The association between concurrent oral cancer and periodontal disease: a systematic review and meta-analysis

Clinical Snapshot

Key Findings

• P Value: P<0.001 for both crude and adjusted analyses

• Effect Size: Crude OR 3.35, Adjusted OR 2.32

• Primary Outcome: Odds ratio for developing oral cancer in patients with periodontal disease

• Nnt Or Sensitivity: Case definition dependent: OR 2.02 (missing teeth) vs OR 2.68 (AAP clinical parameters)

• Confidence Interval: Crude: 95% CI 2.63-4.26; Adjusted: 95% CI 1.71-3.15

Clinical Application

Highly feasible - periodontal assessment is routine in dental practice and can inform cancer risk stratification Relevant to Australian dental and medical practice; aligns with RACGP guidelines for cancer screening and prevention. Could inform Medicare dental benefits and PBS preventive care initiatives Adults over 18 years with periodontal disease in primary care and specialist dental settings

Abstract

OBJECTIVE: Since emerging studies have reported a positive association on oral cancer and periodontal disease, the present study aimed to evaluate the odds ratio of having concurrent oral cancer in patients with periodontal disease. METHOD AND MATERIALS: A systematic review following the PRISMA guidelines was conducted with three electronic databases. The inclusion criteria were structured according to the PECOS framework: (P) Human subjects aged over 18; (E) Patients with periodontal disease; (C) Individuals without periodontal disease; (O) The odds of patients developing oral and/or head and neck cancers; (S) Case-control studies. After screening, 18 clinical studies from 13 different regions, comprising a total of 31,504 participants, were included. RESULTS: A meta-analysis was performed and revealed that the odds ratio for developing oral cancer in patients with periodontal disease, compared to those without, was 3.35 (95% CI 2.63-4.26; P .001). After adjusting for potential confounding factors, the adjusted odds ratio was found to be 2.32 (95% CI 1.71-3.15; P .001). Case definition also has an impact, with odds ratio of 2.02 if using missing teeth compared to odds ratio of 2.68 by using American Academy of Periodontology clinical periodontal parameters. CONCLUSION: Clinical considerations for this specific group of patients should draw new attention for a strategic interdisciplinary care.

References

1. 1.Lin, E. C., Chen, J. H., Sitt, S., Lin, G. H., Wu, C. Y., & Wang, C. W. (2026). The association between concurrent oral cancer and periodontal disease: a systematic review and meta-analysis. Quintessence International, 57(4). https://doi.org/10.3290/j.qi.b6762763