title: Regular dental visits are associated with earlier stage at diagnosis for oral and pharyngeal cancer.
abstract: OBJECTIVE
  Oral and pharyngeal cancer patients diagnosed at an advanced stage experience increased morbidity and mortality relative to those with localized disease. The aim of this study was to assess the impact of dental insurance status and regularity of dental visits on early detection of oral and pharyngeal cancer.
  
  
  METHODS
  We examined the relationship of dental insurance and frequency of dental visits with stage at diagnosis among 441 oral and pharyngeal cancer cases from a population-based study of head and neck cancer. Ordinal logistic regression models were used to assess the association with stage, and tumor (T) and nodal (N) classification.
  
  
  RESULTS
  Never or rarely going to the dentist was associated with being diagnosed at higher stage for oral and pharyngeal cancer (cumulative OR = 2.28, 95 % CI: 1.02-5.10) and oral cancer (cumulative OR = 9.17, 95 % CI: 2.70-31.15) compared to those going to the dentist at least annually. Oral and pharyngeal cancer patients who went to the dentist infrequently (cumulative OR = 1.82, 95 % CI: 1.09-3.05) or rarely/never (cumulative OR = 3.24, 95 % CI: 1.59-6.57) were diagnosed with a higher T classification compared with those who went at least annually.
  
  
  CONCLUSIONS
  Receipt of regular dental examinations at least annually may reduce the public health burden of oral and pharyngeal cancer by facilitating earlier detection of the disease.
authors.affiliation: Department of Epidemiology, Brown University, 70 Ship Street, Box G-E5, Providence, RI 02912, USA.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Langevin
authors.forename: Dominique S
authors.initials: DS
authors.lastname: Michaud
authors.forename: Melissa
authors.initials: M
authors.lastname: Eliot
authors.forename: Edward S
authors.initials: ES
authors.lastname: Peters
authors.forename: Michael D
authors.initials: MD
authors.lastname: McClean
authors.forename: Karl T
authors.initials: KT
authors.lastname: Kelsey
mesh_terms: D003729:Dental Care / Q000191:economics / Q000379:methods* / Q000592:standards; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D007347:Insurance, Dental; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis*; D010610:Pharyngeal Neoplasms / Q000175:diagnosis*; D014481:United States