Can Mouthwash Affect Your Nitric Oxide Levels?

Roma Kunde
Roma Kunde
June 9, 2025
5
min read
Medically reviewed by:
DeAnna McGarity
Can Mouthwash Affect Your Nitric Oxide Levels?
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Nitric oxide (NO) plays a role in many critical functions in the human body. Inadequate levels have been associated with cardiovascular disease, vision problems, depression, memory loss, and more [1]. Fortunately, you can monitor your body's nitric oxide levels using simple, at-home saliva test strips. However, antiseptic mouthwashes, poor oral hygiene, and a low-nitrate diet can lead to low available nitric oxide in the body and inaccurate NO test results. Learn about the important role oral bacteria play in maintaining optimal nitric oxide levels, what you can do to maintain healthy nitric oxide levels in your body, and how to easily test your NO levels at home.

The Nitrate-Nitrite-Nitric Oxide Pathway

Nitrates are chemical compounds that are found naturally in soil and water and in high concentrations in some foods, like beets and leafy green vegetables [1]. When you eat nitrate-rich foods, the nitrate circulates through your bloodstream. About a quarter of the nitrate concentration in your blood is excreted into your saliva through the salivary glands [2]. Hundreds of different types of bacteria live in your mouth, including one that converts nitrate in saliva into nitrite, a substance that can be detected using saliva test strips [2, 3]. The body further reduces nitrite into nitric oxide, which your body uses to maintain healthy systems [4].

How Mouthwash Affects Nitric Oxide Levels

Because nitrate-reducing bacteria on your tongue play an essential role in turning the nitrate found in food into nitrite, oral hygiene can impact both the amount of bioavailable nitric oxide in your body and the accuracy of saliva-based NO tests. Antiseptic mouthwashes, though sometimes recommended to support oral health, indiscriminately wipe out bacteria that live in the mouth and on the tongue. In addition to killing bacteria that can lead to cavities and bad breath, these mouthwashes kill health-promoting bacteria, including nitrate-reducing strains [5].

The use of antiseptic mouthwash has been shown to almost completely suppress the nitrate-nitrite pathway, and some studies have shown serious health implications following the regular use of mouthwash. For example, consuming nitrate-rich foods and supplements can improve blood pressure regulation. However, short-term studies have shown that regular use of antiseptic mouthwashes can eliminate the blood pressure-regulating effect of nitrate supplementation [6].

Other studies have shown that the regular use of these mouthwashes can increase the risk of pre-diabetes and diabetes, and researchers have speculated that this could be due to the interruption in the nitrate-nitrite pathway that normally occurs in the mouth [7].

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Maintaining Healthy Nitric Oxide Levels

There are many things you can do to support healthy nitric oxide levels in your body. These include exercising, eating a nitrate-rich diet, supplementing, practicing good oral hygiene, and avoiding antiseptic mouthwash. Here's a quick look at how you can leverage each of these factors to improve the amount of nitric oxide in your body.

Exercise

Aerobic exercise increases nitric oxide production by encouraging the release of nitric oxide from the cells that line your blood and lymphatic vessels.  So, whether you prefer to take a bike ride, walk your dog, or hit the gym, staying active can lead to higher NO levels in your body [8].

When you do aerobic exercise, your body releases more nitric oxide from the cells lining your blood and lymph vessels.

Diet and Supplements

Beets and beet juice have long been known to contain high levels of nitrates, but if you don't like the taste of beets, you're not entirely out of luck. There are plenty of other nitrate-rich foods you can consume, including leafy greens, garlic, cauliflower, broccoli, nuts and seeds, and citrus fruits [1]. And if your diet is lacking, there are lots of supplements available that can help fill in the gaps [9].

Don’t like beets? No problem—leafy greens, garlic, broccoli, citrus, and even supplements can also boost your nitrate intake.

