Skip to main content

Advertisement

SpringerLink
Log in

A review of the relationship between tooth loss, periodontal disease, and cancer

  • Review Article
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Recent studies have investigated the association between periodontal disease, tooth loss, and several systemic diseases including cancer, cardiovascular disease, and preterm birth. Periodontal disease, a chronic inflammatory condition, is highly prevalent in adult populations around the world, and may be preventable. Estimates of prevalence vary between races and geographic regions, with a marked increase in the occurrence of periodontal disease with advancing age. Worldwide estimates for the prevalence of severe periodontal disease generally range from 10 to 15%. The relationship between oral health and cancer has been examined for a number of specific cancer sites. Several studies have reported associations between periodontal disease or tooth loss and risk of oral, upper gastrointestinal, lung, and pancreatic cancer in different populations. In a number of studies, these associations persisted after adjustment for major risk factors, including cigarette smoking and socioeconomic status. This review provides a summary of these findings, discusses possible biological mechanisms involved, and raises methodological issues related to studying these relationships.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Papapanou PN (1996) Periodontal diseases: epidemiology. Ann Periodontol 1:1–36

    PubMed  CAS  Google Scholar 

  2. Irfan UM, Dawson DV, Bissada NF (2001) Epidemiology of periodontal disease: a review and clinical perspectives. J Int Acad Periodontol 3:14–21

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  4. Borrell LN, Burt BA, Taylor GW (2005) Prevalence and trends in periodontitis in the USA: from the NHANES III to the NHANES, 1988 to 2000. J Dent Res 84:924–930

    PubMed  CAS  Google Scholar 

  5. Pihlstrom BL, Michalowicz BS, Johnson NW (2005) Periodontal diseases. Lancet 366:1809–1820

    Article  PubMed  Google Scholar 

  6. Genco RJ, Grossi SG, Ho A, Nishimura F, Murayama Y (2005) A proposed model linking inflammation to obesity, diabetes, and periodontal infections. J Periodontol 76:2075–2084

    Article  PubMed  Google Scholar 

  7. Michalowicz BS, Diehl SR, Gunsolley JC et al (2000) Evidence of a substantial genetic basis for risk of adult periodontitis. J Periodontol 71:1699–1707

    Article  PubMed  CAS  Google Scholar 

  8. Oringer RJ (2002) Modulation of the host response in periodontal therapy. J Periodontol 73:460–470

    Article  PubMed  Google Scholar 

  9. Slots J, Saygun I, Sabeti M, Kubar A (2006) Epstein-Barr virus in oral diseases. J Periodontal Res 41:235–244

    Article  PubMed  CAS  Google Scholar 

  10. Saygun I, Kubar A, Ozdemir A, Slots J (2005) Periodontitis lesions are a source of salivary cytomegalovirus and Epstein-Barr virus. J Periodontal Res 40:187–191

    Article  PubMed  Google Scholar 

  11. Moutsopoulos NM, Madianos PN (2006) Low-grade inflammation in chronic infectious diseases: paradigm of periodontal infections. Ann N Y Acad Sci 1088:251–264

    Article  PubMed  CAS  Google Scholar 

  12. Gibson FC, Yumoto H, Takahashi Y, Chou HH, Genco CA (2006) Innate immune signaling and Porphyromonas gingivalis-accelerated atherosclerosis. J Dent Res 85:106–121

    PubMed  CAS  Google Scholar 

  13. Wactawski-Wende J (2001) Periodontal diseases and osteoporosis: association and mechanisms. Ann Periodontol 6:197–208

    Article  PubMed  CAS  Google Scholar 

  14. Taylor JJ, Preshaw PM, Donaldson PT (2004) Cytokine gene polymorphism and immunoregulation in periodontal disease. Periodontol 2000 35:158–182

    Article  PubMed  Google Scholar 

  15. Salvi GE, Brown CE, Fujihashi K et al (1998) Inflammatory mediators of the terminal dentition in adult and early onset periodontitis. J Periodontal Res 33:212–225

