Mouthwash may leave your breath minty fresh, but according to a recent study, frequent use can increase your chances of developing diabetes.

The San Juan Overweight Adults Longitudinal Study (SOALS) surveyed 1,206 non-diabetic overweight individuals, between the ages of 40 to 65. Many participants (43 percent) used mouthwash at least once a day, and 22 percent used mouthwash least twice a day. Factors such as income, education, oral hygiene, oral conditions, sleep breathing disorders, diet, medications, and glucose levels were taken into consideration as well.

The result? Participants who used mouthwash twice or more per day were at-risk for developing pre-diabetes or diabetes over the course of three years.

The body’s need for nitric oxide

SOALS stated that frequent mouthwash users should be cautious of antibacterial ingredients that impair oral bacterial nitrate reduction. “Nitric oxide (NO) plays a role in how insulin functions in your body,” explains Greg Gelfand DDS, a Bayside, New York-based general and cosmetic dentist. “Mouthwash kills bad—and some good—bacteria in the mouth that is needed for nitrate reduction. So, if you use mouthwash, you end up having less NO in your system; thus, you have more inflammation and develop issues with insulin. When insulin is not working properly, you could develop diabetes.” Make sure you don’t fall for these diabetes myths that could also ruin your health.

Consult with your dentist

Before you panic and toss your mouthwash bottle, remember that more research is needed on this topic, as acknowledged by the SOALS. “There are many variables to consider,” says Marie Paulis, RDH, MSDH, director of the dental hygiene program at the University of New Haven in Connecticut. “Mouthwashes vary greatly in their purpose and ingredients and the type of mouthwash used in this study was not specified.” Participants in this study may have used mouthwashes containing 20 percent alcohol, a mouth rinse for dry mouth, or an alcohol-free fluoride rinse, Paulis explains. Ask your dentist which type of mouthwash is best for you.

Keep mouthwash use minimal

According to Dr. Gelfand, healthy gums are important in detering diabetes and myriad other health issues. “However, according to this study, mouthwash should be used judiciously,” he adds. “Brushing and flossing should be your main weapons when it comes to keeping your mouth clean.” He recommends using mouthwash only a couple times per week in the mornings, as well as eating nitrate-rich foods like strawberries, raspberries, spinach, lettuce, and beets.