Oral Hygiene

No matter how high your diet is in nitrate-rich foods, if you don't have the necessary nitrate-reducing bacteria residing on your tongue, your body won't be able to use the nitrates to maintain your health. Therefore, proper oral hygiene is critical to ensuring a healthy balance of oral bacteria so that the nitrates you consume can be made into bioavailable nitric oxide in your body. Avoiding antiseptic mouthwash is one of the most important things you can do. Additionally, brushing your tongue has been shown to help healthy bacterial colonies recover more quickly. Routine tongue cleaning may also increase the metabolism of nitrate-reducing bacteria, encouraging a higher rate of nitrate-to-nitrite conversion [10].

Even with a nitrate-rich diet, your body can’t make nitric oxide without the right bacteria on your tongue—so skip antiseptic mouthwash and keep your tongue clean to support those helpful microbes.

Nitric Oxide Testing at Home

Nitric oxide testing provides insights into whether your body is producing adequate amounts of NO to support your overall health. It also allows you to monitor how certain lifestyle factors, like exercising, practicing good oral hygiene, and consuming nitrate-rich foods and supplements, impact your nitric oxide levels. Diagnox's Nitric Oxide test strips let you keep tabs on your nitric oxide levels affordably and from the comfort of your own home. The non-invasive test strips provide accurate results in one minute, allowing you to take control of your body's nitric oxide levels and your full-body health.

References

[1] University Hospitals, “How Nitric Oxide Fuels Your Health,” July 16, 2024. [Online]. [Accessed May 22, 2024].

[2] A. Modi, E. Morou-Bermudez, J, Vergara, R. Patel, A. Nichols, K. Joshipura, “Validation of two point-of-care tests against standard lab measures of NO in saliva and in serum,” Nitric Oxide, vol. 64, pp. 16-21, 2017.

[3] National Institutes of Health, “Technique reveals organization of tongue bacteria,” March 31, 2020. [Online]. [Accessed May 23, 2024].

[4] S. Shiva, “Nitrite: A physiological store of nitric oxide and modulator of mitochondrial function,” Redox Biology, vol. 1, no. 1, 2013.

[5] S. Blot, “Antiseptic mouthwash, the nitrate–nitrite–nitric oxide pathway, and hospital mortality: a hypothesis generating review,” Intensive Care Med, vol. 47, no. 1, pp. 28-38, 2020.

[6] A. Babteen, O. Shannon, J. Mathers, M. Siervo, “Validity and reliability of test strips for the measurement of salivary nitrite concentration with and without the use of mouthwash in healthy adults,” Nitric Oxide, vol. 91, no. 1, pp. 15-22, 2019.

[7] K. Joshipura, F. Munoz-Torres, E. Morou-Bermudez, R. Patel, “Over-the-counter mouthwash use and risk of pre-diabetes/diabetes,” Nitric Oxide, vol. 71, no. 1, pp. 14-20, 2017.

[8] Y. Tsukiyama, T. Ito, K. Nagaoka, E. Eguchi, K. Ogino, “Effects of exercise training on nitric oxide, blood pressure and antioxidant enzymes,” Journal of Clinical Biochemistry and Nutrition, vol. 60, no. 3, 2017.

[9] A. Gonzalez, J. Townsend, A. Pinzone, J. Hoffman, “Supplementation with Nitric Oxide Precursors for Strength Performance: A Review of the Current Literature,” Nutrients, vol. 15, no. 3, p. 660, 2023.

[10] P. Pignatelli, G. Fabietti, A. Ricci, A. Piattelli, M. C. Curia, “How Periodontal Disease and Presence of Nitric Oxide Reducing Oral Bacteria Can Affect Blood Pressure,” International Journal of Molecular Sciences, vol. 21, no. 20, pg. 7538, 2020.

About the Author
Roma Kunde

Roma Kunde is a freelance content writer with a biotechnology and medical background. She has completed her B. Tech in Biotechnology and has a certificate in Clinical Research. She has 6 years of writing and editing experience in fields such as biomedical research, food/lifestyle, website content, marketing, and NGO services. She has written blog articles for websites related to construction chemicals, current affairs, marketing, medicine, and cosmetics.

About the Reviewer
This blog was
Medically reviewed by:
DeAnna McGarity
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