Mouthwash Use and the Risk of Oral, Pharyngeal, and Laryngeal Cancer. A Meta-Analysis

Abstract

Objective: The main aim of this study was to test whether the use of mouthwash is associated with subtypes of squamous cell carcinoma of the head and neck (SCCHN) and to test the potential risk of SCCHN depending on the mouthwash use duration, frequency, or alcoholic content. Materials and methods: We performed a meta-analysis using Web of Science and Scopus databases to detect the risk change associated with mouthwash use depending on the alcohol content, duration and frequency of use, and anatomical location. We used a random-effects model with the Sidik–Jonkman estimator for effect size model measures. Results: We included 17 studies in the meta-analysis containing 17,085 cases and 20,032 controls. The risk difference for SCCHN between mouthwash users and non-users was minimal, with a value of −0.02 [−0.05, 0.01]. Alcoholic mouthwash use was associated with a minimal decrease in risk (of −0.01 [−0.07, 0.05]). Frequent usage of mouthwash was associated with a statistically significant risk increase for SCCHN but the risk increase was marginal (0.04, [0.01, 0.06]). Conclusions: Overall, our study failed to show a statistically significant correlation between mouthwash use and the risk of SCCHN. The only statistically significant correlation that we could identify was between frequent usage and SCCHN, potentially caused by prolonged contact between some constituents of mouthwash (possibly alcohol) and the oral epithelium.

Efficacy of Ceragenins in Controlling the Growth of Oral Microorganisms: Implications for Oral Hygiene Management

“…The development of oral mouthwash products with minimal toxicity is of utmost importance in order to facilitate their effective utilization in clinical settings. To date, some reports suggested the potential harmfulness and an increase in oral cancer development due to mouthwashes [ 53 , 54 ], particularly those that contain alcohol [ 34 ] and are used over the long term; nevertheless, further meta-analyses did not confirm these conclusions [ 44 , 55 ]. Regardless, due to the regular and extended usage of oral hygiene products, it is crucial to conduct constant studies and monitoring of the oral toxicity associated with mouthwashes, and it is important to continually improve their formulation and minimize any potential risks associated with their use.…”

Mouthwash use and oral cancer: a systematic review and meta-analysis

“…A previous systematic review 33 and meta-analyses [34][35][36] have investigated the association between mouthwash use and OC, but none of them found any evidence. The authors did not perform subgroup analyses considering adjusted and unadjusted estimates, type of controls, or frequency and duration of mouthwash use.…”

“…The authors did not perform subgroup analyses considering adjusted and unadjusted estimates, type of controls, or frequency and duration of mouthwash use. Only Houstiuc et al 34 performed analyses in terms of duration and frequency of mouthwash use and alcohol content, but they only considered upper aerodigestive tract cancers, not OC.…”

“…In addition, although the searches have included the grey literature and reference lists, they were restricted to the main online databases, especially PubMed/ Medline, Web of Science, and Scopus. The PICO, PECO, or PEO strategies were not mentioned and few descriptors were inserted, and only studies published in English 34 or English and Spanish 35 were included. Furthermore, some of these meta-analyses 34,35 included studies that may have contained overlapping samples [37][38][39][40][41][42][43] .…”

“…The PICO, PECO, or PEO strategies were not mentioned and few descriptors were inserted, and only studies published in English 34 or English and Spanish 35 were included. Furthermore, some of these meta-analyses 34,35 included studies that may have contained overlapping samples [37][38][39][40][41][42][43] . This potential duplication occurred because these studies were part of multicenter research 44,45 or were smaller in scale [37][38][39][40][41][42][43] .…”