Alveolar Bone Loss, Tooth Loss and Oral Cancer Mortality in Older Patients: A Retrospective Cohort Study

PURPOSE: There has been growing interest in the association between periodontitis and systemic disease. In recent years, however, inconsistent results have also been found by case–control studies for the role of periodontitis in the development of oral cancer. This study aimed to examine whether periodontitis was an independent risk factor for oral cancer with a ≥75-year age group cohort. MATERIALS AND METHODS: Between January 2010 and December 2014, 1385 patients aged ≥75 years who underwent radiographic examination were included in this retrospective cohort study. We collected demographic information and comorbid health conditions from local health authorities. Participants were followed up until either the occurrence of mortality, or the end of the study on December 31, 2018. Cox proportional hazards regression and competing risk hazard models were used to examine the association between periodontitis and oral cancer mortality. RESULTS: Periodontitis and loss of teeth were significantly associated with oral cancer mortality. Compared to oral cancer mortality in healthy subjects, the HR and 95% CI in patients with mild, moderate, and severe periodontitis were 4.46 (0.94–21.06), 5.16 (1.14–23.39), and 6.65 (1.51–29.36), respectively. The HR (95% CI) was 1.05 (1.01–1.09) for tooth loss after controlling for potential confounding factors. All the increases in risk persisted in patients aged ≥80 years. CONCLUSION: The present study provides substantial evidence that poor periodontal health is associated with oral cancer mortality. It is necessary to underline the importance of considering periodontitis in the prevention of oral cancer, particularly in the older patients.