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Updated: May 28, 2025

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Does Mouthwash Use Affect Oral Cancer Risk? A Comprehensive Systematic Review and Meta-Analysis.

Ashwini M Madawana1, Mohamad Arif Awang Nawi1, Liszen Tang1

  • 1School of Dental Sciences, Hospital Pakar Universiti Sains Malaysia, Kota Bharu, MYS.

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|February 10, 2025
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Long-term, frequent mouthwash use may be linked to increased oral cancer risk. More research is needed on mouthwash ingredients and usage patterns to confirm this association.

Keywords:
meta-analysismouthwashoral cancerprismarisk-factorssystematic review

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Area of Science:

  • Oncology
  • Public Health
  • Epidemiology

Background:

  • Alcohol and tobacco use are established oral cancer risk factors.
  • The association between mouthwash use and oral cancer (OC) remains debated.
  • Understanding potential OC risks from mouthwash is crucial for public health guidance.

Purpose of the Study:

  • To investigate the relationship between mouthwash usage and the risk of developing oral cancer.
  • To synthesize existing evidence on mouthwash use and oral cancer incidence.

Main Methods:

  • Systematic review and meta-analysis following PRISMA guidelines.
  • Searched PubMed/MEDLINE, Scopus, and Web of Science for observational studies.
  • Included 15 case-control studies (6,515 cases, 17,037 controls) using Newcastle-Ottawa Scale for quality assessment.

Main Results:

  • No significant increase in oral cancer risk was found for mouthwash use of three or more times daily (OR=1.00).
  • A potential increased risk was observed for users with over 40 years of mouthwash use (OR=1.30), though based on limited studies.
  • Limited data exists on the impact of mouthwash frequency, duration, and specific ingredients.

Conclusions:

  • Current evidence does not strongly link frequent mouthwash use to oral cancer.
  • Prolonged mouthwash use (over 40 years) warrants further investigation due to a possible association.
  • Future research should focus on dose-response effects, including frequency, duration, and specific mouthwash formulations.