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Title: Tooth loss and lack of regular oral hygiene are associated with higher risk of esophageal squamous cell carcinoma.
Authors: Abnet CC,  Kamangar F,  Islami F,  Nasrollahzadeh D,  Brennan P,  Aghcheli K,  Merat S,  Pourshams A,  Marjani HA,  Ebadati A,  Sotoudeh M,  Boffetta P,  Malekzadeh R,  Dawsey SM
Journal: Cancer Epidemiol Biomarkers Prev
Date: 2008 Nov
Branches: NEB
PubMed ID: 18990747
PMC ID: PMC2586052
Abstract: We tested the association between tooth loss and oral hygiene and the risk of esophageal squamous cell carcinoma (ESCC) in people living in a high-risk area of Iran. We used a case-control study of pathologically confirmed ESCC cases (n = 283) and controls (n = 560) matched on sex, age, and neighborhood. Subjects with ESCC had significantly more decayed, missing, or filled teeth (DMFT) with a median (interquartile range) of 31 (23-32) compared with controls 28 (16-32; P = 0.0045). Subjects with ESCC were significantly more likely than controls to fail to practice regular oral hygiene (78% versus 58%). In multivariate-adjusted conditional logistic regression models, having 32 DMFT compared with < or = 15 conferred an odds ratio (95% confidence interval) of 2.10 (1.19-3.70). Compared with daily tooth brushing, practicing no regular oral hygiene conferred an odds ratio (95% confidence interval) of 2.37 (1.42-3.97). Restricting the analysis to subjects that had never smoked tobacco did not materially alter these results. We found significant associations between two markers of poor oral hygiene, a larger number of DMFT and lack of daily tooth brushing, and risk of ESCC in a population at high risk for ESCC where many cases occur in never smokers. Our results are consistent with several previous analyses in other high-risk populations.