title: Association between oral health and gastric precancerous lesions.
abstract: Although recent studies have suggested that tooth loss is positively related to the risk of gastric non-cardia cancer, the underlying oral health conditions potentially responsible for the association remain unknown. We investigated whether clinical and behavioral measures of oral health are associated with the risk of gastric precancerous lesions. We conducted a cross-sectional study of 131 patients undergoing upper gastrointestinal endoscopy. Cases were defined as those with gastric precancerous lesions including intestinal metaplasia or chronic atrophic gastritis on the basis of standard biopsy review. A validated structured questionnaire was administered to obtain information on oral health behaviors. A comprehensive clinical oral health examination was performed on a subset of 91 patients to evaluate for periodontal disease and dental caries experience. A total of 41 (31%) cases of gastric precancerous lesions were identified. Compared with non-cases, cases were significantly more likely to not floss their teeth [odds ratio (OR) = 2.89, 95% confidence interval (CI): 1.09-7.64], adjusting for age, sex, race, body mass index, smoking status, educational attainment and Helicobacter pylori status in serum. Among participants who completed the oral examination, cases (n = 28) were more likely to have a higher percentage of sites with gingival bleeding than non-cases [OR = 2.63, 95% CI: 1.37-5.05 for a standard deviation increase in bleeding sites (equivalent to 19.7%)], independent of potential confounders. Our findings demonstrate that specific oral health conditions and behaviors such as gingival bleeding and tooth flossing are associated with gastric precancerous lesions.
authors.affiliation: Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY 10003, USA.
authors.forename: Christian R
authors.initials: CR
authors.lastname: Salazar
authors.forename: Fritz
authors.initials: F
authors.lastname: Francois
authors.forename: Yihong
authors.initials: Y
authors.lastname: Li
authors.forename: Patricia
authors.initials: P
authors.lastname: Corby
authors.forename: Rosemary
authors.initials: R
authors.lastname: Hays
authors.forename: Celine
authors.initials: C
authors.lastname: Leung
authors.forename: Sukhleen
authors.initials: S
authors.lastname: Bedi
authors.forename: Stephanie
authors.initials: S
authors.lastname: Segers
authors.forename: Erica
authors.initials: E
authors.lastname: Queiroz
authors.forename: Jinghua
authors.initials: J
authors.lastname: Sun
authors.forename: Beverly
authors.initials: B
authors.lastname: Wang
authors.forename: Hao
authors.initials: H
authors.lastname: Ho
authors.forename: Ronald
authors.initials: R
authors.lastname: Craig
authors.forename: Gustavo D
authors.initials: GD
authors.lastname: Cruz
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Blaser
authors.forename: Guillermo
authors.initials: G
authors.lastname: Perez-Perez
authors.forename: Richard B
authors.initials: RB
authors.lastname: Hayes
authors.forename: Ananda
authors.initials: A
authors.lastname: Dasanayake
authors.forename: Zhiheng
authors.initials: Z
authors.lastname: Pei
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
mesh_terms: D001706:Biopsy / Q000379:methods; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000150:complications*; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005757:Gastritis, Atrophic / Q000150:complications; D015438:Health Behavior; D016481:Helicobacter Infections / Q000150:complications; D006801:Humans; D008297:Male; D008679:Metaplasia / Q000150:complications; D008875:Middle Aged; D016017:Odds Ratio; D009909:Oral Health; D011230:Precancerous Conditions / Q000473:pathology*; D012307:Risk Factors; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000473:pathology*; D011795:Surveys and Questionnaires