Mouthwash linked to cancer

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If you are using Listerine or other mouthwashes, read your labels. Do they have alcohol?http://www.news.com.au/dailytelegraph/story/0,22049,24896583-5001021,00.htmlMouthwash linked to cancer

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By Clair Weaver

January 11, 2009 12:00am

AUSTRALIA'S top-selling mouthwashes can cause oral cancer and should be pulled from supermarket shelves immediately.

Leading

independent experts have issued this strong warning after investigating

latest scientific evidence linking alcohol-containing mouthwashes to

the deadly disease.

Their review, published in the Dental Journal of Australia,

concludes there is now ``sufficient evidence'' that "alcohol-containing

mouthwashes contribute to the increased risk of development of oral

cancer''.

The ethanol in mouthwash is thought to allow cancer-causing

substances to permeate the lining of the mouth more easily and cause

harm.

Acetaldehyde, a toxic by-product of alcohol that may accumulate in

the oral cavity when swished around the mouth, is also believed to be

carcinogenic.

Listerine, the nation's biggest-selling mouthwash and a brand

endorsed by the Australian Dental Association (ADA), contains as much

as 26 per cent alcohol.

Mouthwash is one of the fastest-growing grocery products in

Australia, with the category now worth more than $75 million, according

to latest Nielsen market research.

Lead review author Professor McCullough has told The Sunday Telegraph alcohol-containing mouthwash should be reclassified as prescription-only and carry written health warnings.

Prof McCullough, chair of the ADA's therapeutics committee and

associate professor of oral medicine at the University of Melbourne, is

calling on the ADA to urgently re-assess its seal of approval on

mouthwashes containing alcohol.

"We see people with oral cancer who have no other risk factors than

the use of alcohol-containing mouthwash, so what we've done in this

study is review all the evidence that's out there,'' he said.

"Since this article came out, further evidence has come out too. We believe there should be warnings.

"If it was a facial cream that had the effect of reducing acne but

had a four- to five-fold increased risk of skin cancer, no one would be

recommending it.''

Oral cancer is a gruelling and mutilating disease that afflicts more

than 800 Australians each year and kills half of them within five years

of being diagnosed.

Smoking and alcohol consumption are well-established risk factors, but alcohol-containing mouthwash use is more controversial.

Prof McCullough and co-author Dr Camile Farah, director of research

at the University of Queensland's School of Dentistry, recommended

mouthwash be restricted to ``short-term'' medical use or replaced by

alcohol-free versions.

"(We) further feel it is inadvisable for oral health-care

professionals to recommend the long-term use of alcohol-containing

mouthwashes,'' they concluded.

The review reported evidence from an international study of 3210

people which found daily mouthwash use was a "significant risk factor''

for head and neck cancer, irrespective of whether users also drank

alcohol or smoked.

But the effects of mouthwash were worst in smokers, who had a

nine-fold increased risk of cancers of the oral cavity, pharynx and

larynx.

Those who also drank alcohol had more than five times the risk - and

even those who neither drank nor smoked still ran a four- to five-fold

risk of contracting cancer.

A Brazilian study has also found regular mouthwash use is associated

with oral cancer regardless of alcohol or tobacco consumption.

"Mouthwash products are in contact with the oral mucosa as much as

alcoholic beverages, and may cause chemical aggression of the cells,''

researchers from the University of Sao o said.

They said the role of ethanol in causing DNA damage needed to be explored further.

A review in the Journal of Occupational Medicine and Toxicology last

year said it would be "prudent, precautionary public-health policy to

generally refrain from using ethanol in (mouthwash) products'' because

of "doubts about the safety of alcohol-containing oral products''.

Prof McCullough said the most popular mouthwashes contained higher concentrations of alcohol than drinks such as wine or beer.

"If you have a glass of wine, you tend to swallow it,'' he said.

"With mouthwash, you have a higher level of alcohol and spend longer swishing it around your mouth.

"The alcohol that is present in your mouth is turned into acetaldehyde.''

Regular alcohol consumption was a cancer risk, Prof McCullough said, but usually did not involve swishing it around the mouth.

Eating while drinking increased salivation, which lowered the risks, he said.

"The most significant difference (between alcohol and

alcohol-containing mouthwash) is that one is for pleasure and the other

is being recommended as a health product.''

Cancer Council NSW chief executive Penman said the review was "interesting'', but called for further research.

"I think it's quite a well-thought-out proposition, but it does warrant further investigation,'' he said.