    Article  PubMed  CAS  Google Scholar 

  16. Joshipura KJ, Wand HC, Merchant AT, Rimm EB (2004) Periodontal disease and biomarkers related to cardiovascular disease. J Dent Res 83:151–155

    Article  PubMed  CAS  Google Scholar 

  17. Emingil G, Tervahartiala T, Mantyla P, Maatta M, Sorsa T, Atilla G (2006) Gingival crevicular fluid matrix metalloproteinase (MMP)-7, extracellular MMP inducer, and tissue inhibitor of MMP-1 levels in periodontal disease. J Periodontol 77:2040–2050

    Article  PubMed  CAS  Google Scholar 

  18. Haraszthy VI, Zambon JJ, Trevisan M, Zeid M, Genco RJ (2000) Identification of periodontal pathogens in atheromatous plaques. J Periodontol 71:1554–1560

    Article  PubMed  CAS  Google Scholar 

  19. Southerland JH, Taylor GW, Moss K, Beck JD, Offenbacher S (2006) Commonality in chronic inflammatory diseases: periodontitis, diabetes, and coronary artery disease. Periodontol 2000 40:130–143

    Article  PubMed  Google Scholar 

  20. Teng YT, Taylor GW, Scannapieco F et al (2002) Periodontal health and systemic disorders. J Can Dent Assoc 68:188–192

    PubMed  Google Scholar 

  21. Scannapieco FA, Ho AW (2001) Potential associations between chronic respiratory disease and periodontal disease: analysis of National Health and Nutrition Examination Survey III. J Periodontol 72:50–56

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  24. Abnet CC, Qiao YL, Mark SD, Dong ZW, Taylor PR, Dawsey SM (2001) Prospective study of tooth loss and incident esophageal and gastric cancers in China. Cancer Causes Control 12:847–854

    Article  PubMed  CAS  Google Scholar 

  25. Abnet CC, Qiao YL, Dawsey SM, Dong ZW, Taylor PR, Mark SD (2005) Tooth loss is associated with increased risk of total death and death from upper gastrointestinal cancer, heart disease, and stroke in a Chinese population-based cohort. Int J Epidemiol 34:467–474

    Article  PubMed  Google Scholar 

  26. Velly AM, Franco EL, Schlecht N et al (1998) Relationship between dental factors and risk of upper aerodigestive tract cancer. Oral Oncol 34:284–291

    PubMed  CAS  Google Scholar 

  27. Rosenquist K, Wennerberg J, Schildt EB, Bladstrom A, Goran Hansson B, Andersson G (2005) Oral status, oral infections and some lifestyle factors as risk factors for oral and oropharyngeal squamous cell carcinoma. A population-based case–control study in southern Sweden. Acta Otolaryngol 125:1327–1336

    Article  PubMed  Google Scholar 

  28. Cabrera C, Hakeberg M, Ahlqwist M et al (2005) Can the relation between tooth loss and chronic disease be explained by socio-economic status? A 24-year follow-up from the population study of women in Gothenburg, Sweden. Eur J Epidemiol 20:229–236

    Article  PubMed  Google Scholar 

  29. McCaul LK, Jenkins WM, Kay EJ (2001) The reasons for extraction of permanent teeth in Scotland: a 15-year follow-up study. Br Dent J 190:658–662

    Article  PubMed  CAS  Google Scholar 

  30. Martin HE, Pflueger OH (1935) Cancer of the cheek (buccal mucosa). Arch Surg 30:731–747

    Google Scholar 

  31. Zheng TZ, Boyle P, Hu HF et al (1990) Dentition, oral hygiene, and risk of oral cancer: a case–control study in Beijing, People’s Republic of China. Cancer Causes Control 1:235–241

    Article  PubMed  CAS  Google Scholar 

  32. Graham S, Dayal H, Rohrer T et al (1977) Dentition, diet, tobacco, and alcohol in the epidemiology of oral cancer. J Natl Cancer Inst 59:1611–1618

