I am looking for the best way to deal with my patients and with my community members who always ask me about these issues. Here is some information that I hope will help you and us reach a decision on this issue, with the help of Allah.
1. Mouth wash is not a matter of life and death, so patients can live without it, and it is not a pillar of good oral health, it is an enhancer for gum health and “supposed” to improve the smell of the mouth. Brushing and flossing, in addition to dental visits are enough for good oral health. (Unless we have an immuno-compromised patient, like cancer or AIDS, then it is important to keep the mouth disinfected as much as possible)
2. It is not swallowed, or at least not supposed to.
3. Many kinds and types, variety of alcohol percentages (from 0 to 26%), each manufacturer claim to have the best product and put down other products.
4. Only Mouth washes with Alcohol got the approval seal of ADA, due to the fact that it is more proven to have an antiseptic effect.
5. Alcohol used in mouthwashes in high percentages, 20-26%.
6. Some researchers claim that alcoholic mouthwash causes cancer, but no organization is confirming that yet, as those patients who developed cancer using these mouthwashes, already had many other problems that might caused it, like smoking, gum diseases…etc which were the reasons why they used the mouth wash in the first place.
7. Some researches show that non-alcoholic mouthwashes cause staining and possibly decaying of enamel, something I personally seen and witnessed.
8. Drinking mouthwash has been reported in very few cases to cause intoxication, but in a very poisonous way that ended up the person in a hospital. (For those, it was an expensive drink to get intoxicated with!)
9. Purity of Alcoholic mouth wash was not an issue, as I understood from the presentation.
10. Buying an alcoholic mouthwash wasn’t discussed as we didn’t pass the first discussion, weather it is allowed to be used or not. (Not sure if the rule of the vanilla extract applies here). On the personal level it will follow the ruling of its permissibility or not. But buying it by a Muslim dentist for a dental office use might be another case, especially that most patients are not Muslims and don’t mind using it, actually prefer using it.
11. Rinsing is not swallowing, but closer to swallowing than outside skin. Many regulations are made in the dental field to prevent swallowing some dental materials, but at the same time, these regulations allow us to use these same materials inside the oral cavity. That gives us, dentists, the belief that anything in the oral cavity is not considered inside the body, nor considered swallowed.
I’m hoping that these points will be helpful to reach a decision on the matter.
Dear Dr. …,
I am very glad to see your keenness as a dentist to provide the best care to your patients, while helping them observe their religious commitments.
Based on your detailed explanation, it appears that the use of alcohol-containing mouthwash would be only permissible in those limited cases of necessity if there are no alternatives. Whether one may sell those mouthwashes is an area of suspicion. When possible, the Muslim dentist is advised to avoid it.
The rationale behind this conclusion is as follows:
First, the pertinent reports:
Abu Dawood narrated from Abi al-Darda’ t: The Messenger of Allah r said:
”إِنَّ اللَّهَ أَنْزَلَ الدَّاءَ وَالدَّوَاءَ، وَجَعَلَ لِكُلِّ دَاءٍ دَوَاءً، فَتَدَاوَوْا، وَلا تَدَاوَوْا بِحَرَامٍ“.
“Allah sent down the disease and the cure, and He made a cure for every disease. So seek treatment, but do not use as medicine that which is haram.”
The Prophet r also said:
”كل مسكر خمر، وكل مسكر حرام “ مسلم.
“Every intoxicant is khamr, and every intoxicant is haram.” (M)
Tariq ibn Suwayd al-Ju‘fi t asked the Prophet r about wine and he forbade him or disliked his making it. He said: I only make it as a medicine. He said:
”إِنَّهُ لَيْسَ بِدَوَاءٍ وَلَكِنَّهُ دَاءٌ“.
“It is not a medicine; rather it is a disease.” (M)
I thank you for mentioning the possible link between Alcohol containing mouthwashes and oral cancer. The established link between oral cancer and Alcohol consumption does favor the hypothesis (proven in some studies) that alcohol-containing mouthwashes may be a precursor for oral cancer.
In addition to the above hadeeths, there are the following fiqhi maxims and rulings regarding the issue:
The default concerning treatment is permissibility with anything except what was forbidden by a clear text of revelation.
الأصل في التداوي الحل إلا ما حرمه النص
When a large amount of a substance is intoxicant, it will be haram even in small amounts.
ما أسكر كثيره فالقليل منه حرام.
This means that the rulings of khamr apply to those mouthwashes that could result in intoxication.
That which must be avoided for haram to be avoided is mandatory to avoid.
مالا يتم ترك الحرام إلا به فتركه واجب وفعله محرم.
Although Khamr (intoxicant alcohol) is not physically impure – according to the stronger position and it may be used for external application, rinsing one’s mouth with alcohol may lead to swallowing some, even if that is not prescribed or wanted.
Necessities make the prohibited permissible.
الضرورات تبيح المحظورات
This also applies, according to the stronger position, to the area of medicine.
Whatever was permitted for an excuse, its permission expires upon the end of the excuse.
ما جاز لعذر بطل بزواله.
This means that upon the presence of alternatives, the use of the prohibited substance for a necessity is no more allowed.
When a substance is haram, its sale is haram as well. However, in the case of those mouthwashes, the issue is still controversial, and the toxicity of it is a deterrent against its consumption by most people, and there are those cases where it may be permissible to use for a necessity, which may make its sale permissible, but not without suspicion, which is always recommended to avoid.
Allah knows best.