Poor Oral Health Is an Independent Risk Factor for Cancer-Causing Oral HPV Infection
Poor oral health, including gum disease and dental problems, is a newly recognized independent risk factor for oral human papillomavirus (HPV) infection, which causes between 40% and 80% of oropharyngeal cancers, according to a study published in Cancer Prevention Research. Researchers from the School of Public Health at the University of Texas Health Science Center at Houston examined the relationship between oral health and oral HPV infection and the interactive effects of oral health, smoking, and oral sex on oral HPV infection.
The researchers analyzed data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. The survey included a nationally representative sample of about 5,000 people. The researchers identified 3,439 participants aged 30 to 69, and examined data on their oral health and the presence or absence of 19 low-risk HPV types and 18 high-risk HPV types in the oral cavity. The data included four measures of oral health: self-rating of overall oral health, presence of gum disease, use of mouthwash to treat dental problems within the past week of the survey, and the number of teeth lost. Data on age, gender, marital status, and personal habits—including marijuana use, cigarette smoking, and oral sex habits, which can influence HPV infection—were also examined.
Study Findings
The researchers found that among the study participants, those who reported poor oral health had a 56% higher prevalence of oral HPV infection, and those who had gum disease and dental problems had a 51% and 28% higher prevalence of oral HPV infection, respectively. Being male, smoking, drinking alcohol, using marijuana, having lifetime experience of oral sex, and having multiple lifetime and past-year oral sex partners increased the likelihood of oral HPV infection.
“Previous studies have shown pretty consistently that heavy smokers are at greater risk for oral HPV, as are those with more lifetime experience with the number of partners for oral sex,” said Christine Markham, PhD, Associate Professor of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research at the University of Texas, Health Science Center at Houston, and a coauthor of the study. “The importance of this study is that even when we controlled for smoking status and past experience with oral sex, those known risk factors, poor oral hygiene or poor oral health were still an independent risk factor for oral HPV infection.”
Although not confirmed by this study, Dr. Markham said a theory of why poor oral health contributes to an increased risk for oral HPV infection is that wounds in the mouth, inflamed gums, or ulcers may provide an entry portal into the basal cells of the epithelium and infect the body.
Modifying Behavior Can Reduce the Risk of Infection
Maintaining good oral health and hygiene, including daily flossing and brushing, and making regular visits to the dentist can reduce the risk of oral oncogenic HPV infection, said Dr. Markham. “These are modifiable behaviors and are things most people can do something about. This study shows additional evidence that not maintaining good oral hygiene and good oral health may increase the risk for HPV infection.”
The study authors reported no potential conflicts of interest. The study was funded by the UT Health Innovation for Cancer Prevention Research postdoctoral fellowship, CPRIT grant #RP101503.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
