Oral health, dental care and mouthwash associated with upper aerodigestive tract cancer risk in Europe: The ARCAGE study

Abstract

Objective: To evaluate the association of oral health (OH), dental care (DC) and mouthwash with tumors of the upper-aerodigestive tract (UADT), and to which extend enzymes involved in the metabolism of alcohol modify the effect of alcohol-based mouthwashes.' Materials and Methods: Subjects were interviewed about OH and DC behaviors. Mouthwash use was analyzed in relation to alcohol dehydrogenase genes (ADH1B,ADH1C,ADH7) and one aldehyde dehydrogenase gene (ALDH2) known to be associated with head and neck cancers. Adjusted odds ratios (ORs) and 95%-confidence intervals [CI] were estimated with multiple logistic regression models. Results: ORs of low versus high scores of DC and OH were 2.36[CI=1. , respectively, for all UADT sites combined. The OR for use of mouthwash 3 or more times/day was 3.23[CI=1. 68-6.19]. The OR for the rare variant ADH7 coding for fast ethanol metabolism was lower in ) as compared to ) indicating effect modification (pheterogeneity=0.65) while no relevant differences were observed between users and non-users for the variant alleles of ADH1B, ADH1C or ALDH2. Conclusions: Poor OH and DC are independent risk factors for UADT. Whether mouthwash use may entail some risk through the alcohol content in most formulations on the market remains to be clarified. Materials and MethodsSubjects were interviewed about OH and DC behaviors. Mouthwash use was analyzed in relation to alcohol dehydrogenase genes (ADH1B,ADH1C,ADH7) and one aldehyde dehydrogenase gene (ALDH2) known to be associated with head and neck cancers.Adjusted odds ratios (ORs) and 95%-confidence intervals [CI] were estimated with multiple logistic regression models. Results ORs ConclusionsPoor OH and DC are independent risk factors for UADT. Whether mouthwash use may entail some risk through the alcohol content in most formulations on the market remains to be clarified. 5

Mouthwash use and cancer of the head and neck: a pooled analysis from the International Head and Neck Cancer Epidemiology Consortium

“…In conclusion, the results of this pooled analysis confirm recent systematic reviews and meta-analyses [3, 20] and multicenter studies [21] that reported no overall increased risk of head and neck cancer in individuals who ever used mouthwash, but an association in long-term frequent users. The study is limited by significant methodological issues, yet reveals potential risks for head and neck cancer sub-sites and in long-term and frequent users of mouthwash.…”

Influence of factors in the oral mucosa maturation pattern: a cross-sectional study applying multivariate analyses

“…However, it remains uncertain whether the consumption of alcohol and tobacco, in addition to individual parameters modify the normal process of epithelial maturation of the oral cavity. Other factors that may change the pattern of oral epithelial maturation are oral hygiene status and socioeconomic factors, since they have been suggested as risk factors for the development of oral cancer [8][9] .…”

Esophageal Cancer Patients Have a High Incidence of Severe Periodontitis and Preoperative Dental Care Reduces the Likelihood of Severe Pneumonia after Esophagectomy

“…Poor oral health is reportedly a risk factor for upper aerodigestive tract tumors, including tumors of the oral cavity, larynx, oropharynx, hypopharynx and esophagus [10][11][12][13] . This risk is independent of tobacco use and alcohol consumption [13] .…”