Role of Poor Oral Hygiene in Causation of Oral Cancer-a Review of Literature

Abstract

Oral squamous cell carcinomas (OSCC) are among the commonest cancers in South East Asia and more so in the Indian subcontinent. The role of tobacco and alcohol in the causation of these cancers is well-documented. Poor oral hygiene (POH) is often seen to co-exist in patients with OSCC. However, the role of poor oral hygiene in the etio-pathogenesis of these cancers is controversial. We decided to evaluate the available literature for evaluating the association of POH with OSCC. A thorough literature search of English-language articles in MEDLINE, PubMed, Cochrane Database of Systematic Reviews, and Web of Science databases was conducted, and 93 relevant articles were short-listed. We found that POH was strongly associated with oral cancers. It aids the carcinogenic potential of other known carcinogens like tobacco and alcohol. Even on adjusting for known confounding factors like tobacco, alcohol use, education, and socio-economic strata, presence of POH exhibits higher odds of developing oral cancer.

Keywords: Dental visits; Missing teeth; Mouth neoplasm; Oral cancer; Poor oral hygiene; Tooth brushing.

Fig. 1

Factors and mechanisms by which poor oral hygiene can cause oral carcinogenesis

Fig. 2

Mechanisms of carcinogenesis by Porphyromonas gingivalis in the presence of poor oral hygiene