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Ann Oncol. 2016 Aug;27(8):1619-25. doi: 10.1093/annonc/mdw224. Epub 2016 May 27.

The role of oral hygiene in head and neck cancer: results from International Head and Neck Cancer Epidemiology (INHANCE) consortium.

Author information

1
The Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, USA dana.hashim@mssm.edu.
2
The Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, USA.
3
International Agency for Research on Cancer, Lyon, France.
4
Epidemiology-CIPE/ACCAMARGO, Sao Paulo.
5
School of Public Health, University of São Paulo, São Paulo, Brazil.
6
Department of Pediatric Dentistry.
7
Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill.
8
Department of Otolaryntology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill.
9
Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, USA.
10
Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Catalonia CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
11
Department of Cancer Epidemiology and Prevention, The M. Sklasodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
12
National Public Health Center, Budapest, Hungary.
13
Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan.
14
Department of Epidemiology Department of Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor.
15
Fred Hutchinson Cancer Research Center, Seattle.
16
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda.
17
Johns Hopkins Bloomberg School of Public Health, Baltimore.
18
Dana Farber Cancer Institute, Harvard Medical School, Boston.
19
Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA.
20
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
21
The Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, USA The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA.

Abstract

BACKGROUND:

Poor oral hygiene has been proposed to contribute to head and neck cancer (HNC) risk, although causality and independency of some indicators are uncertain. This study investigates the relationship of five oral hygiene indicators with incident HNCs.

METHODS:

In a pooled analysis of 8925 HNC cases and 12 527 controls from 13 studies participating in the International Head and Neck Cancer Epidemiology Consortium, comparable data on good oral hygiene indicators were harmonized. These included: no denture wear, no gum disease (or bleeding), <5 missing teeth, tooth brushing at least daily, and visiting a dentist ≥once a year. Logistic regression was used to estimate the effects of each oral hygiene indicator and cumulative score on HNC risk, adjusting for tobacco smoking and alcohol consumption.

RESULTS:

Inverse associations with any HNC, in the hypothesized direction, were observed for <5 missing teeth [odds ratio (OR) = 0.78; 95% confidence interval (CI) 0.74, 0.82], annual dentist visit (OR = 0.82; 95% CI 0.78, 0.87), daily tooth brushing (OR = 0.83, 95% CI 0.79, 0.88), and no gum disease (OR = 0.94; 95% CI 0.89, 0.99), and no association was observed for wearing dentures. These associations were relatively consistent across specific cancer sites, especially for tooth brushing and dentist visits. The population attributable fraction for ≤ 2 out of 5 good oral hygiene indicators was 8.9% (95% CI 3.3%, 14%) for oral cavity cancer.

CONCLUSION:

Good oral hygiene, as characterized by few missing teeth, annual dentist visits, and daily tooth brushing, may modestly reduce the risk of HNC.

KEYWORDS:

head and neck neoplasms; oral hygiene; oral neoplasms; pharyngeal neoplasms; pooled analyses

PMID:
27234641
PMCID:
PMC4959929
DOI:
10.1093/annonc/mdw224
[Indexed for MEDLINE]
Free PMC Article

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