Seeking the Last Word on a Mouthwash

Question: My question is with regard to Listerine’s new commercial wherein they say that using Listerine can help in the reduction of plaque. Is there any way of finding out if this is true?

I and, I believe, a lot of consumers, would be interested in an answer to this question as dentists now say the loss of teeth most often is because of gum disease, which is a direct result of plaque.--G.J.G.

Answer: Our own dentist, at one point in our life, was a bit of a cynic and commented: “A good mouthwash is one that will kill any bacteria that can’t swim.”

The American Dental Assn. (ADA) is kinder than that, however, and Richard Asa, a media spokesman for the Chicago-based organization, concedes that any mouthwash “can clean some loose food particles from the teeth.” So can warm water, he also concedes.

In a country, however, where 50% of the population do not visit a dentist in any given year, where 98%, Asa says, “are afflicted by some form of dental disease and where, at some time in their lives, three out of four people will be afflicted with some form of periodontal disease,” the ADA is loathe to be critical of any product that makes people conscious of oral hygiene--unless it’s downright harmful.

Where the dental association draws the line, however, is in commenting on the cosmetic aspects of any dental product: What is “bright”? What is “whiter than white”? What is “sparkling”? What is “fresh”? And since, in broad terms, the cosmetic appeal is about nine-tenths of the sales pitch for any toothpaste, toothbrush, dental floss or mouthwash, it doesn’t leave a whole lot for the ADA to work with.

Right now, the big catch phrase is anti-plaque , and it has a definite consumer appeal because, sure enough, plaque is a major dental problem.

And what, pray, is plaque? As the ADA’s Asa defines it: “a sticky, colorless film on the teeth composed of bacteria that produces acids that, without proper daily cleaning and with increased acid production, attack the enamel. It feeds on sugars and starches in a wide range of food.”

And so far, the only chemical that seems to be effective against plaque, Asa continues, is fluoride, “which interacts with the tooth enamel and strengthens it against decay. As a matter of fact, there’s some evidence to suggest that fluoride even re-mineralizes teeth that have begun to show evidence of decay.”

So, does this mean that Listerine’s claim for its mouthwash is based on the fact that it contains fluoride?

No, not at all, according to Marshall Molloy, manager of media relations for Morris Plains, N.J-based Warner-Lambert Co., Listerine’s parent company (which--among a variety of other products--also manufactures Rolaids and Bromo-Seltzer).

“Fluoride isn’t an ingredient in Listerine,” Molloy adds, “and our claims, at present, are entirely cosmetic--as opposed to a therapeutic claim. That simply means that, when used in conjunction with a well-established regimen of brushing and flossing, it will remove up to 50% of the plaque. We’ve submitted extensive clinical studies to the Food and Drug Administration.” As far as the ADA is concerned, according to Asa, “they (Listerine) haven’t submitted anything to us yet and, as a matter of fact, we don’t even have our anti-plaque guidelines finalized yet that would allow our Council of Dental Therapeutics to evaluate products making anti-plaque claims, although this is expected in the next few weeks,”

When the ADA’s guidelines are in place, however, Warner-Lambert’s Molloy adds: “We’re one of about half a dozen products already lined up to apply for the seal--based on therapeutic claims as well as the cosmetic claims we’re now making.”

A strictly voluntary move, applying for the Council of Dental Therapeutics’ seal of approval entails submitting detailed clinical studies to the ADA for evaluation. But even if the seal is granted, Asa continues, it simply means that the product is adjudged “safe and effective,” but the it falls far short of endorsement of advertising claims that may be made.

While a number of toothpastes carry the seal, only five over-the-counter mouth rinses--not mouthwashes (a subtle, but important, distinction to the ADA)--carry it: ATC Fluoride Anti-Cavity Dental Rinse, Fluorigard Anti-Cavity Dental Rinse, Kolynos Fluoride Dental Rinse, Listermint With Fluoride Anti-Cavity Dental Rinse and StanCare Anti-Cavity Fluoride Rinse.

And note that none of these mention “anti-plaque” protection. All of them got the seal, Asa adds, simply because each contains no sugars or starches but does contain fluoride.

The validity of advertising claims--at least those that are aired or distributed nationally--falls under the jurisdiction of the Federal Trade Commission. “Whenever we have reason to think that a claim is invalid,” Ann Guler, public information officer of the Los Angeles office of the FTC, says, “we ask the advertiser for substantiation of the claims.

“If the claims don’t seem to hold up,” she continues, “we can, and do, sue them.”

And one of the FTC’s most widely publicized court actions along these lines took place in 1975 when it sued Warner-Lambert on the basis of that company’s claims (since 1921) that its mouthwash killed the germs in the mouth that most often cause colds and sore throats.

The FTC won its case and was upheld on appeal clear up to the U.S. Supreme Court, which, in 1978, refused to hear the case. In so doing, it let stand the novel wording of the FTC’s order demanding that Listerine not only drop the cold-cure claim but also--since it had been pursuing this line of advertising for 54 years--that it devote a specified amount of advertising dollars, Guler said, “to corrective advertising--telling the public that Listerine doesn’t combat the germs that cause colds.”

Whether the FTC is investigating the current Listerine advertising campaign is a question without answer, however.

“I can’t comment on it,” Guler adds. “Our policy is to say nothing about any investigations we may have under way until we have enough to take it public.”

In New York, a spokesman for the National Advertising Division of the Council of Better Business Bureaus, a self-regulatory group that also monitors advertising, weighs claims and periodically publishes its opinions, says his organization “hasn’t been contacted about the claim, but I understand that the FTC is looking into it.”

Warner-Lambert’s Molloy sees no connection between the highly publicized cold-germ case of the ‘70s and Listerine’s current anti-plaque campaign. “This is a definitely proved claim,” he adds. “Our clinical studies establish, clearly, that it does what we say it does.”

As far as the American Dental Assn. is concerned, the ADA’s Asa says, even those toothpastes and mouth rinses that carry the Council of Dental Therapeutics’ seal, don’t make the grade entirely on their fluoride content, but on the fact that they all also emphasize a complete regimen of dental care--of which the toothpaste or rinse, itself, is just a part.

“There’s no substitute for daily brushing and flossing and periodic trips to the dentist,” he continues.

A mouthwash alone? Forget it.

“It may be temporarily helpful in halting bad breath,” Asa adds, “but temporarily only. If bad breath is a continuing thing, it can be a warning of a possible periodontal disease--a serious gum problem--which requires a thorough dental checkup.”

Don G. Campbell cannot answer mail personally but will respond in this column to questions of general interest. Write to Consumer VIEWS, You section, The Times, Times Mirror Square, Los Angeles 90053.