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Original Article
May 2007

Chronic Periodontitis and the Risk of Tongue Cancer

Author Affiliations

Author Affiliations: Departments of Periodontics and Endodontics (Dr Tezal), Restorative Dentistry (Dr Sullivan), Social and Preventive Medicine (Drs Reid, Marshall, Hyland, and Wactawski-Wende), Surgery (Dr Loree), and Oral Biology (Dr Scannapieco), State University of New York at Buffalo; and Departments of Dentistry and Maxillofacial Prosthetics (Drs Tezal and Sullivan), Cancer Prevention and Control (Drs Reid and Marshall), Cancer Prevention and Population Sciences (Dr Hyland), Head and Neck Surgery (Dr Loree), and Tumor Registry (Mss Lillis and Hauck), Roswell Park Cancer Institute, Buffalo.

Arch Otolaryngol Head Neck Surg. 2007;133(5):450-454. doi:10.1001/archotol.133.5.450

Objective  To assess the association between the history of chronic periodontitis and the risk of tongue cancer.

Design  Case-control study using preexisting data from patients admitted between June 15, 1999, and November 17, 2005.

Setting  Department of Dentistry and Maxillofacial Prosthetics at Roswell Park Cancer Institute (RPCI), Buffalo, NY.

Patients  The cases comprised 51 non-Hispanic white men newly diagnosed as having primary squamous cell carcinoma of the tongue, and the controls, 54 non-Hispanic white men evaluated during the same period but with negative results for malignancy. Children (aged <21 years), edentulous or immunocompromised patients, and those with history of any cancer were excluded. History of periodontitis was assessed by alveolar bone loss measured from panoramic radiographs by 1 examiner blind to cancer status.

Main Outcome Measure  Incidence of tongue cancer obtained from the RPCI Tumor Registry.

Results  After adjusting for the effects of age at diagnosis, smoking status, and number of teeth, each millimeter of alveolar bone loss was associated with a 5.23-fold increase in the risk of tongue cancer (odds ratio, 5.23; 95% confidence interval, 2.64-10.35).

Conclusions  This study suggests an association between chronic periodontitis and the risk of tongue cancer in men, independent of smoking status, age, race, ethnicity, and number of teeth. This association needs to be confirmed by larger studies using quantitative assessment of lifetime tobacco exposure. If this association is confirmed, it has a potential impact on understanding the etiology of oral cancer as well as on its prevention and control.