title: Poor oral hygiene and risk of esophageal squamous cell carcinoma in Kashmir.
abstract: BACKGROUND
  Several studies have suggested an association between poor oral health and esophageal squamous cell carcinoma (ESCC). We conducted a case-control study in Kashmir, a region with relatively high incidence of ESCC in north India, to investigate the association between oral hygiene and ESCC risk.
  
  
  METHODS
  We recruited 703 histologically confirmed ESCC cases, and 1664 controls individually matched to the cases for age, sex, and district of residence. Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  We found an inverse association between teeth cleaning and ESCC risk. As compared with never cleaning teeth, the OR (95% CI) was 0.41 (0.28-0.62) for cleaning less than daily and 0.44 (0.25-0.77) for cleaning at least once a day (P for trend=0.026) in models adjusted for multiple potential confounders, including several indicators of socioeconomic status. This association persisted after we limited our analyses to never tobacco users. The inverse association between cleaning teeth and ESCC was stronger with using brushes than with using sticks/fingers. We also found an association between the number of decayed, filled, and missing teeth and ESCC risk, but the trend of the associations was not statistically significant. Avoiding solid food and cold beverages because of teeth and oral problems were also associated with ESCC risk.
  
  
  CONCLUSIONS
  We found an association between poor oral hygiene indicators and ESCC risk, supporting the previous studies that showed the same associations.
authors.affiliation: Department of Biochemistry, University of Kashmir, Hazratbal Srinagar, JK 190006, India. nazirramzan@gmail.com
authors.forename: N A
authors.initials: NA
authors.lastname: Dar
authors.forename: F
authors.initials: F
authors.lastname: Islami
authors.forename: G A
authors.initials: GA
authors.lastname: Bhat
authors.forename: I A
authors.initials: IA
authors.lastname: Shah
authors.forename: M A
authors.initials: MA
authors.lastname: Makhdoomi
authors.forename: B
authors.initials: B
authors.lastname: Iqbal
authors.forename: R
authors.initials: R
authors.lastname: Rafiq
authors.forename: M M
authors.initials: MM
authors.lastname: Lone
authors.forename: C C
authors.initials: CC
authors.lastname: Abnet
authors.forename: P
authors.initials: P
authors.lastname: Boffetta
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D016022:Case-Control Studies; D003731:Dental Caries / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000453:epidemiology*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009909:Oral Health; D009910:Oral Hygiene; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012923:Social Class; D012959:Socioeconomic Factors; D016388:Tooth Loss / Q000453:epidemiology
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