The role of alcohol in oral carcinogenesis with particular reference to alcohol‐containing mouthwashes

Australian Dental Journal (Impact Factor: 1.48). 11/2008; 53(4):302 - 305. DOI: 10.1111/j.1834-7819.2008.00070.x

ABSTRACT Worldwide, oral cancer represents approximately 5 per cent of all malignant lesions, with over 800 new intra-oral squamous cell carcinomas registered in Australia each year. Despite recent advances in therapy, the five-year survival rate remains around 50 per cent and the sequelae of treatment can be seriously debilitating. It has been long established that smoking and alcohol consumption are risk factors linked to the development of oral cancer. This review assesses the epidemiological evidence, supportive in vitro studies and mechanism by which alcohol is involved in the development of oral cancer. Further, we review the literature that associates alcohol-containing mouthwashes and oral cancer. On the basis of this review, we believe that there is now sufficient evidence to accept the proposition that alcohol-containing mouthwashes contribute to the increased risk of development of oral cancer and further feel that it is inadvisable for oral healthcare professionals to recommend the long-term use of alcohol-containing mouthwashes.

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    ABSTRACT: Use of alternative medicine to control oral streptococci is a new topic worthy of further investigation. This study aimed to elucidate the dose-dependent anti-bacterial activity of crude aqueous extract of ripe Morinda citrifolia L. (Family: Rubiaceae) fruits against oral streptococci i.e. Streptococcus mutans and Streptococcus mitis, that cause dental caries in humans. Fresh ripe M. citrifolia fruits (750g) were ground in an electronic blender with sterile water (500ml). The crude aqueous extract was lyophilized to yield a brown colored powder. Various concentrations (1000-100μg/ ml) of the extract were tested for its antibacterial activity (Kirby and Bauer method) against whole cells of S. mutans and S. mitis. Minimum Inhibitory Concentration (MIC) was determined by micro-dilution method, using serially diluted (2 folds) fruit extract, according to the National Committee for Clinical Laboratory Standards (NCCLS). Crude aqueous extract (1000μg/ ml) of ripe M. citrifolia fruits effectively inhibited the growth of S. mutans (19±0.5 mm) and S. mitis (18.6±0.3 mm) compared to the streptomycin control (21.6±0.3 mm). The growth inhibition was clearly evident with "nil" bacteriostasis, even after 48 hours of incubation at 37°C. The MIC of the extract for S. mutans and S. mitis was 125 μg and 62.5 μg, respectively. Our results suggest that phytochemicals naturally synthesized by M. citrifolia have an inhibitory effect on oral streptococci. Furthermore, purification and molecular characterization of the "bioactive principle" would enable us to formulate a sustainable oral hygiene product.
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