Are alcohol containing mouthwashes safe?

Alcohol (ethanol) is a constituent of many proprietary mouthwashes. Some studies have shown that regular use of such mouthwashes can increase the risk of developing oral cancer. Recently, the evidence has been reviewed by two separate authors. The conclusions from these reviews are conflicting. In this paper, we reconsider the epidemiological evidence linking alcohol containing mouthwashes with an increased risk of oral cancer. The evidence is considered in term of sample size, strength of association, confounding variables and data collection. In addition, clinical studies comparing alcohol versus non-alcohol mouthwashes are evaluated. The evidence suggests that the alcohol component of mouthwashes affords little additional benefit to the other active ingredients in terms of plaque and gingivitis control. In view of this outcome and the hypothetical risk of oral cancer, it would seem prudent that members of the dental team advise their patients accordingly.