    PubMed  CAS  Google Scholar 

  33. Marshall JR, Graham S, Haughey BP et al (1992) Smoking, alcohol, dentition and diet in the epidemiology of oral cancer. Eur J Cancer B Oral Oncol 28B: 9–15

    Article  PubMed  CAS  Google Scholar 

  34. Ringstrom E, Peters E, Hasegawa M, Posner M, Liu M, Kelsey KT (2002) Human papillomavirus type 16 and squamous cell carcinoma of the head and neck. Clin Cancer Res 8:3187–3192

    PubMed  Google Scholar 

  35. Hansson BG, Rosenquist K, Antonsson A et al (2005) Strong association between infection with human papillomavirus and oral and oropharyngeal squamous cell carcinoma: a population-based case–control study in southern Sweden. Acta Otolaryngol 125:1337–1344

    Article  PubMed  Google Scholar 

  36. Bundgaard T, Wildt J, Frydenberg M, Elbrond O, Nielsen JE (1995) Case–control study of squamous cell cancer of the oral cavity in Denmark. Cancer Causes Control 6:57–67

    Article  PubMed  CAS  Google Scholar 

  37. Garrote LF, Herrero R, Reyes RM et al (2001) Risk factors for cancer of the oral cavity and oro-pharynx in Cuba. Br J Cancer 85:46–54

    Article  PubMed  CAS  Google Scholar 

  38. Talamini R, Vaccarella S, Barbone F et al (2000) Oral hygiene, dentition, sexual habits and risk of oral cancer. Br J Cancer 83:1238–1242

    Article  PubMed  CAS  Google Scholar 

  39. Furniss CS, McClean MD, Smith JF et al (2007) Human papillomavirus 16 and head and neck squamous cell carcinoma. Int J Cancer 120:2386–2392

    Article  PubMed  CAS  Google Scholar 

  40. Abnet CC, Kamangar F, Dawsey SM et al (2005) Tooth loss is associated with increased risk of gastric non-cardia adenocarcinoma in a cohort of Finnish smokers. Scand J Gastroenterol 40:681–687

    Article  PubMed  Google Scholar 

  41. Watabe K, Nishi M, Miyake H, Hirata K (1998) Lifestyle and gastric cancer: a case–control study. Oncol Rep 5:1191–1194

    PubMed  CAS  Google Scholar 

  42. Wolff G, Lauter J (1976) [On epidemiology of gastric cancer (author’s transl)]. Arch Geschwulstforsch 46:1–14

    PubMed  CAS  Google Scholar 

  43. Demirer T, Icli F, Uzunalimoglu O, Kucuk O (1990) Diet and stomach cancer incidence. A case–control study in Turkey. Cancer 65:2344–2348

    Article  PubMed  CAS  Google Scholar 

  44. Tu YK, Galobardes B, Smith GD, McCarron P, Jeffreys M, Gilthorpe MS (2007) Associations between tooth loss and mortality patterns in the Glasgow Alumni Cohort. Heart 93:1098–1103

    Article  PubMed  Google Scholar 

  45. Joshipura KJ, Ritchie C (2005) Can the relation between tooth loss and chronic disease be explained by socio-economic status? Eur J Epidemiol 20:203–204

    Article  PubMed  Google Scholar 

  46. Tomar SL, Asma S (2000) Smoking-attributable periodontitis in the United States: findings from NHANES III. National Health and Nutrition Examination Survey. J Periodontol 71:743–751

    Article  PubMed  CAS  Google Scholar 

  47. Bergstrom J (2004) Tobacco smoking and chronic destructive periodontal disease. Odontology 92:1–8

    Article  PubMed  CAS  Google Scholar 

  48. Alberg AJ, Samet JM (2003) Epidemiology of lung cancer. Chest 123:21S–49S

    Article  PubMed  Google Scholar 

  49. Hujoel PP, Drangsholt M, Spiekerman C, DeRouen TA (2002) Periodontitis-systemic disease associations in the presence of smoking–causal or coincidental? Periodontol 2000 30:51–60

