New study flags oral cancer risk from mouthwash: Do we really need it for oral hygiene?

Can the alcohol in mouthwash be harmful?

First, let’s understand how any alcohol can be harmful. The body breaks down alcohol or ethanol in case of mouthwashes and turns it into a compound called acetaldehyde, which is a carcinogen (cancer-causing substance). This damages DNA and stops our cells from repairing the damage, exposing them to the effects of harmful chemicals. It disturbs the oral microbiome, or the community of microbes which maintains our oral health. This can allow cancerous cells to grow.

Prolonged use of alcohol can increase the levels of hormones like oestrogen and insulin, which can encourage cells to divide more often, increasing the chances of cancer. So if you are a smoker, used to drinking and are a frequent mouthwash user, then you are upping your risk of cancer. Remember, studies have not found causation but correlation, which means you have to become careful about how you use mouthwashes.

Overuse of mouthwash should also be avoided because it causes dry mouth, affects production of saliva which washes off harmful bacteria, irritates soft tissues and triggers inflammation in the oral cavity.

What do the study results mean?

This finding confirms a 2009 Australian study that found the alcohol content in mouthwash allows for carcinogens to penetrate into the mouth lining, increasing cancer risk. The researchers have recommended that healthcare professionals not recommend long-term use of alcohol-based mouthwashes. We must also understand that the amount of mouthwash the study defines as “excessive” is far above what the average person would typically use. The study looked at subjects who use mouthwash three times per day. Normally, one should not use it more than twice a week.

Should we stop using mouthwash? Do we really need it?

I would say if you are using a regular mouthwash already, then limit its use to once a week. The safest way to keep your mouth clean is to go for a non-alcohol based mouthwash. It is important to maintain oral hygiene, so frequent swilling and sloshing your mouth with water after meals and beverages and using a good toothpaste should work.

As I say, if you are brushing your teeth at least twice a day, then you do not need to rinse your mouth using mouthwash.

What are other risks for oral cancer and how to prevent the disease?

More than mouthwash, what we should concern ourselves with is chewing tobacco, betel leaf and drinking alcohol. Independently, all have a carcinogenic effect. Together, the risk multiplies. Oral cancer gets complicated if detected in the later stages.