- High strength garlic mouthwash performed as well as chlorhexidine in small clinical trials
- Some studies suggest garlic rinses keep antibacterial effects going for longer than standard products
- Side effects include burning and strong smell, which may put some people off
Garlic extract is emerging as an unlikely challenger to chlorhexidine, the antiseptic mouthwash that dentists have relied on for decades.
A new systematic review from the University of Sharjah suggests that concentrated garlic mouthwash can match, and in some cases beat, chlorhexidine when it comes to killing oral bacteria.
For people looking for a more natural approach to oral care, the findings sound appealing. However, the evidence base is still small and the researchers are clear that chlorhexidine remains the gold standard mouthwash for now.
Chlorhexidine is widely used to control plaque, gum disease and mouth infections, yet it is far from perfect.
It can stain teeth, alter taste and contribute to antimicrobial resistance. That has prompted interest in plant based agents that might offer similar benefits with fewer long term risks.
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Garlic has a long history as a natural antimicrobial. Laboratory studies show that compounds in garlic, including allicin, can damage bacteria, fungi and some viruses. The question is whether these laboratory effects translate into meaningful benefit in the real world when people swill garlic extract around their mouth.
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The team followed strict international guidelines for systematic reviews, screening hundreds of papers to find robust clinical studies.
Out of more than 400 records identified, only five met the inclusion criteria.
These were small clinical trials and randomised studies that compared garlic extract mouthwash directly with chlorhexidine.
Concentrations of garlic extract and treatment durations varied between studies, which makes it harder to combine the results into a single clear answer.
Overall, higher concentration garlic mouthwashes performed surprisingly well. In several trials, bacterial counts in saliva or plaque fell by a similar amount in both the garlic and chlorhexidine groups. Some results even tilted in favour of garlic at specific concentrations.
The review notes that effectiveness depended on how strong the mouthwash was and how long people used it. In some experiments, chlorhexidine was better at maintaining a higher salivary pH, which is considered protective for teeth. In others, garlic rinses produced stronger antibacterial effects.
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One important observation was that garlic mouthwash appeared to have a longer residual action in the mouth. In theory that might mean more sustained protection between rinses, although this remains to be confirmed in larger and longer studies.
Garlic extract is not free of side effects. People using garlic mouthwash reported burning or tingling, along with an obvious strong odour.
These effects could limit real world use, regardless of how well the product works in laboratory measurements.
That said, the side effects were different from those associated with chlorhexidine and may be milder for some users.
As a result, garlic rinses might suit people who cannot tolerate chlorhexidine or who prefer plant based products, provided their dentist agrees.
