Investigating the association between oral hygiene and head and neck cancer

Jeffrey S. Chang, Hung I. Lo, Tung Yiu Wong, Cheng Chih Huang, Wei Ting Lee, Sen Tien Tsai, Ken Chung Chen, Chia Jui Yen, Yuan Hua Wu, Wei Ting Hsueh, Ming Wei Yang, Shang Yin Wu, Kwang Yu Chang, Jang Yang Chang, Chun Yen Ou, Yi Hui Wang, Ya Ling Weng, Han Chien Yang, Fang Ting Wang, Chen Lin LinJehn Shyun Huang, Jenn Ren Hsiao

Research output: Contribution to journalArticlepeer-review

97 Citations (Scopus)


Objectives: This analysis examined the association between oral hygiene and head and neck cancer (HNC) and whether this association differed by the consumption of alcohol, betel quid, or cigarette and by the genetic polymorphisms of inflammation-related genes. Materials and methods: Interviews regarding dental care and oral health were conducted with 317 HNC cases and 296 controls. Genotyping was performed for 6 single nucleotide polymorphisms in IL6, IL10 and PTGS2. Results: A positive association was observed between HNC and no regular dental visits (odds ratio (OR) = 2.86, 95% confidence interval (CI): 1.47-5.57), brushing teeth <2 times/day (OR = 1.51, 95% CI: 1.02-2.23), frequent gum bleeding (OR = 3.15, 95% CI: 1.36-7.28), and loss of >20 teeth (OR = 2.31, 95% CI: 1.05-5.07). Analysis with dental care score (range: 0-4, 4 = worst dental care), which combined regular dental visits, toothbrushing, and use of dental floss and mouthwash, showed a positive trend with HNC risk, particularly among alcohol drinkers and cigarette smokers. Multifactor dimensionality reduction analysis divided the study subjects into high- and low-risk group based on combinations of dental care score and IL6 rs1800796 genotypes. Compared to the low-risk group, the high-risk group had an OR of HNC = 2.16 (95% CI: 1.44-3.25). Conclusions: This study observed a positive association between poor oral hygiene and HNC, which appeared to differ by alcohol or cigarette consumption and the genotypes of IL6 rs1800796. Further investigations are needed to determine whether poor oral hygiene is a cause for HNC or a surrogatemarker of an unhealthy lifestyle that increases the risk of HNC.

Original languageEnglish
Pages (from-to)1010-1017
Number of pages8
JournalOral Oncology
Issue number10
Publication statusPublished - 2013 Oct

All Science Journal Classification (ASJC) codes

  • Oral Surgery
  • Oncology
  • Cancer Research


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