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ABSTRACT OBJECTIVE This study aimed to investigate the effect of mouthwash use on the development of oral cancer. METHODS Observational studies with adult/older adult populations that have examined the association between mouthwash use and oral cancer were included. Electronic search was performed in July 2022, with no time or language restrictions. PubMed/Medline, Embase, and Web of Science databases were used, and the search was extended to theses and dissertations libraries, Google Scholar, reference lists, and other sources. Methodological quality was assessed using the Newcastle-Ottawa Scale and quantitative data synthesis was performed by random effects meta-analysis, with different subgroup analyses and meta-regression. This revision was registered in Prospero (CRD42020143307). RESULTS Of the 4,094 studies identified in the search, 15 case-control studies were included in the review, totaling 6,515 cases and 17,037 controls. The meta-analysis included 17 measures of effect from 15 case-control studies. The pooled OR was 1.00 (95%CI: 0.79–1.26, n = 17 studies), but it was 2.58 (95%CI: 1.38–4.82, n = 2 studies) among those who had used mouthwashes three times or more times a day, and 1.30 (95%CI: 1.10–1.54, n = 4 studies) among those who had used mouthwashes for more than 40 years. CONCLUSIONS We found evidence that a high frequency of mouthwash use may be associated with an increased risk of oral cancer. However, despite the biological plausibility for this association, we suggest caution upon interpretation of our findings due to the few number of studies that have investigated the mouthwash use frequency, which should be considered. Therefore, we recommend that future studies assess, in detail, the frequency, duration, and content of mouthwashes to increase the strength of evidence for a possible dose-response effect of mouthwashes on oral cancer risk. adultolder older 2022 restrictions PubMedMedline PubMed Medline PubMed/Medline Embase libraries Scholar lists sources NewcastleOttawa Newcastle Ottawa metaanalysis, metaanalysis meta analysis, analysis metaregression. metaregression regression. regression meta-regression CRD42020143307. CRD42020143307 CRD . (CRD42020143307) 4094 094 4,09 1 casecontrol case control review 6515 6 515 6,51 17037 037 17,03 controls 100 00 1.0 95%CI 95CI CI 95 (95%CI 079126 0 79 26 0.79–1.26 studies, , 258 58 2.5 138482 38 82 1.38–4.82 day 130 30 1.3 110154 10 54 1.10–1.54 years However considered Therefore assess detail duration doseresponse dose response 202 CRD4202014330 (CRD42020143307 409 09 4,0 651 51 6,5 1703 03 17,0 1. 9 07912 7 0.79–1.2 25 5 2. 13848 3 8 1.38–4.8 13 11015 1.10–1.5 20 CRD420201433 (CRD4202014330 4, 65 6, 170 17, 0791 0.79–1. 1384 1.38–4. 1101 1.10–1. CRD42020143 (CRD420201433 079 0.79–1 138 1.38–4 110 1.10–1 CRD4202014 (CRD42020143 07 0.79– 1.38– 11 1.10– CRD420201 (CRD4202014 0.79 1.38 1.10 CRD42020 (CRD420201 0.7 1.1 CRD4202 (CRD42020 0. CRD420 (CRD4202 CRD42 (CRD420 CRD4 (CRD42 (CRD4 (CRD