Association of Periodontitis with Oral Cancer: A Case-Control Study

Abstract

The association between oral squamous cell carcinoma (OSCC) and periodontitis in large hospital cases with cohort controls has yet to be evaluated. The aim of this study was to investigate the association of periodontitis with OSCC across tumor location and tumor-node-metastasis (TNM) stage among Koreans ( N = 424). OSCC cases ( n = 146) were recruited from Seoul National University Dental Hospital and matched by age, sex, and smoking to controls ( n = 278) from the Yangpyeong health and periodontal cohort in Korea. OSCC was diagnosed through biopsy and radiographs, including computed tomography and magnetic resonance imaging. Tumor location and TNM stage were classified after the surgery. Periodontitis was defined by alveolar bone loss with panoramic radiographs following the guidelines of the Fifth European Workshop in Periodontology. Alcohol intake, education, physical activity, obesity by body mass index, hypertension by blood pressure, diabetes by plasma glucose, and hypercholesterolemia by plasma cholesterol were considered as confounders. Information about age, sex, smoking, alcohol intake, education, and physical activity was obtained through interview; body mass index and blood pressure, through physical examination; and preoperative glucose and cholesterol, through laboratory tests. Bivariate analysis was applied with Fisher’s exact chi-square test. Multivariable conditional logistic regression models were applied to evaluate the adjusted association of periodontitis with OSCC after controlling for confounders. Subgroup analyses were explored by OSCC and periodontitis. Participants with periodontitis were 3.7 times more likely to have OSCC (adjusted odds ratio [aOR] = 3.66, 95% CI = 1.46 to 9.23) than participants without periodontitis. The differences in periodontitis were not statistically significant across TNM stages of OSCC ( P > 0.05) and its location ( P > 0.05). The link was highlighted among males (aOR = 6.55), elders aged >60 y (aOR = 4.98), and those with more tooth loss (aOR = 9.99). Our data showed that periodontitis was independently associated with OSCC. Thus, the risk of OSCC could be modulated by reducing periodontitis.

The Oral Microbiota May Have Influence on Oral Cancer

“…Prevotella intermedia and Porphyromonas gingivalis are considered to be the pathogen of periodontitis (Mysak et al, 2014;Zhang et al, 2017;Hsiao et al, 2018). Studies have reported that repeated periodontitis were associated with increased risk of OSCC (Li et al, 2018;Shin et al, 2019). Both of them can secrete peptides (Lisi et al, 2014;Zhang et al, 2017;Eftekhari et al, 2018).…”

Analysis of DNA methylation and TP53 mutational status for differentiating feline oral squamous cell carcinoma from non‐neoplastic mucosa: A preliminary study

“…54 For this and other reasons, chronic periodontitis is supposed to be a risk factor for HOSCC, and several other potentially malignant oral disorders with an inflammatory base are well-recognized in humans. [55][56][57] No oral lesions of confirmed pre-neoplastic significance have been so far identified in cats. Considering the high incidence of chronic stomatitis in geriatric cats, it can be difficult to estimate how reliable is the risk of a neoplastic transformation of these lesions, although this has been previously hypothesized.…”

IDF Diabetes Atlas: Diabetes and oral health – A two-way relationship of clinical importance

“…Just like cancers at several body sites, oral cancer and precancerous lesions are more prevalent among people with type 2 diabetes, with an overall 15% (and 85% for case studies only) excessive risk compared to people without diabetes as reported by a 2015 systematic review [59]. Among people with periodontitis, those also suffering from diabetes had 2.5 times (adjusted OR (aOR) = 2.52; 95% CI: 1.22-5.18) greater risk for oral squamous cell carcinoma (OSCC) than those with only periodontitis [60]. Furthermore, women may be at greater risk than men, having a 13% excess risk as reported by a 2018 systematic review [61].…”