Reduction of oral acetaldehyde levels using a controlled-release chlorhexidine chip as a prevention strategy against upper digestive tract cancer.

Increasing evidence indicates a strong relationship exists between harmful habits like smoking and alcohol drinking and upper digestive tract cancer. In addition, smokers and alcohol drinkers also exhibit high salivary levels of carcinogenic acetaldehyde, the first metabolite of alcohol. This compound has been indicated as a major cancer causing factor in the upper digestive tract, especially among alcohol drinkers. Interestingly, acetaldehyde is produced from alcohol present in the epithelia by mucosal alcohol dehydrogenases (ADH) in the upper digestive tract. However, much higher levels derive from the bacterial oxidation of alcohol by the oral microflora. In this respect, the reduction of oral microbes can become a fundamental factor in diminishing the risk of cancer. In this article, we hypothesize that the antimicrobial agent chlorhexidine, formulated as controlled-release chip, and fixed by a dental device, (i.e., a modified orthodontic bracket), may be the most rational strategy for reducing acetaldehyde production by microflora.