Oral health in oral and oropharyngeal cancer patients at diagnosis

Background: Some oral health factors have been associated with a higher risk for head and neck cancers (HNCs) and most clearly the existing evidence refers to an association between periodontitis and HNC. Aims: To examine oral health in a subset of HNC patients, namely patients with oropharyngeal cancer (OPC) or oral cavity cancer (OCC), and to compare these two tumor sites in this regard. Subjects and Methods: A retrospective study consisting of a series of OPC and OCC patients diagnosed between 2005-2008 at the Helsinki University Hospital, Helsinki, Finland. Study subjects were randomly selected from hospital registries. Oral health at diagnosis was assessed by reviewing the corresponding panoramic radiographs. We used modified Total Dental Index (Mattila et al. 1989) to assess oral health as a whole. Results: In univariate analysis the difference in modified Total Dental Index (mean 3,49 ±0,20 for OPC vs. 2,85 ±0,22 for OCC) was statistically significant, but after adjusting for age, gender, smoking, and heavy alcohol consumption statistical significance was lost. When individual dental variables were considered, the only statistically significant difference in univariate analysis was found concerning residual roots (mean 0,60 ±0,21 for OPC vs. 0,19 ±0,15 for OCC). Conclusions: The present findings demonstrate a fairly poor oral health status among oral and oropharyngeal cancer patients. The observed prevalence of caries and periodontitis seems to be even more common than among the Finnish general population. Whether or not there are differences in oral health risk factors between OPC and OCC patients cannot be reliably established in this study. Further studies with larger sample sizes are needed to confirm our findings either way