Alcohol’s effects on the mouth go well beyond a stained smile. The National Cancer Institute (NCI) states that there is strong scientific evidence that drinking alcohol can cause cancer, including cancers of the mouth and throat. Alcohol is also linked to dry mouth, and many mixed drinks are sugary or acidic. This guide pulls together what federal health agencies and the American Dental Association (ADA) say, without judgment, so you can make informed choices.
Alcohol and oral cancer
According to the National Institute of Dental and Craniofacial Research (NIDCR), most cancers in the mouth are related to tobacco use, drinking alcohol, or both. NIDCR says heavy alcohol use increases the risk.
How much the risk rises
The NCI fact sheet summarizes research comparing drinkers with non-drinkers. For cancers of the oral cavity (mouth) and throat, it reports a risk 1.1 times as high in light drinkers and 5 times as high in heavy drinkers. The NCI notes these are relative risks, comparing one group’s chance of a new cancer diagnosis with another’s.
The NCI uses the National Institute on Alcohol Abuse and Alcoholism (NIAAA) definition of heavy drinking: four or more drinks on any day or eight or more per week for women, and five or more drinks on any day or 15 or more per week for men.
Alcohol plus tobacco
The combination is especially harmful. The NCI says people who use both alcohol and tobacco have much greater risks of cancers of the mouth, throat, larynx and esophagus than people who use either alone. The combined effect is multiplicative, greater than adding the two risks together. NIDCR agrees that using both increases risk even further. One reason, according to the NCI, is that alcohol can make it easier for the mouth and throat to absorb harmful chemicals, such as those in cigarette smoke. See smoking, vaping and oral health.
Why alcohol may cause cancer
The NCI explains that the body breaks down ethanol into acetaldehyde, a toxic chemical and probable human carcinogen that can damage DNA and proteins. Alcohol can also generate reactive molecules that damage cells and impair absorption of several nutrients.
Cutting back helps
The NCI reports that stopping drinking is associated with lower risks of oral cavity and esophageal cancers, and possibly others.
Guidelines on drinking
The NCI cites the Dietary Guidelines for Americans, 2020–2025. They advise that people who don’t drink should not start for any reason, and that adults who drink should limit it to two drinks or fewer in a day for men and one or fewer for women, on days when alcohol is consumed. The NCI adds that a Surgeon General’s Advisory has called for reconsidering those limits because cancer risk increases even at or below them. The National Institute on Aging (NIA) also lists drinking only in moderation, if at all, as one way to lower oral cancer risk.
Dry mouth
Saliva protects teeth by washing away food and neutralizing acids. NIDCR lists avoiding alcohol among the self-care steps for easing dry mouth. The NIA likewise suggests avoiding alcohol, along with caffeine and acidic juices, if your mouth feels dry. The NIA notes dry mouth increases the risk of tooth decay and fungal infections. Read more in dry mouth and your teeth.
Some mouthwashes also contain alcohol. The NCI notes ethanol is found in some medicines, mouthwashes and household products. If dry mouth bothers you, ask your dentist about alcohol-free rinses.
Mixers, sugar and acid
The ADA identifies soda, sports drinks and citrus juices as major sources of the acid that causes tooth erosion, and notes that carbonation raises any drink’s acid level. Many cocktails combine these mixers. Sipping slowly over an evening exposes teeth to acid and sugar for longer. Water between drinks, and rinsing with water afterward as the ADA suggests after acidic drinks, can help.
Know the warning signs
Because alcohol raises oral cancer risk, regular dental checkups matter. NIDCR says your regular dental checkup is an excellent opportunity for an oral cancer exam, which is painless and takes only a few minutes. NIDCR advises seeing a dentist or doctor if mouth symptoms last more than two weeks. Symptoms include a sore or irritation that doesn’t go away, red or white patches, pain, numbness, a lump or thickening, or trouble chewing or swallowing. See what happens at an oral cancer screening.
Be honest with your dentist about how much you drink. It helps them judge your risk.
Frequently asked questions
Does light drinking affect my mouth cancer risk?
The NCI fact sheet reports a modest increase (1.1 times) in oral cavity and throat cancer risk for light drinkers, rising to 5 times for heavy drinkers.
Is wine better for my teeth than beer or spirits?
Our sources don’t rank drinks for dental health. The NCI’s cancer risk figures are based on alcohol consumption generally.
Does alcohol in mouthwash cause cancer?
The NCI notes that mouthwashes can contain ethanol. Our sources don’t establish a cancer risk from mouthwash. If you are concerned or have dry mouth, alcohol-free options are widely available.
Sources
- National Cancer Institute: Alcohol and Cancer Risk Fact Sheet
- NIDCR: Oral Cancer
- NIDCR: Dry Mouth
- National Institute on Aging: Taking Care of Your Teeth and Mouth
- ADA MouthHealthy: Dietary Acids and Your Teeth
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “Wine glasses (Unsplash)” by James Harris, via Wikimedia Commons, licensed CC0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.