Mouthwash – and oral cancer?

What are the risk factors for oral cancer? Smoking and excess alcohol consumption.

It’s probably the alcohol consumption risk factor that has led to ongoing speculation about a link between the use of alcohol-containing mouthwash and oral cancer.

There have been numerous studies and several reviews and meta-analyses on this topic. These have yielded mixed results, with some supporting an association and others finding no association. The overall weight of evidence still suggests that there is no increased risk for oral cancer from using alcohol-containing mouthwash. 

Major cancer and health organisations agree that there isn’t enough evidence that alcohol-containing mouthwashes increase the risk of oral cancer.

For example, the Australian Cancer Council¹, Cancer Research UK², the Oral Health Foundation³ and the US Centers for Disease Control & Prevention⁴ list smoking and heavy alcohol consumption as the major risk factors for oral cancer, there is no mention of mouthwash use among the minor risk factors listed by these organisations.

'Around 90% of mouth cancers can be linked to preventable lifestyle factors such as smoking and excessive alcohol consumption.’⁵

Similarly, dental organisations such as the Oral Health Foundation⁵ do not list mouthwash use as a risk factor for development of mouth cancer. 

Australia’s government has rigorous regulatory systems in place to deliver safety to consumers. This includes monitoring new information on the safety of products or their ingredients and taking action, if needed.

In Australia, the way that mouthwashes are regulated depends on the claims that are made about the product.

Mouthwashes that make a therapeutic claim, like ‘fights gingivitis’ or ‘kills germs that cause gum disease’ are regulated by the Therapeutic Goods Administration. Mouthwashes that do not make a therapeutic claim are regulated as cosmetics by the national industrial chemicals regulator AICIS (formerly NICNAS).

NICNAS evaluated ethanol in 2014, concluding that the cancer risks are ‘not considered relevant’ at the low doses used in mouthwashes.⁶