A composite oral hygiene score and the risk of oral cancer and its subtypes: a large-scale propensity score-based study

Risk Factors Associated with Oral Cancer: A Hospital-based Case-control Study in Telangana State, India

Introduction

The use of tobacco products and alcohol consumption are two of the main risk factors for cancer of the oral cavity. The contribution of other factors such as diet, genetic predisposition, oral hygiene, and demographic variables to the occurrence of oral cancer has been debatable. This study explored the association between different risk factors and the risk of oral cancer using propensity score methods.

Methodology

A case-control study was conducted in Hyderabad, Telangana state, India in cancer hospitals between October 2022 and July 2023. Direct interviews with 238 cases and 450 controls were used to gather information about the different risk factors using structured data collection forms. Chi-square tests and multivariable logistic regression along with computation of propensity scores and inverse probability of treatment weighting for odds ratios (ORs) with weighted logistic regression were conducted using R version 4.3.2.

Results

Bivariate analysis found a significant difference in tobacco use, duration of use, frequency of alcohol consumption, and vegetable consumption between the cases and controls. Comparing cases of oral cancer to controls, the propensity weighed ORs were higher for those who had a habit of using smokeless tobacco (OR = 9.09, 95% confidence interval [CI]: 5.624-15.143) and smoking (OR = 8.96, 95% CI: 4.988-16.113) for more than 10 years. Oral cancer risk factors also included a history of chronic trauma in the mouth (OR = 3.00, 95% CI: 1.287-6.996) and daily alcohol consumption (OR = 5.69, 95% CI: 3.518-9.220).

Conclusion

This study establishes the role of tobacco use as a risk factor for oral cancer, with an emphasis on duration of use, and provides supporting evidence for the role of chronic oral trauma in oral cavity cancer.

Oral microbial dysbiosis in patients with oral cavity cancers

OBJECTIVES

The pathogenesis of oral cavity cancers is complex. We tested the hypothesis that oral microbiota dysbiosis is associated with oral cavity cancer.

MATERIALS AND METHODS

Patients with primary oral cavity cancer who met the inclusion and exclusion criteria were included in the study. Matching healthy individuals were recruited as controls. Data on socio-demographic and behavioral factors, self-reported periodontal measures and habits, and current dental status were collected using a structured questionnaire and periodontal chartings. In addition to self-reported oral health measures, each participant received a standard and detailed clinical examination. DNA was extracted from saliva samples from patients and healthy controls. Next-generation sequencing was performed by targeting V3-V4 gene regions of the 16 S rRNA with subsequent bioinformatic analyses.

RESULTS

Patients with oral cavity cancers had a lower quality of oral health than healthy controls. Proteobacteria, Aggregatibacter, Haemophilus, and Neisseria decreased, while Firmicutes, Bacteroidetes, Actinobacteria, Lactobacillus, Gemella, and Fusobacteria increased in oral cancer patients. At the species level, C. durum, L. umeaens, N. subflava, A. massiliensis, and V. dispar were significantly lower, while G. haemolysans was significantly increased (p < 0.05). Major periodontopathogens associated with periodontal disease (P. gingivalis and F.nucleatum) increased 6.5- and 2.8-fold, respectively.

CONCLUSION

These data suggested that patients with oral cancer had worse oral health conditions and a distinct oral microbiome composition that is affected by personal daily habits and may be associated with the pathogenicity of the disease and interspecies interactions.

CLINICAL RELEVANCE

This paper demonstrates the link between oral bacteria and oral cancers, identifying mechanistic interactions between species of oral microbiome.

The association between oral hygiene and head and neck cancer: a meta-analysis

OBJECTIVE

Oral hygiene has been suspected to contribute to the aetiology of head and neck cancer (HNC). Based on the meta-analysis, we evaluated the impact of oral hygiene on head and neck cancer (HNC) and its survival.

MATERIALS AND METHODS

Relevant case-control and cohort studies reporting survival data, oral hygiene data were searched via PubMed, Embase, Cochrane Library, and Web of Science databases. The odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs) were used. Subgroup analysis was performed.

RESULTS

Oral hygiene was associated with HNC. Tooth brushing ≥2 a day, dental floss use, denture wearing, caries ≥3, and dental visit ≥1 reduced the risk of oral cavity cancer while mouth wash use, missing teeth >5, gum bleeding, and periodontal disease increased the risk of oral cavity cancer. For oropharynx cancer, tooth brushing ≥2 and caries ≥3 were associated with reduced risk of it. Tooth brushing ≥2 and dental visits ≥1 decreased the risk of pharynx cancer risk and larynx cancer risk, however, missing teeth >5 increased both of them.

CONCLUSION

Oral hygiene was associated with HNC and its sub sites. Oral hygiene should be strengthened, a dental floss use and dentist's visits can be recommended.

