When it comes to safety, there are important differences between alcoholic beverages and alcohol-containing mouthrinses.
THE SAFETY OF ALCOHOL-CONTAINING MOUTHRINSES HAS BEEN DEMONSTRATED IN CLINICAL STUDIES FOR DECADES
LISTERINE is the most extensively tested mouthrinse in the world, with more than 30 clinical trials examining its safety and efficacy.1-10
Clinical studies, meta-analyses, quantitative analyses, and systematic reviews of data have demonstrated that there is no causal link between the use of LISTERINE® mouthrinse and oral cancer or xerostomia.2-10
LISTERINE® Does not promote oral dryness
Clinical study findings
- Favorable tolerability and no increase in dryness of oral tissue in patients with xerostomia (Fischman SL et al. Am J Dent)2
- No significant differences in salivary flow rates or patient-reported sensations of dry mouth between alcohol- and nonalcohol-containing mouthrinse groups (2-week randomized, crossover pilot studying the use of alcohol- and nonalcohol–containing mouthrinses in healthy adults; Kerr AR, et al. Quintessence Int)3
- Alcohol-based essential oil mouthrinse is no more likely to cause a reduction in salivary flow or perceived dryness than a nonalcohol-based cetylpyridinium chloride (CPC) mouthrinse (Kerr AR, et al. Oral Surg Oral Med Oral Pathol Oral Radiol Endod)4
LISTERINE®: No credible link to oral cancer
Clinical study findings
- “There is no sufficient evidence to accept the proposition that the use of mouthwashes containing alcohol can influence the development of oral cancer.” (Systematic review of 14 articles—11 case-control studies and 3 clinical trials—on mouthwash use and risk of oral cancer; Aceves Argemí R et al. J Evid Based Dent Pract)5
- No significant association between mouthwash and risk of oral cancer (Meta-analysis of 12 epidemiologic studies on mouthwash and risk of oral cancer; International Agency for Research on Cancer [IARC])6
- “Data do not support a causal relationship between alcohol-containing mouthrinses and oropharyngeal cancer.” (FDA subcommittee reviewed 7 case-control studies; US Food and Drug Administration)7
- Alcohol-containing mouthwash does not increase risk of oropharyngeal cancer (Review of 9 case-control studies; Cole P et al. J Am Dent Assoc)8
- A link between mouthwash use and oral cancers is not supported by epidemiological evidence (Critical review of published data; La Vecchia et al. Oral Oncology)9
- There is no association between mouthwash use and oral cancer (Quantitative analysis of all published epidemiological studies of mouthwash use and oral malignancy; Boyle, et al. Oral Surg, Oral Med, Oral Pathol, Oral Radiol Endod)10
- Acetaldehyde is a naturally occurring substance. It is found in the human body as well as in fruits and vegetables, and is a metabolite produced when ethanol is ingested10
- Acetaldehyde associated with consumption of alcoholic beverages can be carcinogenic6
- The peak acetaldehyde level found for LISTERINE® is 44.3 μmol at 30s, a concentration approximately 1000 times lower than the levels required to damage DNA in cultured buccal epithelial cells11
References: 1. Data on file, Johnson & Johnson Consumer Inc. 2. Fischman SL, Aguirre A, Charles CH. Use of essential oil—containing mouthrinses by xerostomic individuals: determination of potential for oral mucosal irritation. Am J Dent. 2004;17(1):23-26. 3. Kerr AR, Katz RW, Ship JA. A comparison of the effects of 2 commercially available nonprescription mouthrinses on salivary flow rates and xerostomia. Quintessence Int. 2007;38(8):e440-e447. 4. Kerr AR, Corby PM, Kalliontzi K, McGuire JA, Charles CA. Comparison of two mouthrinses in relation to salivary flow and perceived dryness. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119(1):59-64. 5. Aceves Argemí R, González Navarro B, Ochoa García-Seisdedos P, Estrugo Devesa A, López-López J. Mouthwash with alcohol and oral carcinogenesis: systematic review and meta-analysis. J Evid Based Dent Pract. 2020;20(2):101407. 6. International Agency for Research on Cancer (IARC). World Health Organization. IARC monographs on the evaluation of carcinogenic risks to humans: Report of the advisory group to recommend priorities for IARC Monographs during 2015-2019. https://monographs.iarc.fr/wp-content/uploads/2018/ 08/14-002.pdf. Accessed November 1, 2021. 7. Food and Drug Administration. Oral health care drug products for over-the-counter human use; antigingivitis/antiplaque drug products; establishment of a monograph; proposed rules. Part Ill. Fed Regist. 2003;68(103):32232-32287. 8. Cole P, Rodu B, Mathisen A. Alcohol-containing mouthwash and oropharyngeal cancer: a review of the epidemiology. J Am Dent Assoc. 2003;134(8):1079-1087. 9. La Vecchia C. Mouthwash and oral cancer risk: an update. Oral Oncol. 2009;45(3):198-200. 10. Boyle P, Gandini S, Boffetta P, Negri E, La Vecchia C. Mouthwash use and oral cancer risk: quantitative meta-analysis of epidemiologic studies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(6):e130. 11. Boyle P, Koechlin A, Autier P. Mouthwash use and the prevention of plaque, gingivitis and caries. Oral Dis. 2014;20(suppl 1):1-68.