Poor oral health may signal esophageal cancer risk

Individuals with impaired dental health are more likely to be diagnosed with esophageal cancer, with the odds similarly elevated for both histopathological subtypes, according to a study.

Researchers looked at 5,042,303 individuals from the Swedish Dental Health Register and identified 1,259 esophageal adenocarcinoma (EAC) and 758 esophageal squamous cell carcinoma (ESCC) cases. They examined the risk of cancer in relation to dental diagnoses classified as follows: healthy, caries, root canal infection, mild inflammation, and periodontitis, as well as number of remaining teeth, at baseline and during multiple visits.

The primary outcome was the incidence of esophageal cancer, which was further categorized into the EAC and ESCC subtypes. Multivariable Cox proportional hazards models revealed that poor dental health was associated with excess risks of both cancer subtypes.

Specifically, root canal infection at baseline conferred a 41-percent higher risk of EAC (hazard ratio [HR], 1.41, 95 percent confidence interval [CI], 1.10–1.82). Meanwhile, periodontitis at baseline contributed to 32-percent and 45-percent increase in the risks of EAC (HR, 1.32, 95 percent CI, 1.13–1.53) and ESCC (HR, 1.45, 95 percent CI, 1.20–1.75), respectively.

Fewer remaining teeth at baseline was also associated with higher risks of both esophageal cancer types, with a dose–response effect (p_trend<0.01).

Cox regression analyses with time-varying exposures yielded consistent results.