recommended concentration levels.

Tooth Enamel Erosion

Another concern related to chlorine dioxide’s oxidizing properties is its potential to erode tooth enamel. Enamel erosion can lead to tooth sensitivity, discoloration, and increased susceptibility to decay. Some studies have suggested that prolonged exposure to chlorine dioxide can lead to enamel erosion, but further research is needed to fully understand the implications of its long-term use.

Regulatory Stance and Recommendations

To date, regulatory bodies such as the U.S. Food and Drug Administration (FDA) and the American Dental Association (ADA) have not issued a definitive stance on the use of chlorine dioxide in mouthwashes. The ADA, however, has a Seal of Acceptance program that endorses dental products proven to be safe and effective. As of 2021, there were no mouthwashes containing chlorine dioxide that had received this seal.

While the absence of a seal does not automatically disqualify a product’s safety or efficacy, it suggests that further research and clinical trials are needed to conclusively determine the safety profile of chlorine dioxide in mouthwashes.

Wrap Up

In conclusion, chlorine dioxide offers potential benefits as an active ingredient in mouthwash, thanks to its antimicrobial properties and its ability to neutralize volatile sulfur compounds. However, concerns about its safety, particularly about oral tissue irritation and tooth enamel erosion, warrant caution. Consumers are urged to consult with dental professionals before using products with chlorine dioxide. More research and regulation will be pivotal in assessing the long-term safety and effectiveness of chlorine dioxide in oral care products.


Chlorine dioxide oxidation of Escherichia coli in water – A study of the disinfection kinetics and mechanism. By Isaac Ofori, Suresh Maddila, Johnson Lin, Sreekantha B Jonnalagadda

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