Backed by Research
How Oral Care Choices Affect Nitric Oxide
By AdhereAdent™ — Advanced Dental Innovations LLC · Updated June 2026
For general educational and informational purposes only. This article summarizes published research and is not medical advice or a substitute for consultation with a licensed healthcare or dental professional. Cited studies are the work of their respective authors; summaries and commentary are by Advanced Dental Innovations LLC.
The short answer
About half the body’s nitric oxide supply depends on nitrate-reducing bacteria living in the
mouth. Research shows antiseptic mouthwash can sharply reduce these bacteria and lower
nitric oxide, while antibacterial toothpaste does not appear to affect nitrate reduction — an
important distinction for anyone rethinking their oral-care routine.
Nitric oxide supports cardiovascular and broader health, and a large share of the
body’s supply is produced with the help of bacteria in the mouth. The reputable evidence shows
this pathway is disrupted chiefly by antiseptic mouthwash — not by toothpaste.
The Nitric-Oxide Connection
The nitrate–nitrite–nitric-oxide pathway
Nitric oxide is produced both by enzymes and by an alternative route in which dietary nitrate is
reduced to nitrite and then nitric oxide. Active uptake of nitrate by the salivary glands, its
excretion in saliva, and its reduction by oral commensal bacteria are all necessary steps. Multiple
studies show the biological effects of dietary nitrate are abolished when an oral antibacterial
mouthwash disrupts those bacteria. Notably, the same review reports that antibacterial triclosan
toothpaste does not appear to affect nitrate reduction.1
“An anti-bacterial triclosan-containing toothpaste does not seem to affect nitrate reduction.”
Hezel & Lundberg — Oral Diseases (Wiley)
Why the right oral bacteria matter
Up to a quarter of dietary nitrate is taken up by the salivary glands and concentrated many times
over in saliva. Salivary nitrate is then reduced to nitrite by oral commensal bacteria — a
reaction human cells cannot perform — creating an important reservoir for nitric oxide.
Several cardiovascular benefits of dietary nitrate are reduced or prevented when an antiseptic
mouthwash abolishes those bacteria. A seven-day course of antiseptic mouthwash lowered both oral and
plasma nitrite and was associated with a sustained rise in blood
pressure.2
“An important storage pool for NO in blood and tissues.”
NIH / NCBI PMC — Metagenomic Analysis
A dental-hygiene perspective
This practitioner overview explains why disrupting the oral microbiome carries real consequences.
Nitrate-reducing bacteria living in the crypts of the tongue convert dietary nitrate into nitrite,
which becomes nitric oxide. Research cited shows that seven days of antibacterial mouthwash reduced
oral nitrite production by roughly 90% and plasma nitrite by about 25%, with measurable effects on
blood pressure. The takeaway for everyday care is to protect — not indiscriminately eliminate
— the helpful bacteria in the mouth.3
“Fifty percent of our daily NO production is from our diet and oral bacteria.”
RDH Magazine — Anne O. Rice, RDH
Where AdhereAdent™ Fits
AdhereAdent™ is a fluoride-free, 100% organic overnight balm — a gentle approach to
overnight care that doesn’t rely on antiseptic rinses. Its patent-pending adherent technology
keeps organic botanicals in contact with your gumline through the night.
See how AdhereAdent’s overnight adhesion supports this →