J Korean Acad Oral Health.  2017 Mar;41(1):16-21. 10.11149/jkaoh.2017.41.1.16.

Relationship between cancer and oral health in Korean adults determined using data from the 6th (2013-2014) Korea National Health and Nutritional Examination Survey

• Shin HE
• Kim HJ
• Cho MJ
• Choi YH
• Song KB

• KMID: 2376034
• DOI: http://doi.org/10.11149/jkaoh.2017.41.1.16

Abstract

OBJECTIVES
Dental caries and periodontitis are major oral bacterial infections associated with dental plaque. Infection and inflammation play a role in carcinogenesis, and a significant link has been found between some highly prevalent oral and dental diseases and some types of cancer. Therefore, the aim of this study was to evaluate the relationship between cancer and oral health among Korean adults.
METHODS
Data from the 6th Korea National Health and Nutrition Examination Survey were used to analyze the incidence of cancer according to oral health. Demographic and socioeconomic statuses and oral behavior of the participants was analyzed using complex chi-square tests. Logistic regression was used to analyze the relationship between a high DMFT index and cancer by calculating the 95% confidence intervals.
RESULTS
In total, 6,450 case-control subjects were included. Significant difference was observed in the DMFT index, but not in periodontal diseases, between the cases and controls. The odds ratio for cancer was 1.80 (95% confidence interval: 1.18 to 2.73) in the high-risk group. However, no significant difference was observed after adjusting for age, education level, and income.
CONCLUSIONS
The results provide potential evidence of a significant association between cancer and oral disease.

Keyword

Cancer; DMFT index; Korea National Health and Nutrition Examination Survey (KNHANES); Oral health

MeSH Terms

Adult*
Bacterial Infections
Carcinogenesis
Case-Control Studies
Dental Caries
Dental Plaque
Education
Humans
Incidence
Inflammation
Korea*
Logistic Models
Nutrition Surveys
Odds Ratio
Oral Health*
Periodontal Diseases
Periodontitis
Social Class
Stomatognathic Diseases

Reference

1. Statistics Korea. 2015 Causes of death statistics. Daejeon: Statistics Korea;2016. p. 13.

2. Ministry of Health & Welfare. Cancer Facts & Figures 2010. Seoul: Ministry of Health & Welfare;2010. p. 122.

3. Bernard WS, Paul K. World cancer report. IARC Press: International Agency for Research on Cancer;2003. p. 21–76.

4. Lee SH, Choi YH. Link between periodontal disease and cancer: a recent research trend. J Life Sci. 2013; 23:602–608.

5. Kim SJ, Kim WJ, Lee MC. The effects of physical activity on cancer prevention. Korean J Health Promot Dis Prev. 2008; 8:67–77.

6. Meurman JH, Martinez AB. Are oral and dental diseases linked to cancer? Oral Dis. 2011; 17:779–784.

7. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008; 454:436–444.

8. Amabile N, Susini G, Pettenati SI, Bonello L, Gil JM, Arques S, et al. Severity of periodontal disease correlates to inflammatory systemic status and independently predicts the presence and angiographic extent of stable coronary artery disease. J Intern Med. 2008; 263:644–652.

9. Ji JD, Lee YH, Song GG. Prostaglandin E2(PGE2): roles in immune responses and inflammation. J Korean Rheum Assoc. 2004; 11:307–316.

10. Persson GR, Persson RE. Cardiovascular disease and periodontitis: an update on the associations and risk. J Clin Periodontol. 2008; 35:8 Suppl. 362–379.

11. Takahashi N, Nyvad B. The role of bacteria in the caries process: ecological perspectives. J Dent Res. 2011; 90:294–303.

12. Gaffen SL, Hajishengallis G. A new inflammatory cytokine on the block: re-thinking periodontal disease and the Th1/Th2 paradigm in the context of Th17 cell and IL-17. J Dent Res. 2008; 87:817–828.

13. Stolzenberg RZ, Dodd KW, Blaser MJ, Virtamo J, Taylor PR, Albanes D. Tooth loss, pancreatic cancer, and Helicobacter pylori. Am J Clin Nutr. 2003; 78:176–181.

14. Abnet CC, Kamangar F, Dawsey SM, Stolzenberg RZ, Albanes D, Pietinen P, et al. Tooth loss is associated with increased risk of gastric non-cardia adenocarcinoma in a cohort of Finnish smokers. Scand J Gastroenterol. 2005; 40:681–687.

15. Michaud DS, Joshipura K, Giovannucci E, Fuchs CS. A prospective study of periodontal disease and pancreatic cancer in US male health professionals. J Natl Cancer Inst. 2007; 99:171–175.

16. Zeng XT, Leng WD, Zhang C, Liu J, Cao SY, Huang W. Meta-analysis on the association between tooth brushing and head and neck cancer. Oral Oncol. 2015; 51:446–451.

17. Söder B, Yakob M, Meurman JH, Andersson LC, Söder PÖ. The association of dental plaque with cancer mortality in Sweden. A longitudinal study. BMJ Open. 2012; 2:[Epub]. DOI: 10.1136/bmjopen-2012-001083.

18. Tezal M, Scannapieco FA, Wactawski J, Meurman JH, Marshall JR, Rojas IG, et al. Dental caries and head and neck cancers. JAMA Otolaryngol Head Neck Surg. 2013; 139:1054–1060.

19. Virtanen E, Söder B, Andersson LC, Meurman JH, Söder PÖ. History of dental infections associates with cancer in periodontally healthy subjects: a 24-year follow-up study from Sweden. J Cancer. 2014; 5:79–85.

20. Ministry of Health and Welfare. 2015 Korean National Health and Nutrition Examination Survey. Seoul: Ministry of Health and Welfare;2015. p. 36.

21. Misaki T, Naka S, Hatakeyama R, Fukunaga A, Nomura R, Isozaki T, et al. Presence of Streptococcus mutans strains harbouring the cnm gene correlates with dental caries status and IgA nephropathy conditions. Sci Rep. 2016; 11. 04. [Epub]. DOI: 10.1038/srep36455.

22. Linden GJ, Lyons A, Scannapieco FA. Periodontal systemic associations: review of the evidence. J Clin Periodontol. 2013; 40:Suppl 14. S8–S19.

23. Tezal M, Grossi SG, Genco RJ. Is periodontitis associated with oral neoplasms? J Periodontol. 2005; 76:406–410.

24. Hujoel PP, Drangsholt M, Spiekerman C, Weiss NS. An exploration of the periodontitis-cancer association. Ann Epidemiol. 2003; 13:312–316.

25. Talamini R, Vaccarella S, Barbone F, Tavani A, La Vecchia C, Herrero R, et al. Oral hygiene, dentition, sexual habits and risk of oral cancer. Br J Cancer. 2000; 83:1238–1242.

26. Watabe K, Nishi M, Miyake H, Hirata K. Lifestyle and gastric cancer: a case-contrl study. Oncol Rep. 1998; 5:1191–1194.

27. Hiraki A, Matsuo K, Suzuki T, Kawase T, Tajima K. Teeth loss and risk of cancer at 14 common sites in Japanese. Cancer Epidemiol Biomarkers Prev. 2008; 17:1222–1227.