Poor oral health is an independent risk factor of oral human papillomavirus infection regardless of smoking and oral sex practices, analysis of a large, nationally representative sample showed.
Poor oral health was associated with a 56% higher prevalence of oral HPV infection in 3,439 study participants aged 30-69 years, Thanh Cong Bui, Dr.P.H., of the University of Texas Health Sciences Center, Houston, and his colleagues wrote in Cancer Prevention Research.
For those with gum disease and dental problems, prevalence of oral HPV infection was 51% and 28% higher, respectively. More men (12%) than women (3%) were infected with oral HPV (Cancer Prev. Res. 2013 Aug. 21 [doi:10.1158/1940-6207.CAPR-13-008]).
Courtesy Dr. Marjorie Jeffcoat
Poor oral health was associated with a 56% higher prevalence of oral HPV infection in 3,439 study participants aged 30-69 years.
Marijuana use also was linked to higher rates of infection: 5% in nonusers, 8% in former users, and 14% in current users.
The findings were derived from the 2009-2010 National Health and Nutrition Examination Survey (NHANES), a nationally representative sampling conducted by the Centers for Disease Control and Prevention. Oral health data were taken from participants’ self-assessments of overall oral health, presence of gum disease, use of mouthwash to treat dental problems within past 7 days of the survey, and number of teeth lost.
"The good news is, this risk factor is modifiable – by maintaining good oral hygiene and good oral health, one can prevent HPV infection and subsequent HPV-related cancers," Dr. Bui said in a statement.
Previous studies have linked oral sex, number of sex partners, and cigarettes smoked per day with infection with high-risk oral HPV. Because oral sex and smoking previously had been found to have similar predictive value, Dr. Bui and colleagues examined NHANES data for both low-risk and high-risk HPV type. Using multivariable logistic regression models, they determined oral HPV infection was significantly linked with self-rated overall poor oral health, independent of tobacco use and oral sex.
According to the researchers, the study was limited because the temporal relationship between variables could not be established because of the cross-sectional nature of the data; however, because oral HPV infection normally is asymptomatic, "it is unlikely to affect self-reported oral health." Still, they noted that the data, based on self-report, could be subject to recall bias or under-reporting.
"Public health interventions may aim to promote oral hygiene and oral health as additional preventative measures for HPV-related oral cancers," Dr. Bui and his colleagues said.
The study was supported by a grant from the University of Texas Health Innovation for Cancer Prevention Research. The authors reported no conflicts of interest.