Oral hygiene and the overall survival of head and neck cancer patients

Chan Chi Chang, Wei Ting Lee, Jenn Ren Hsiao, Chun Yen Ou, Cheng Chih Huang, Sen Tien Tsai, Ken Chung Chen, Jehn Shyun Huang, Tung Yiu Wong, Yu Hsuan Lai, Yuan Hua Wu, Wei Ting Hsueh, Shang Yin Wu, Chia Jui Yen, Jang Yang Chang, Chen Lin Lin, Ya Ling Weng, Han Chien Yang, Yu Shan Chen, Jeffrey S. Chang

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)


Poor oral hygiene is an established risk factor of head and neck cancer (HNC); however, its role in the survival of HNC patients is unclear. This study evaluated the association between oral hygiene habits, including regular dental visits, frequency of tooth brushing, and use of dental floss, and the overall survival (OS) of HNC patients using interview data collected from 740 HNC patients. In addition, the interactions between oral hygiene and the polymorphisms of TLR2 and TLR4 on the OS of HNC patients were assessed. The analysis indicated that poor oral hygiene was significantly associated with poorer OS of HNC patients (hazard ratio (HR) = 1.38, 95% confidence interval (CI): 1.03-1.86). This association was modified by a single nucleotide polymorphism, rs11536889, of TLR4. A significant association between poor oral hygiene and worse survival of HNC was observed among those with the CG or CC genotype (HR = 2.32, 95% CI: 1.41-3.82) but not among those with the GG genotype (HR = 0.95, 95% CI: 0.65-1.40). Our results suggested that poor oral hygiene is not only a risk factor but may also be a prognostic factor of HNC.

Original languageEnglish
Pages (from-to)1854-1864
Number of pages11
JournalCancer medicine
Issue number4
Publication statusPublished - 2019 Apr

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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