The effect of smoking, drinking, diet, dental care and sexual habits on the risk of oral and pharyngeal cancer was investigated in a case-control study conducted in Warsaw, Poland. The study comprised 122 patients (including 44 females) aged 23-80 years with histologically confirmed cancer of oral cavity and pharynx. Controls were 124 subjects (including 52 females) admitted to the hospital for different non-neoplastic conditions unrelated to tobacco and alcohol consumption, with frequency matched to cases by age and sex. Smoking and drinking were strongly associated with an increased risk of oral cancer. Among consumers of both products, risks of oral cancer tended to combine in a multiplicative fashion and were increased more than 14-fold among those who consumed more than 15 cigarettes and seven or more drinks per day. Cessation of smoking was associated with reduced risk of this cancer. The risks varied by type of cigarettes smoked, being lower among those consuming filtered cigarettes only (OR = 1.6) than nonfilter (OR = 6.5) or mixed (OR = 4.2) cigarettes. High fruit intake was associated with significantly decreased risk (OR = 0.4) with the strongest significant inverse association found for fruit juices and citrus fruits ( < 0.01). After adjustment for tobacco smoking and alcohol drinking, poor dentition as evidenced by missing teeth, frequency of dental check-ups and frequency of teeth brushing emerged as a strong risk factor. Number of missing teeth and frequency of dental check-ups and frequency of tooth brushing showed increased ORs of 9.8, 11.9 and 3.2, respectively. Denture wearing did not affect oral cancer risk. No differences were detected in sexual practices (including oral sex and intercourse with prostitutes). In terms of attributable risk, smoking accounted for 57% of oral cancer cases in Poland, alcohol for 31% and low fruit intake for 12%. Attributable risks for low frequency of tooth brushing and dental check-ups were 56% and 47%, respectively. In conclusion, smoking and drinking cessation and increase of fresh fruit intake are likely to be effective preventive measures against oral cancer. These findings indicate also that poor oral hygiene may be an independent risk factor.

Chronic inflammation is related to oxidative stress and is still believed to be the cause of carcinogenesis. Patients with oral cavity cancer (OCC) exhibited lower total antioxidant capacity, uric acid (UA) concentration, salivary peroxidise (SPO) and superoxide dismutase (SOD) activity in their saliva than did healthy subjects. This could be a risk factor for tumour induction. Odontogenic cysts also arise in response to locally acting proinflammatory factors, for example, a gangrenous tooth. Furthermore, cyst development is accompanied by chronic inflammation. There are some reports in the literature concerning primary tumours such as squamous cell carcinomas arising from odontogenic cysts. The reason for this transformation is still unknown. The aim of this study was to compare the status of the antioxidant defence system in the saliva of the group with odontogenic cysts and OCC with that of the healthy control. Saliva samples were collected in the morning. SOD, SPO activity and UA concentration were determined using standard methods. Patients with odontogenic cysts and OCC exhibited lower activity of major antioxidants in their saliva (SPO, UA) than did healthy people. SOD activity and age are the main factors that distinguish these diseases. Discriminant function analysis showed that once data such as antioxidant status of saliva, age and smoking status are known 80% cases can be correctly classified as healthy, 80% as having odontogenic cysts and 40% as cancerous. To conclude, the decrease in concentrations of major antioxidants in the saliva of patients with cysts may increase the risk of neoplastic transformation especially in advanced age.

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Low salivary ALDH activity may be a risk factor for oral cancer development.