OP138: Intra-oral acetaldehyde levels after rinsing with an alcohol-containing mouthwash, evidence of “Super-Producers”

Abstract

Introduction Oral cancer is associated with alcohol consumption, potentially due to acetaldehyde, the carcinogenic metabolite of alcohol. We hypothesize that intra-oral acetaldehyde may vary individually and be related to oral disease. Purpose To assess intra-oral acetaldehyde production and correlate this with dental disease. Methods Saliva samples (30 s, 20 ml water mouth-swill), collected prior to rinsing (30 s, 20 ml of 27% alcohol mouthwash), then 1 and 5 min post-rinsing had acetaldehyde measured using headspace gas chromatography. Results were grouped: absent (Group 0); low (Group 1 – below 10 mM); active (Group 2–10 – 30 mM); high (Group 3–30 – 50 mM); excessive (Group 4–50 – 150 mM); and “Super-Producers” (Group 5 – above 150 mM). Orally healthy, edentulous and periodontal patients were enrolled. Results 66 enrolled: 21 healthy (10 non-smokers, 11 smokers); 20 with periodontitis (nine non-smokers, 11 smokers); 24 edentulous (16 patients non-smokers, eight smokers). The majority had no acetaldehyde pre-rinse (62/66; 94%). 2 min all had intra-oral acetaldehyde, the majority (67%, 44/66) actively producing (Group 3), seven produced excessive amounts (Group 4 and 5), with two “Super-Producers” over seven times the “safe” level. 6 min levels had returned to low for 92%, however five remained at over 10 mM. No correlation with oral conditions was found. Conclusion This is the first study to demonstrate that individuals can produce very high levels of intra-oral acetaldehyde, “intra-oral acetaldehyde super-producers”, with no specific dental characteristics. These individuals may be at very high risk of developing oral cancer with long-term, multiple daily, alcohol-containing mouthwash use.