Oral infections and dental factors in relation to oral cancer: a Swedish case--control study

We investigated the role of oral infections, dentition and dental X-rays for oral cancer in a north Swedish population. This case-control study consisted of 410 cases with oral cancer for the period 1980-89 and 410 matched controls. All subjects received a mailed questionnaire. The response rates were 96% and 91% for cases and controls, respectively. The univariate analysis showed a statistically significant increased risk for oral cancer among individuals reporting problems with recurrent clinical oral infection (odds ratio (OR) 3.8). Separate analyses were made for groups with a clearly stated HSV-1 infection (OR 1.9) and highly suspected HSV-1 infection (OR 3.3) as reported by the subjects. Odds ratios were also calculated for infections in relation to tobacco and alcohol habits. For individuals reporting recurrent infection problems an increased risk was observed in every combination category. Dental factors such as different fillings, dentures and fixed prostheses showed no increased risks. Dental X-ray did not produce an increased OR either. A multivariate analysis suggested that the most important risk factors were oral infections followed by liquor consumption and active smoking.