title: Periodontal disease and mouthwash use are risk factors for head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  The purpose of this study was to examine associations between oral hygiene, including history of periodontal disease and mouthwash use, and risk of head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  We measured history of oral hygiene and dental care on 513 HNSCC cases and 567 controls from a population-based study of HNSCC. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CI).
  
  
  RESULTS
  Periodontal disease was associated with a slightly elevated risk of HNSCC (OR = 1.09, 95% CI: 1.02, 1.16). Using any type of mouthwash at least once per day was associated with increased risk compared to never using mouthwash (OR = 1.11, 95% CI: 1.02, 1.20). HNSCC was associated with frequent use of non-alcoholic mouthwash compared to using any kind of mouthwash rarely or never (OR = 1.24, 95% CI: 1.05, 1.47).
  
  
  CONCLUSIONS
  Our results support an association between periodontal disease and HNSCC. Our data suggest that mouthwash use is associated with HNSCC, but we noted no difference between the effects of alcohol-containing and non-alcoholic mouthwashes.
authors.affiliation: Department of Epidemiology, Brown University, Providence, RI 02912, USA. melissa_eliot@brown.edu
authors.forename: Melissa N
authors.initials: MN
authors.lastname: Eliot
authors.forename: Dominique S
authors.initials: DS
authors.lastname: Michaud
authors.forename: Scott M
authors.initials: SM
authors.lastname: Langevin
authors.forename: Michael D
authors.initials: MD
authors.lastname: McClean
authors.forename: Karl T
authors.initials: KT
authors.lastname: Kelsey
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D016001:Confidence Intervals; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000009:adverse effects*; D009910:Oral Hygiene; D010510:Periodontal Diseases / Q000150:complications* / Q000473:pathology; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D009067:Mouthwashes