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Title Inconclusive Evidence on Causal Relationship Between Alcohol-Containing Mouthwash and Oropharyngeal Cancer
Clinical Question Does a dental patient who uses alcohol-containing mouthwash have an increased incidence of oropharyngeal cancer than one who uses non-alcohol containing mouthwash?
Clinical Bottom Line Available evidence is inconclusive. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 14990877Carretero Pelaez/ 2004N/ASystematic Review
Key resultsThe available data does not support a causal relationship between the use of alcohol-containing mouthwashes and the development of oral cancer.
Evidence Search Meta-Analysis, Systematic ReviewsSearch "Mouth Neoplasms"[Mesh]Search "Alcohols"[Mesh]Search "Mouthwashes"[Mesh]
Comments on
The Evidence
This is a systematic review of 9 cases and controls, not randomized controlled trials. The article makes no mention as to whether the individual studies were assessed for validity. The article discussed 7 trials with a total of more than 1,897 patients. A meta-analysis could not be performed due to the heterogeneity of the studies.
Applicability A potential patient benefit is peace of mind for patients using alcohol-containing mouthwashes, knowing that a causal relationship has not been established. However, since no randomized controlled clinical trial or longitudinal study have investigated the safety of the long-term use of alcohol-containing mouthwashes, the available results could potentially give a false security in using a product that may one day be shown to increase the risk for oropharyngeal cancer.
Specialty/Discipline (General Dentistry)
Keywords alcohol, ethanol, mouth neoplasms, oral cancer, oropharyngeal cancer, mouthwash, mouthrinse
ID# 548
Date of submission: 03/29/2010spacer
E-mail MorganS4@uthscsa.edu
Author Starr Morgan Mayen
Co-author(s) e-mail
Faculty mentor/Co-author Cristina Villar, DDS
Faculty mentor/Co-author e-mail Villar@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Alexander Padalino (San Antonio, TX) on 09/28/2022
I found an update article on this topic (Argemi et al. 2020, PubMed ID: 32473798). This was a meta-analysis and systematic review of 11 case-control studies and 3 clinical trials. The results agreed with previous reports that there is not sufficient evidence to accept any proposal that alcohol containing mouth rinses increase the risk of oral cancer.
by Amber O’Connor (San Antonio, TX) on 04/16/2012
In a PubMed search done on this topic in April 2012 I found a more recent publication: PubMed: 18952488. A systematic review of 10 case-control studies found the same key results as this CAT and further confirms the evidence that there is not a relationship between alcohol-containing mouthwash and oral cancer.

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