dentalssale A multinational investigation has unearthed substantial correlations between dental well-being and the survival rates of individuals afflicted with head and neck malignancies. Improved oral hygiene, as assessed through the count of natural teeth and dental consultations preceding diagnosis, exhibited an association with heightened survival prospects.
Notably, those who adhered to more frequent dental appointments displayed an elevated likelihood of having their malignancy detected at an earlier stage, rendering it less fatal than those who made infrequent or no dental visits.
Published on September 19, 2023, in the Journal of the National Cancer Institute, this study was conducted by a team of researchers from the UNC Lineberger Comprehensive Cancer Center and UNC Adams School of Dentistry in Chapel Hill, North Carolina, in collaboration with the Moffitt Cancer Center in Tampa, Florida, working alongside the International Head and Neck Cancer Epidemiology (INHANCE) consortium.
Jason Tasoulas MD, DMD, a current PhD candidate and the lead author of the study, commented, “The extensive patient data from the INHANCE consortium enabled us to conduct a meticulous investigation, revealing robust connections between oral health and survival. We assembled a diverse and seasoned team to scrutinize the records of approximately 2,500 patients hailing from eight different countries, employing cutting-edge statistical analyses.”
Head and neck cancer patients were tasked with self-reporting facets of their oral hygiene and health, encompassing indicators like gum bleeding, frequency of tooth brushing, utilization of mouthwash, and the number of natural teeth present, along with the frequency of dental visits, all documented over a ten-year span leading up to their cancer diagnosis.
Those who maintained frequent dental check-ups (exceeding five visits over a decade) showcased superior overall survival rates at both the five-year mark (74 percent) and the ten-year mark (60 percent), in contrast to individuals who had no dental visits (with survival rates of 54 percent at five years and 32 percent at ten years).
This discovery was particularly pronounced among those afflicted with oropharyngeal cancers, encompassing the anatomical structures located in the rear of the throat, such as the base of the tongue, tonsils, and soft palate. The absence of natural teeth correlated with a 15 percent reduction in five-year overall survival when compared to those possessing more than 20 natural teeth.
Survival differentials of less than 5 percent, which were statistically insignificant, were observed for patient-reported gum bleeding, tooth brushing, and mouthwash utilization.
While advancements in treatment have led to improved survival rates over the past decades, head and neck squamous cell carcinoma (HNSCC) remains the sixth most prevalent malignancy worldwide, accounting for approximately 4 percent of all cancer cases in the United States. In 2023, an estimated 66,920 individuals in the U.S. are anticipated to receive a diagnosis of this condition. Primary environmental risk factors for HNSCC include tobacco use, but increased alcohol consumption and testing positive for the human papillomavirus also heighten the risk.
The present research initiative capitalizes on earlier data collection endeavors by a North Carolina-based team through the Carolina Head and Neck Cancer Epidemiology (CHANCE) study, with the aim of exploring the role of oral health in patients diagnosed with head and neck squamous cell carcinoma. The current report constitutes a more comprehensive study, accounting for geographical variations and encompassing a broader spectrum of oral health variables, as explained by Kimon Divaris, DDS, PhD, a study author and James Bawden Distinguished Professor at the UNC Adams School of Dentistry and UNC Gillings School of Global Public Health.
Antonio L Amelio, PhD, the corresponding author, who serves as vice chair of research in the Head and Neck Oncology Department and is an associate member of the Tumor Biology Department at Moffitt Cancer Center, in addition to being an adjunct associate professor at the UNC Department of Otolaryngology-Head and Neck Surgery, remarked, “Inspired by Dr. Divaris’ prior work, we actively sought collaboration with a vast network of epidemiologists, surgeons, physicians, dentists, and scientists from across the globe to address an issue of considerable significance but often overshadowed, pertaining to patients afflicted with head and neck squamous cell carcinoma.”
He added, “We aspire to see these findings incorporated as standard components in guidelines aimed at preventing and managing head and neck squamous cell carcinomas in the near future.” Carole Fakhry, MD, MPH, the Charles W. Cummings MD Professor of Otolaryngology at Johns Hopkins School of Medicine, who was not involved in the research, described the findings as momentous.
“This is a pivotal study that underscores the intricate relationship between oral health, head and neck squamous cell carcinoma, and overall survival. While we search for biomarkers to prognosticate favorable outcomes for patients, this study highlights historical and clinical features associated with survival. Furthermore, it may pave the way for preventive measures against these forms of cancer.”