Oral Cavity Squamous Cell Carcinoma Risk Factors: State of the Art

Head and neck (HN) squamous cell carcinomas (SCCs) originate from the epithelial cells of the mucosal linings of the upper aerodigestive tract, which includes the oral cavity, the pharynx, the larynx, and the sinonasal cavities. There are many associated risk factors, including alcohol drinking coupled with tobacco use, which accounts for 70% to 80% of HNSCCs. Human papilloma virus (HPV) is another independent risk factor for oropharyngeal SCC, but it is only a minor contributor to oral cavity SCC (OSCC). Betel quid chewing is also an established risk factor in southeast Asian countries. However, OSCC, and especially oral tongue cancer, incidence has been reported to be increasing in several countries, suggesting risk factors that have not been identified yet. This review summarizes the established risk factors for oral cavity squamous cell carcinomas and examines other undemonstrated risk factors for HNSCC.

Knowledge and Practices Regarding Oral Hygiene, Cariogenic Diet Intake, and Dental Check-Ups Among Registered Nurses in Nigeria: A Pilot Study

Objectives To investigate the knowledge and practices of registered nurses in Nigeria concerning oral hygiene, cariogenic diets, and dental check-ups through a pilot study.

Methods This study was an online survey of 129 registered nurses in Nigeria. Data were collected via the WhatsApp social media using an electronic questionnaire (Google form). Data analysis was done using the SPSS version 26 software (IBM Corp, New York, USA).

Results The response and completeness rates of this pilot study were 41.7% (129/311) and 96.9% 9125/129), respectively. The majority (62.2%) of the respondents were females. The majority (89.1%) had average/above average score on basic oral health knowledge; however, there was no significant relationship between their level of basic oral health knowledge and their sociodemographic characteristics (p > 0.05). The majority (66.7%) of the respondents brushed twice daily, 86.8% used a fluoridated toothpaste, and 60.5% changed their toothbrush every 3 months. Furthermore, more than half (55.8%) consumed sugary snack/drink on daily basis, while 55.0% rinsed their mouth with water immediately after taking sugary snack, and only 55.8% did floss their teeth. Among those who flossed their teeth, only 37.5% did it once daily. It is also striking that 26.4% of the respondents had never visited a dentist for a dental check-up.

Conclusion Study findings showed a high level of basic oral health knowledge and a lower level of appropriate oral self-care practices among nurses in Nigeria. However, there is a need for a nationally representative study of nurses in Nigeria to further establish these findings.

The Link between Stroke Risk and Orodental Status-A Comprehensive Review

One of the primary causes of disability and mortality in the adult population worldwide is stroke. A person's general health is significantly impacted by their oral and dental health. People who have poor oral health are more susceptible to conditions such as stroke. Stroke risk has long been linked to oral and dental conditions. The risk of stroke and its cost impact on the healthcare systems appear to be significantly reduced as a result of the decline in the incidence and prevalence of oral and dental illnesses. Hypothetically, better management of oral hygiene and dental health lead to reduced stroke risk. To the authors' best knowledge, for the first time, the potential link between dental health and stroke were cross-examined. The most typical stroke symptoms, oral and dental illnesses linked to stroke, and the role of oral healthcare professionals in stroke prevention are revealed. The potential mediating processes and subsequent long-term cognitive and functional neurological outcomes are based on the available literature. It must be noted that periodontal diseases and tooth loss are two common oral health measures. Lack of knowledge on the effects of poor oral health on systemic health together with limited access to primary medical or dental care are considered to be partially responsible for the elevated risk of stroke. Concrete evidence confirming the associations between oral inflammatory conditions and stroke in large cohort prospective studies, stratifying association between oral disease severity and stroke risk and disease effects on stroke survival will be desirable. In terms of clinical pathology, a predictive model of stroke as a function of oral health status, and biomarkers of systemic inflammation could be useful for both cardiologists and dentists.

Human Microbiota in Esophageal Adenocarcinoma: Pathogenesis, Diagnosis, Prognosis and Therapeutic Implications

Esophageal adenocarcinoma (EAC) is one of the main subtypes of esophageal cancer. The incidence rate of EAC increased progressively while the 5-year relative survival rates were poor in the past two decades. The mechanism of EAC has been studied extensively in relation to genetic factors, but less so with respect to human microbiota. Currently, researches about the relationship between EAC and the human microbiota is a newly emerging field of study. Herein, we present the current state of knowledge linking human microbiota to esophageal adenocarcinoma and its precursor lesion—gastroesophageal reflux disease and Barrett’s esophagus. There are specific human bacterial alternations in the process of esophageal carcinogenesis. And bacterial dysbiosis plays an important role in the process of esophageal carcinogenesis via inflammation, microbial metabolism and genotoxicity. Based on the human microbiota alternation in the EAC cascade, it provides potential microbiome-based clinical application. This review is focused on novel targets in prevention, diagnosis, prognosis, and therapy for esophageal adenocarcinoma.