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Clinical Oral Investigations
Published in: Clinical Oral Investigations 8/2018

01-11-2018 | Short Communication

A 30-s exposure to ethanol 20% is cytotoxic to human keratinocytes: possible mechanistic link between alcohol-containing mouthwashes and oral cancer

Authors: José Manuel Calderón-Montaño, Julio José Jiménez-Alonso, Emilio Guillén-Mancina, Estefanía Burgos-Morón, Miguel López-Lázaro

Published in: Clinical Oral Investigations | Issue 8/2018

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Abstract

Objectives

To provide mechanistic evidence for the epidemiological link between long-term use of alcohol-containing mouthwashes and oral cancer.

Material and methods

Human epithelial keratinocytes were exposed for 30 s to concentrations of ethanol commonly present in mouthwashes. After a recovery period, cell viability was assessed with the MTT assay.

Results

A marked cytotoxic effect was observed for ethanol concentrations of 20% and above.

Conclusions

The cytotoxicity of ethanol may explain the epidemiological association between mouthwash use and oral cancer. Evidence suggests that the risk of developing cancer in a tissue is strongly determined by the number of stem cell divisions accumulated by the tissue during a person’s lifetime; cell division is a major source of mutations and other cancer-promoting errors. Since cell death activates the division of stem cells, the possible cytotoxicity of ethanol on the cells lining the oral mucosa will promote the division of the stem cells located in deeper layers to produce new cells to regenerate the damaged epithelium. If we regularly use mouthwashes containing cytotoxic concentrations of ethanol, the stem cells of the oral cavity may need to divide more often than usual and our risk of developing oral cancer may increase.

Clinical relevance

Many mouthwashes contain percentages of ethanol above 20%. Because ethanol is not crucial to prevent and reduce gingivitis and plaque, members of the dental team should consider the potential risk of oral cancer associated with frequent use of alcohol-containing mouthwashes when advising their patients.
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Metadata
Title
A 30-s exposure to ethanol 20% is cytotoxic to human keratinocytes: possible mechanistic link between alcohol-containing mouthwashes and oral cancer
Authors
José Manuel Calderón-Montaño
Julio José Jiménez-Alonso
Emilio Guillén-Mancina
Estefanía Burgos-Morón
Miguel López-Lázaro
Publication date
01-11-2018
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 8/2018
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-018-2602-z

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