Evaluation of the association between periodontal disease and total cancer risk: A cross-sectional study

Background: The body is in a continuous state of inflammatory burden due to local and systemic inflammation, which is triggered in periodontal tissues in response to microorganisms. A number of studies have linked periodontitis to systemic diseases such as diabetes mellitus, cardiovascular disease and respiratory disease. Periodontal inflammation acts as a focus of infection, which can cause detrimental effects on distant target organs. In some cases, it may lead to tumor progression in various cancers.

Objectives: The aim of the study was to evaluate the correlation between periodontal disease (PD) and its potential role as a risk factor for the development of systemic cancer and its metastasis.

Material and methods: A single-center, cross-sectional study was conducted, including 66 patients with different systemic malignancies (group 1, the test group) and 66 healthy individuals (group 2, the control group). Group 1 was further subdivided into 2 categories: M0, comprising patients without metastases (n = 34); and M1, comprising patients with distant metastases (n = 32). The number of missing teeth, Greene and Vermilion's simplified oral hygiene index (OHI-S), probing pocket depth (PPD), Löe and Silness' bleeding on probing (BoP), clinical attachment loss (CAL), and Ramfjord's periodontal disease index (PDI) were recorded. Appropriate statistical tests were performed to analyze the data. A p-value <0.05 was considered statistically significant.

Results: The differences between the PDI, CAL and PPD values in both group 1 and group 2 were found to be statistically significant (p = 0.000). In M0 and M1, no statistically significant differences were observed between any of the parameters. The odds ratios (ORs) between group 1 and group 2 for CAL and PDI were 3.986 and 4.286, respectively. The ORs for M0 and M1 with regard to CAL and the mean number of teeth lost were 0.373 and 0.188, respectively.

Conclusions: The findings of the study indicate a significant association between the overall risk of cancer and PD. In cases of known systemic malignancies, no significant correlation has been identified between PD and the risk of metastasis.