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What happens if people start drinking mouthwash as surrogate alcohol? A quantitative risk assessment

pmid: 23041419
Mouthwash ingestion has been observed in settings of restricted availability to alcoholic beverages such as in hospitals, prisons or military establishments. The literature offers limited evidence that ingredients of mouthwash may have health effects above the effects of ethanol. This study provides a quantitative risk assessment based on analysis of 30 mouthwash samples. All investigated brands contained alcohol, most of them menthol (93%), eucalyptol (90%), benzoic acid (87%), methyl salicylate (67%), and thymol (30%). For low risk drinking scenarios with average levels, only ethanol will exceed acceptable daily intakes (ADI). In worst case scenarios for alcohol dependent consumers ingesting 100g ethanol per day in the form of mouthwash, methyl salicylate will also exceeded the ADI by a factor of 17. The margin of exposure (MOE) for methyl salicylate, benzoates and thymol was below 100 for average scenarios, and below 10 for worst case scenarios, but ethanol is still the most toxic ingredient with MOE below 1. The occasional or even chronic ingestion of mouthwash may not cause health effects except the effects of ethanol alone. Only in extreme exposures, ingredients such as thymol or methyl salicylate could exacerbate the effects of ethanol, especially by contributing to metabolic acidosis.
- University of Toronto Canada
- TU Dresden Germany
- Chemisches und Veterinäruntersuchungsamt Karlsruhe Germany
- Centre for Addiction and Mental Health Canada
- Saratov State University Russian Federation
Eucalyptol, Ethanol, Mouthwashes, Drinking Behavior, Benzoic Acid, Cyclohexanols, Risk Assessment, Salicylates, Thymol, Menthol, Monoterpenes, Humans
Eucalyptol, Ethanol, Mouthwashes, Drinking Behavior, Benzoic Acid, Cyclohexanols, Risk Assessment, Salicylates, Thymol, Menthol, Monoterpenes, Humans
citations This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).21 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Top 10% influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Top 10% impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Top 10%