    Article  PubMed  CAS  Google Scholar 

  50. Department of Health, Human Services (2004) The Health Consequences of Smoking: A Report of the Surgeon General. Dept. of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA

  51. Michaud DS (2004) Epidemiology of pancreatic cancer. Minerva Chir 59:99–111

    PubMed  CAS  Google Scholar 

  52. Hung HC, Colditz G, Joshipura KJ (2005) The association between tooth loss and the self-reported intake of selected CVD-related nutrients and foods among US women. Community Dent Oral Epidemiol 33:167–173

    Article  PubMed  Google Scholar 

  53. Kuriki K, Hirose K, Tajima K (2007) Diabetes and cancer risk for all and specific sites among Japanese men and women. Eur J Cancer Prev 16:83–89

    Article  PubMed  Google Scholar 

  54. Jee SH, Ohrr H, Sull JW, Yun JE, Ji M, Samet JM (2005) Fasting serum glucose level and cancer risk in Korean men and women. JAMA 293:194–202

    Article  PubMed  CAS  Google Scholar 

  55. Inoue M, Iwasaki M, Otani T, Sasazuki S, Noda M, Tsugane S (2006) Diabetes mellitus and the risk of cancer: results from a large-scale population-based cohort study in Japan. Arch Intern Med 166:1871–1877

    Article  PubMed  Google Scholar 

  56. Coussens LM, Werb Z (2002) Inflammation and cancer. Nature 420:860–867

    Article  PubMed  CAS  Google Scholar 

  57. van Kempen LC, de Visser KE, Coussens LM (2006) Inflammation, proteases and cancer. Eur J Cancer 42:728–734

    Article  PubMed  CAS  Google Scholar 

  58. Karin M, Lawrence T, Nizet V (2006) Innate immunity gone awry: linking microbial infections to chronic inflammation and cancer. Cell 124:823–835

    Article  PubMed  CAS  Google Scholar 

  59. Loos BG (2005) Systemic markers of inflammation in periodontitis. J Periodontol 76:2106–2115

    Article  PubMed  Google Scholar 

  60. Nair J, Ohshima H, Nair UJ, Bartsch H (1996) Endogenous formation of nitrosamines and oxidative DNA-damaging agents in tobacco users. Crit Rev Toxicol 26:149–161

    Article  PubMed  CAS  Google Scholar 

  61. Shapiro KB, Hotchkiss JH, Roe DA (1991) Quantitative relationship between oral nitrate-reducing activity and the endogenous formation of N-nitrosoamino acids in humans. Food Chem Toxicol 29:751–755

    Article  PubMed  CAS  Google Scholar 

  62. Risch HA (2003) Etiology of pancreatic cancer, with a hypothesis concerning the role of N-nitroso compounds and excess gastric acidity. J Natl Cancer Inst 95:948–960

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Financial Support: This work was supported by grant T32 CA 09001 from the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Harvard School of Public Health, Kresge Building, 677 Huntington Avenue, Boston, MA, 02115, USA

    Mara S. Meyer, Kaumudi Joshipura, Edward Giovannucci & Dominique S. Michaud

  2. School of Dentistry, University of Puerto Rico, Medical Sciences Campus, San Jan, Puerto Rico

    Kaumudi Joshipura

  3. Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA

    Kaumudi Joshipura

  4. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA

    Edward Giovannucci

  5. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Edward Giovannucci

  6. Department of Epidemiology and Public Health, Imperial College, London, UK

    Dominique S. Michaud

Authors
  1. Mara S. Meyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kaumudi Joshipura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Edward Giovannucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dominique S. Michaud
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mara S. Meyer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Meyer, M.S., Joshipura, K., Giovannucci, E. et al. A review of the relationship between tooth loss, periodontal disease, and cancer. Cancer Causes Control 19, 895–907 (2008). https://doi.org/10.1007/s10552-008-9163-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-008-9163-4

Keywords

Search

Navigation