Association between oral health and gastric precancerous lesions

Christian R. Salazar1,2, Fritz Francois3,4, Yihong Li5, Patricia Corby6, Rosemary Hays7, Celine Leung8, Sukhleen Bedi8, Stephanie Segers8, Erica Queiroz9, Jinghua Sun5, Beverly Wang10, Hao Ho10, Ronald Craig5,6, Gustavo D. Cruz1, Martin J. Blaser3,11, Guillermo Perez-Perez3,11, Richard B. Hayes4,8, Ananda Dasanayake1, Zhiheng Pei3,10 and Yu Chen3,4,8,* 1Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY 10003, USA 2Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA 3Department of Medicine 4New York University Cancer Institute, New York University School of Medicine, New York, NY 10016, USA 5Department of Basic Science and Craniofacial Biology 6Department of Periodontology and Implant Dentistry 7Department of Dental Hygiene, New York University College of Dentistry, New York, NY 10010, USA 8Division of Epidemiology, Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA 9Bluestone Center for Clinical Research, New York University College of Dentistry, New York, NY 10010, USA 10Department of Pathology 11Department of Microbiology, New York University School of Medicine, New York, NY 10016, USA ↵*To whom correspondence should be addressed. Tel: +1 212 263 4839; Fax: +1 212 263 8570; Email: yu.chen{at}nyumc.org Received September 15, 2011. Revision received November 18, 2011. Accepted November 25, 2011. Abstract Although recent studies have suggested that tooth loss is positively related to the risk of gastric non-cardia cancer, the underlying oral health conditions potentially responsible for the association remain unknown. We investigated whether clinical and behavioral measures of oral health are associated with the risk of gastric precancerous lesions. We conducted a cross-sectional study of 131 patients undergoing upper gastrointestinal endoscopy. Cases were defined as those with gastric precancerous lesions including intestinal metaplasia or chronic atrophic gastritis on the basis of standard biopsy review. A validated structured questionnaire was administered to obtain information on oral health behaviors. A comprehensive clinical oral health examination was performed on a subset of 91 patients to evaluate for periodontal disease and dental caries experience. A total of 41 (31%) cases of gastric precancerous lesions were identified. Compared with non-cases, cases were significantly more likely to not floss their teeth [odds ratio (OR) = 2.89, 95% confidence interval (CI): 1.09–7.64], adjusting for age, sex, race, body mass index, smoking status, educational attainment and Helicobacter pylori status in serum. Among participants who completed the oral examination, cases (n = 28) were more likely to have a higher percentage of sites with gingival bleeding than non-cases [OR = 2.63, 95% CI: 1.37–5.05 for a standard deviation increase in bleeding sites (equivalent to 19.7%)], independent of potential confounders. Our findings demonstrate that specific oral health conditions and behaviors such as gingival bleeding and tooth flossing are associated with gastric precancerous lesions.

Abbreviations CI confidence interval OR odds ratio © The Author 2011. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com « Previous | Next Article » Table of Contents This Article Carcinogenesis (2012) 33 (2): 399-403. doi: 10.1093/carcin/bgr284 First published online: December 1, 2011 » AbstractFree Full Text (HTML) Full Text (PDF) Supplementary Data All Versions of this Article: bgr284v1 bgr284v2 33/2/399 most recent Classifications INFLAMMATION, MICROENVIRONMENT AND PREVENTION Services Alert me when cited Alert me if corrected Find similar articles Similar articles in Web of Science Similar articles in PubMed Add to my archive Download citation Request Permissions Citing Articles Load citing article information Citing articles via CrossRef Citing articles via Scopus Citing articles via Web of Science Google Scholar Articles by Salazar, C. R. Articles by Chen, Y. PubMed PubMed citation Articles by Salazar, C. R. Articles by Chen, Y. Related Content Load related web page information Share Email this article CiteULike Connotea Delicious Facebook Google+ Mendeley Twitter What's this?

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