Mouthwash and the links with oral cancer

This is becoming a hot topic in dentistry as we continue to see patients without typical risk factors ( smoking and drinking lots of alcohol) developing oral cancer. The search is on to identify what is really behind the rise in oral cancer rates and mouthwash containing alcohol is coming in for some close scrutiny.

As yet no one has proven beyond all reasonable doubt a significant  link between the use of alcohol containing mouthwash and an increased risk of oral cancer unless you are rinsing 3 or more times per day, which lest be honest  is an awful lot.

What we do know though is that alcohol increases the ability of other toxins to penetrate through the surface of the mouth and throat lining. So it does lead me to wonder if  rinsing your mouth with it every day is a great plan.  We also know that any remnants of alcohol in the mouth can break down into acetaldehyde which its self is though to be a carcinogen. So where does that leave us in terms of practical dental advice?

Here are my views…

1. shot term use ( less than 2 weeks)  of  chlorhexidine and alcohol  containing mouthwash to control plaque after an extraction or when the gums are inflamed for some other reason is fine. Even though it can be bought over the counter it is best used only on the specific advice of a dentist, doctor or pharmacist.

2. if you take medications that cause a dry mouth or have a dry mouth for any other reason  you are more at risk of tooth decay. A fluoride mouthwash is a helpful part of a prevention strategy. As the alcohol free versions are just as effective why not choose one of those? or consider asking your dentist or doctor about prescription strength Fluoride toothpaste.

3.if you have a high rate of decay for some other reason a fluoride mouthwash may be a valuable addition to your home care routine  BUT only after  you have brushed and flossed

4. mouthwash does not an alternative to  tooth brushing, despite the graphics in the adverts unless you mechanically clean the teeth first the mouthwash can’t do its job.