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Oral Cancer

No credible link exists between alcohol-containing mouth rinses and oral cancer

Key reviews examining the potential links between alcohol-containing mouth rinses and oral cancer have reported no association.1–7

Citation

Study type

Findings

Gandini et al. 20121

Quantitative analysis of 18 published epidemiological studies of mouth rinse use and oral malignancy
  • No statistically significant association between mouth rinse use and risk of oral cancer, including no significant trend in risk with increasing daily use
  • No association between use of mouth rinses containing alcohol and oral cancer risk

La Vecchia et al. 20092

Critical review of published data
  • Link between use of alcohol-containing mouth rinse andoral cancers not supported by epidemiological evidence

Coleet et al. 20033

Critical review of published data
  • The weight of the evidence strongly suggests that the use of alcohol-containing mouth rinse does not increase the risk of oropharyngeal cancer

Warnakulasuriya. 20094

Review article
  • No excess risk for oral cancer from alcoholic mouth rinse use

Lemos-Junior. 20085

Review article
  • Correlation is weak, inconsistent and contradictory

Lewis & Murray. 20066

Review article
  • Alcohol in mouth rinses is not associated with oral cancer or an adverse effect on oral mucosa

US FDA. 20037

Review
  • Available data do not support a relationship between use of alcohol-containing mouth rinses and oral cancer

Additionally, the German Federal Institute of Risk Assessment concluded: ...no carcinogenic or pre-neoplastic effect by mouth rinses should be expected at intended use resulting from short contact of ethanol to the mucosa.8

Risk factors

The risk factors for oral cancers are presented below, with the level of evidence that supports them. As can be seen, alcohol in mouth rinses is rated as having inconsistent evidence as a risk factor in oral cancer.1

Exploring with ethanol

When the body is exposed to ethanol it is metabolised, and the compound acetaldehyde is produced.1 Acetaldehyde has been identified as a carcinogen, and occurs naturally in many foods.2

Acetaldehyde exposure

The length of time of exposure to acetaldehyde is far less with mouth rinse than with alcoholic beverages.1–3 A mouth rinse is used for a short period before being spat out, for instance for 30 seconds twice daily in the case of LISTERINE®.

Evaluation

References

  1. Gandini S et al. Mouthwash and oral cancer risk – quantitative meta-analysis of epidemiologic studies. Ann Agric Environ Med 2012; 19(2): 173–180.
  2. La Vecchia C et al. Mouthwash and oral cancer risk: an update. Oral Oncol 2009; 45: 198–200.
  3. Cole P et al. Alcohol-containing mouthwash and oropharyngeal cancer: a review of the epidemiology. JADA 2003; 134(8): 1079–1087.
  4. Warnakulasuriya S. Causes of oral cancer - an appraisal of controversies. Br Dent J 2009; 207: 471–475.
  5. Lemos-Junior CA, Villoria GEM. Reviewed evidence about the safety of the daily use of alcohol-based mouth rinses. Braz Oral Res 2008; 22(S1): 24–31.
  6. Lewis MAO, Murray S. Safety of alcohol-containing mouthwashes. Dental Health 2006; 45: 5–8.
  7. The Department of Health and Human Services, Food and Drug Administration 2003.
  8. BfR Committee for Cosmetics: Protocol Meeting 5th May 2009 (BfR-Kommission für kosmetische Mittel Protokoll des BfR vom 5. Mai 2009).