Is Periodontal Disease Associated With Oral Neoplasm?

Infections have been suggested in the etiology of oral neoplasm. Objectives: Evaluate associations between periodontal disease and non-specific tumor as well as pre-cancerous lesions in the mouth. Methods: 13,798 subjects of the Third National Health and Nutrition Examination Survey (NHANES III) aged 20 years or older and who have at least 6 natural teeth were analyzed cross-sectionally. Periodontal disease was represented by clinical attachment loss (CAL) and was dichotomized as: <1.5 mm., and >=1.5 mm. according to the distribution of CAL in the NHANES III population. As outcome variables, non-specific tumor and pre-cancerous lesions (erythroplakia, leukoplakia, smokeless tobacco associated lesion, and non-specific ulcer) were used. As a third outcome variable, the presence of any oral soft tissue lesion was employed. Weighed multiple logistic regression analyses controlling for smoking, alcohol intake, age, gender, race, education, income and number of dental visits were used to estimate the effect sizes. Results: . CAL was significantly related to the frequency of non-specific tumor (OR: 2.88, 95% CI: 1.46 - 5.67) and pre-cancerous lesions (OR: 1.66, 95% CI: 1.12 – 2.46) independent of the effects of known risk factors of oral neoplasm. CAL was not significantly related to the presence of any oral lesion (OR: 1.17, 95% CI: 0.99 – 1.40). Conclusion: These results suggest an association between periodontal disease and oral neoplasm. Prospective or retrospective cohort studies are needed to confirm this relationship, establish its temporality and ultimately understand its biological mechanism.