Poor oral health and tooth loss have been proposed as possible risk
factors for some chronic diseases, including gastric cancer. However only a
small number of studies have tested these associations.
We conducted a case-control study in Golestan Province, Iran, that
enrolled 309 cases diagnosed with gastric adenocarcinoma (118 noncardia, 161
cardia, and 30 mixed-locations) and 613 sex, age and neighborhood matched
controls. Data on oral health were obtained through physical examination and
questionnaire including tooth loss, the number of decayed, missing, and
filled teeth, and frequency of tooth brushing. Odds ratios (ORs) and
95% confidence intervals (95% CIs) were obtained using
conditional logistic regression models adjusted for potential confounders.
Standard one degree-of-freedom linear trend test and a multiple degree of
freedom global test of the effect of adding oral hygiene variables to the
model were also calculated.
Our results showed apparent associations between tooth loss and DMFT
score with risk of gastric cancer, overall and at each anatomic subsite.
However, these associations were not monotonic and were strongly confounded
by age. The results also showed that subjects who brushed their teeth less
than daily were at significantly higher risk for gastric cardia
adenocarcinoma OR (95% CI) of 5.6 (1.6–19.3).
We found evidence for an association between oral health and gastric
cancer, but the non- monotonic association, the relatively strong effect of
confounder adjustment, and inconsistent results across studies must temper
the strength of any conclusions.