Do you like using Listerine after you brush your teeth? If so, you’re actually using it at the wrong time and decreasing the benefits of your toothpaste. But here comes the jaw-dropping news, recent studies have shown that Listerine mouthrinses can actually increase your risk of ORAL CANCER!
Research Behind Listerine’s Link to Oral Cancer
For decades, Listerine has been one of the most popular mouthrinses in the world. However, its ingredients went under the spotlight not too long ago, and a nasty discovery was uncovered – its alcohol levels! Surprisingly, the discovery made very little to no impact on Listerine’s popularity, because they have a huge advertising budget and strategic marketing tactics.
It’s common knowledge that smoking and alcohol are linked to oral cancer, but what about alcohol-containing mouthwashes? In recent studies, alcohol-containing mouth rinses, like Listerine have shown a link to oral cancer.
Acetaldehyde, a toxic by-product of alcohol, is known to cause cancer. Even though most of the alcohol metabolism takes place in the liver, there is evidence that it can also take place in your mouth during social drinking.[4,5] However when you drink socially, you simply sip on the alcohol and immediately swallow it. Whereas when using alcohol-containing mouthrinses (Listerine), you tend to swish it around for a few minutes prolonging the alcohol exposure time to your mouth.
Many studies have shown that long exposure and high concentrations of alcohol in mouthrinses have negative effects in the mouth. These effects can include mouth ulcers, gingivitis, pain, epithelial detachment, keratosis, and diffuse white oral lesions. [2,6,7]
Is Listerine Essential in your Oral Hygiene Regime?
The simple answer is, NO, you do not need to include an alcohol-containing mouthwash in your daily routine. Strangely, people associate the ‘burning/stinging’ feeling after using Listerine with ‘clean’ and ‘freshness’. But in reality, that feeling should be associated with ‘unnecessary alcohol exposure.
Let me give you an analogy that might be more relatable: if your dermatologist recommended that you start using a cream, which will help reduce your acne but also increase your chances of getting skin cancer…would you still use it? Most likely, your answer will be ‘no‘.
Therefore, what is the recommendation for using alcohol-containing Listerine mouthrinses? Ditch them, you don’t need them, and that’s based on scientific evidence. To prevent bad breath, cavities, and gum disease, simply brush your teeth twice a day, floss, and chew sugar-free gum!
However, after reading everything above, if you are still keen on using Listerine mouthrinses, then the remainder of this article is for YOU.
Loyal Listerine Users, Which Listerine Mouthrinse Should You Buy?
I want to start off by saying that dentists rarely recommend Listerine to their patients for every-day use. According to many research studies its efficacy and benefits are quite low. 
Thus, the following advice about which Listerine product to buy is only for people who have become accustomed to using Listerine mouthrinses every day and absolutely need it in their oral hygiene routine.
So, here’s the advice: buy Listerine products that contain ZERO alcohol. They actually advertise it as Listerine ZERO.
However, as previously mentioned, the effectiveness of Listernine-ZERO is highly questionable. This is evident by the subtle change Listerine made in advertising the two products. You’ll notice that alcohol-containing Listerine uses the slogan, “Kills 99.9% of germs”, whereas Listerine with ZERO alcohol uses the slogan, “Kills millions of germs”. But the truth is, you have a lot more than a “million germs” in your mouth, you actually have BILLIONS of germs. Hence, they removed the “kills 99.9% of germs” claim. This is considered to be very strategic advertising and marketing.
Are You Using Listerine at the Wrong Time?
Listerine ZERO should not be used as a substitute for toothbrushing and flossing, and it certainly should NOT be used immediately after toothbrushing. Here’s the reason why: Your toothpaste contains approximately 1000-1500ppm of fluoride, which is well known for its protective properties against tooth decay. On the other hand, Listerine mouthrinses only contain 200ppm of fluoride, thus, making it less protective than your toothpaste. So, if you brush your teeth with toothpaste, you’re better off leaving 1500ppm of protective fluoride on your teeth instead of rinsing it away with a lousy 200ppm.
What Is The Best Time to Use Listerine Zero?
The best time to use Listerine Zero is in between your meals when a toothbrush and toothpaste aren’t easily accessible. Also, swishing Listerine around your mouth more vigorously will increase the chances of you disturbing the biofilm that sits on your teeth and can house bad bacteria.
Important Take-Home Messages
- Alcohol-containing Listerine mouthrinses increase the risk of oral cancer. 
- Listerine is NOT essential for everyday use to maintain good oral health. A good tooth brushing and flossing routine is enough to prevent bad breath, cavities (dental decay) and gum disease.
- For loyal Listerine users: Invest in Listerine ZERO (no alcohol) & use it in between meals.
Written by: Dr. Sanya Arora (Doctor of Dental Surgery)
 McCullough, M. J., & Farah, C. S. (2008). The role of alcohol in oral carcinogenesis with particular reference to alcohol‐containing mouthwashes. Australian dental journal, 53(4), 302-305.
 Guha N, Boffetta P, Wunsch Filho V, et al. Oral health and risk of squamous cell carcinoma of the head and neck and esophagus: results of two multicentric case-control studies. Am J Epidemiol 2007;166:1159–1173.
 IARC Monographs. Re-evaluation of some organic chemicals, hydrazine and hydrogen peroxide. Proceedings of the IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Lyon, France, 17–24 February 1998. IARC Monogr Eval Carcinog Risks Hum 1999;71 Pt 1:1–315.
 Dong YJ, Peng TK, Yin SJ. Expression and activities of class IV alcohol dehydrogenase and class III aldehyde dehydrogenase in human mouth. Alcohol 1996;13:257–262.
 Seitz HK, Matsuzaki S, Yokoyama A, Homann N, Va ̈ keva ̈ inen S, Wang XD. Alcohol and cancer. Alcohol Clin Exp Res 2001;25:137S–143S.
 Bernstein ML. Oral mucosal white lesions associated with excessive use of Listerine mouthwash. Report of two cases. Oral Surg Oral Med Oral Pathol 1978;46:781–785.
 Bolanowski SJ, Gescheider GA, Sutton SV. Relationship between oral pain and ethanol concentration in mouthrinses. J Periodontal Res 1995;30:192–197.
 Siegrist, B. E., Gusberti, F. A., Brecx, M. C , Weber, H. P & Lang, N. P (1986) Efficacy of supervised rinsing with chlorhexidine di- gluconate in comparison to phenolic and plant alkaloid compounds. Journal of Periodontal Research 21. Supplement 16. 60-73.