Abstract
BackgroundObservational studies suggest an association between tooth loss and risk of head and neck cancer. However, whether tooth loss is an independent risk factor for head and neck cancer still remains controversial. The aim of this study is to assess the association between tooth loss and head and neck cancer risk.MethodsEligible studies were searched in PubMed and Embase databases from their inception to March 2013. A random-effects model or fixed-effects model was used to calculate the overall combined risk estimates.ResultsEight case-control studies and one cross-sectional study involving 5,204 patients and 5,518 controls were included in the meta-analysis. The overall combined odds ratio for tooth loss and head and neck cancer was 2.00 (95% confidence interval, 1.28–3.14). Similar results yielded both in the moderate and severe tooth loss group. Sensitivity analysis based on various exclusion criteria maintained this significance with respect to head and neck cancer individually. Little evidence of publication bias was observed.ConclusionThis meta-analysis suggests that tooth loss is associated with increased risk of head and neck cancer. This increase is probably independent of conventional head and neck cancer risk factors.
Highlights
Observational studies suggest an association between tooth loss and risk of head and neck cancer
The majority were excluded after reviewing titles and abstracts, mainly because they were reviews, letter, comment, or not relevant to our analysis, leaving 18 for full-text review
9 articles were excluded for the reasons as follows: three articles with unavailable data for analysis [16,17,20], and six articles not with #5 lost teeth as the referent category [6,13,14,15,18,19]
Summary
Observational studies suggest an association between tooth loss and risk of head and neck cancer. It is estimated that one out of 99 people born in the United States today will experience head and neck cancer during their lifetime [1]. It has been recognized as a significant component of the global burden of cancer [2,3,4]. Tobacco use and alcohol consumption have been well established as the predominant etiologic factors for head and neck cancer, with their population-attributable risk for head and neck cancer in the United States by 74% [5]. Other risk factors such as periodontal disease [6], Human papillomavirus (HPV) infections [7], oral hygiene and dental status [8,9], have been implicated in the etiology of head and neck cancer
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