Written by Dr. Reza Khazaie
Does Mouthwash Cause Oral Cancer?
What’s the evidence against mouthwash?
Many mainstream types of mouthwash contain a significant amount of ethanol and other alcohol agents. The original Listerine formula, for example, is over 50 proof and calls for nearly 27% alcohol. The high alcohol content is what gives conventional mouthwashes their bacteria-killing properties.
Alcohol is also known as a powerful antiseptic. Regular use of alcohol and its exposure to oral tissues is believed by many medical professionals to raise a person’s risk of developing oral cancer. The consumption of alcohol has known carcinogenic effects, which will also increase your risk of developing oral or other forms of cancer.
Frequent Use of Mouthwash and Cancer: Is There A Link?
Can swishing with alcohol-based mouthwash do the same?
According to a recent study, excessive use of mouthwash containing ethanol alcohol, along with poor oral hygiene in general, may be linked to a higher incidence of oral cancers.
It is important to note, however, that the amount of mouthwash the study defines as “excessive” is far above what the average person would typically use. In the study, subjects with poor oral health rinsed with mouthwash three times per day. The average user rinses no more than once or twice per day.
Furthermore, correlation does not indicate causation. Based on the parameters of the study, it is impossible to determine whether oral cancer is the result of excessive mouthwash use, or if it is the result of poor oral health.
Nonetheless, alcohol in mouthwash has other known potential adverse effects on your oral health, including:
It should be noted that alcohol is irritating to the soft tissues of your mouth, including your gums and the inner lining of your cheeks. Unsurprisingly, chronic irritation resulting from recurrent exposure to alcohol could very well lead to chronic inflammation. Chronic inflammation has been linked to heart disease, diabetes, and, yes, even oral cancer.
Furthermore, the dental and oral health industry has been shifting its stance on bacteria in recent decades. In the past, all bacteria were viewed as evil pests that needed to be eliminated at all costs. Alcohol-based mouthwash provided an easy, consumer-friendly way to do just that. However, modern science and professional wisdom have taken a softer approach towards the microbes in our mouths.
Scientists have discovered that not all bacteria are harmful. Bacteria responsible for oral diseases are a tiny percentage of the total bacteria that make our mouths their homes. By indiscriminately attacking all bacteria at once, with regular mouthwash, for example, we are just giving dangerous bacteria more room to grow and flourish.
Recent wisdom is pushing oral health professionals to take a more balanced approach that promotes a healthy and diverse oral ecology while attempting to manage the relatively small number of bacterial species responsible for most oral diseases.
Some even suggest that alcohol-based mouthwash, as a concept, is entirely counterproductive to achieving the aim of better oral and dental health. The argument goes that regular mouthwash reduces the diversity of a person’s oral bacteria leading to overgrowth of one species or another and, as a result, poorer oral health.
Furthermore, alcohol is known to hamper saliva production and dry out the mouth. Saliva washes bacteria off the gums and teeth and plays an essential role in remineralizing teeth. When saliva is lacking, destructive strains of bacteria, particularly those associated with dental caries, can flourish.
Should I Stop Using Mouthwash?
While some studies have suggested a link between excessive mouthwash use, specifically rinsing with mouthwashes that contain alcohol and oral cancer, other studies have demonstrated no statistical correlation.
The disagreement in the scientific literature suggests that there is no clear-cut answer to whether or not mouthwash is dangerous. Furthermore, mouthwash can provide a valuable benefit for promoting oral health and hygiene by eliminating harmful bacteria. Remember, poor oral health is another important factor linked to oral cancer.
When weighing the potential benefits with the potential risks, it would be foolish to recommend that patients stop using mouthwash outright. Instead, we recommend that patients who choose to use mouthwash and other oral rinses containing alcohol limit the number of times they swish with mouthwash to once per day.
Better yet, there are numerous alcohol-free alternatives on the market today that utilize a litany of natural ingredients, such as various essential oils and naturally-derived extracts that can also be effective. Opt for alcohol-free mouthwash instead of regular mouthwash to avoid the problems associated with alcohol exposure altogether.
Where Did The Myth Linking Mouthwash and Cancer Originate?
Like many modern medical myths and conspiracy theories in recent years, the idea that mouthwash use can lead to higher risks of cancer results from poor reporting and misleading headlines rather than solid science.
Examples of shoddy news work include reporting done by the UK’s Daily Mirror, whose headline on the subject stated, “Experts warn using mouthwash more than twice a day can give you cancer.” Any reasonable reader could make the logical leap connecting mouthwash use with cancer based on the headline alone. Unfortunately, this is precisely the opposite of what the original researchers of the study had intended. The authors of the study went out of their way to state that their research does not provide any evidence whatsoever, proving the assertion that mouthwash causes cancer.
The original study itself, which was published in the peer-reviewed Journal of Clinical Oncology, was not designed to seek answers to whether mouthwash causes cancer. Instead, the study aimed to determine whether more extensive oral health and dental care, adjusting for potential confounders such as smoking and alcohol use, is associated with throat and mouth cancers.
The conclusion of the study found that poor oral health and dental hygiene were in of themselves independent factors for oral cancer. In regards to mouthwash use, the researchers go on to state, “Whether mouthwash use may entail some risk through the alcohol content in most formulations on the market remains to be fully clarified.” As you can see, the actual conclusion is a far cry from the sensational headlines found on the web.
Does mouthwash use cause cancer?
The study merely states that more investigations and studies into the subject will be necessary to flush out a more definitive picture.
