title: Oral health and risk for head and neck squamous cell carcinoma: the Carolina Head and Neck Cancer Study.
abstract: OBJECTIVE
  Recent reports have linked oral health and periodontal disease indicators with increased risk of squamous cell carcinoma of head and neck (SCCHN). Thus far, evidence has been inconclusive; our objective was to study the association between oral health and SCCHN risk in the context of a large population-based study.
  
  
  METHODS
  A population-based case-control study of incident SCCHN, the Carolina Head and Neck Cancer Study was carried out in 2002-2006 in 46 counties in North Carolina. Controls (n = 1,361) were frequency matched with cases (n = 1,289) on age, race, and gender. Oral health was assessed using interview data on tooth loss and mobility, mouthwash use, and frequency of dental visits.
  
  
  RESULTS
  Subjects were 26-80 years old (median age = 61). The distribution of tooth loss among controls was 0-5 teeth = 60%; 5-14 = 15%; and 16-28 = 25%. After controlling for covariates, tooth loss did not yield any notable association with SCCHN (16-28 vs. 0-5 lost teeth: OR: 1.21, 95% CI: 0.94, 1.56). Self-reported history of tooth mobility was moderately associated with increased SCCHN risk (OR: 1.33, 95% CI: 1.07, 1.65); however, the association did not persist among never smokers. Routine dental visits were associated with 30% risk reduction (OR: 0.68, 95% CI: 0.53, 0.87).
  
  
  CONCLUSIONS
  These data provide support for a possible modest association of periodontal disease, as measured by self-reported tooth loss indicators, but not tooth loss per se, with SCCHN risk.
authors.affiliation: Department of Epidemiology, CB#7435, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, USA.
authors.forename: Kimon
authors.initials: K
authors.lastname: Divaris
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Olshan
authors.forename: Joanna
authors.initials: J
authors.lastname: Smith
authors.forename: Mary E
authors.initials: ME
authors.lastname: Bell
authors.forename: Mark C
authors.initials: MC
authors.lastname: Weissler
authors.forename: William K
authors.initials: WK
authors.lastname: Funkhouser
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Bradshaw
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology*; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D009909:Oral Health; D009910:Oral Hygiene; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking