Oral health and gastrointestinal cancer: A nationwide cohort study

Abstract

Aims Poor oral hygiene is closely associated with bacteraemia and systemic inflammation, which are known mediators of cancer development. We investigated the relationship between oral hygiene indicators and the risk of gastrointestinal cancer in a nationwide population‐based cohort. Materials and Methods This study was conducted on data from 150,774 subjects from the Korean National Health Screening Cohort. The occurrence of gastrointestinal cancer was analysed according to the presence of periodontal disease and oral hygiene indicators: frequency of toothbrushing, dental visits for any reason, professional dental cleanings and number of missing teeth. Gastrointestinal cancer was defined using International Statistical Classification of Diseases‐10 codes C15–C26. Results During a median 11.6 years of follow‐up, the estimated 10‐year event rate for gastrointestinal cancer was 6.76%. In a multivariable analysis, after adjusting for age, sex, income level, regular exercise, alcohol consumption, smoking status, body mass index, history of comorbidities, systolic blood pressure and laboratory findings, frequent toothbrushing (≥3/day) was significantly associated with a reduced risk for gastrointestinal cancer (hazard ratio: 0.91, 95% confidence interval (0.86–0.96), p < .001, p for trend < .001). Conclusions Good oral hygiene behaviour, especially frequent toothbrushing, could be associated with a lower risk of gastrointestinal cancer.

Toothbrushing frequency and gastric and upper aerodigestive tract cancer risk: A meta‐analysis

“…Among them, 66 studies were ineligible for the following reasons: not available outcomes (n = 34), only available in abstract form (n = 3), inappropriate exposure (n = 28) and repeated published study (n = 1). Finally, 30 studies 22‐51 were included in our overall analysis (Figure 1).…”

“…Overall, 40 independent reports from 30 studies 22‐51 of 1 194 017 participants investigated the association between toothbrushing frequency and the risk of gastric and UADT cancers. The results of the random‐effect meta‐analysis were presented in Figure 2.…”

“…39 Furthermore, three included articles were multicentric studies. 23,32,35 Considering anatomical distribution, 14 studies evaluated the relationship of toothbrushing frequency with the occurrence of oral cavity cancer (including oral cavity and oropharynx), [24][25][26][30][31][32][33]35,42,43,[47][48][49]51 seven 25,32,35,40,43,49,50 with pharyngeal cancer (including nasopharyngeal), five 25,32,35,43,49 with laryngeal cancer, nine 22,27,28,32,37,38,41,43,46 with oesophageal cancer and three 37,38,44 with gastric cancer. One study 43 divided oral cancer into three subgroups: oral cancer, oropharyngeal cancer and hypopharyngeal and laryngeal cancer.…”

Oral health and longitudinal changes in fasting glucose levels: A nationwide cohort study

“…Our findings added evidence for the negative relationship between tooth brushing and longitudinal glucose levels based on the population-based health examination data. There is increasing evidence to suggest that frequent tooth brushing is an effective intervention in reducing both periodontal inflammation and the risk of heart failure, stroke, gastrointestinal cancer, and new-onset diabetes [15][16][17][18][41][42][43].…”

Oral health and changes in lipid profile: A nationwide cohort study

“…In a self-questionnaire, the frequency of tooth brushing was subgrouped into ≤1 time/, 2 times/day and ≥3 times/day. During The questionnaire for lifestyle in the health examination contained questions regarding smoking habit (never smoker, former smoker or current smoker), alcohol consumption (average alcohol consumption frequency: <1 time, 1-2 times, 3-4 times or ≥5 times/week) and physical activity (average exercise frequency: <1 day, 1-3 days or ≥4 days/week) (Chang et al, 2019;Lee et al, 2020).…”