From Volume 43, Issue 8, October 2016 | Pages 728-733
There have been numerous reports in the scientific literature investigating the possible association between alcohol-containing mouthwashes and oral cancer but relatively few epidemiological surveys have taken place and the findings have been equivocal. This article will address the controversial issue of the safety of mouthwashes and provide an objective assessment of the latest scientific evidence.
Although mouthwashes are marketed to benefit the oral health of patients, there is the potential for harmful side-effects as a result of using these products. In the first article in this series the local unwanted side-effects from active ingredients in mouthwashes have been discussed, including staining of the teeth and oral soft tissues, taste disturbance, increased calculus formation, and mucosal erosion. The rare reports of parotid enlargement and anaphylactic response to the use of chlorhexidine-containing mouthwashes were also raised. In the past 20 years, there has been a marked increase in the availability and use of ‘over the counter’ low alcohol and alcohol-free mouthwashes. However, a number of mouthwashes containing higher concentrations of alcohol are marketed as anti-plaque products. The concentration of alcohol varies from around 5% to 27%. Alcohol is added to mouthwashes to act as a solvent for other constituents and for taste purposes. Above concentrations of 10–12%, it also acts as a preservative, antiseptic and as an anti-plaque agent enhancer.1 Ethanol at high concentration (18–27%) enhances the effect of essential oils.2
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