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Poor oral health was found to be associated with oral human papillomavirus (HPV), according to a study published in Cancer Prevention Research.[1] The good news, say researchers, is that the risk can be modified by maintaining good oral hygiene and health. HPV infection causes approximately 40% to 80% of oropharyngeal cancers.

The research was led by Thanh Cong Bui, DPH, a postdoctoral fellow in the School of Public Health at the University of Texas Health Science Center in Houston, and Christine Markham, PhD, deputy director of The University of Texas Prevention Research Center. They and colleagues found that of the study participants who reported poor oral health, 56% had a higher prevalence of HPV infection. Those who had gum disease and dental problems had a 51% and 28% higher prevalence of oral HPV infection, respectively. In addition, researchers were able to associate HPV infections with the number of teeth lost.

Oral HPV infection can include low-risk HPV types that do not cause cancer but instead cause benign tumors of the oral cavity, as well as high-risk types that cause oropharyngeal cancers. Researchers used data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. The survey included approximately 5000 people recruited each year from across the United States.

Participants were identified for whom data were available on oral health and the presence or absence of 19 low-risk and 18 high-risk HPV types in the oral cavity. Among the measures of oral health were selfrating of overall oral health, presence of gum disease, use of mouthwash to treat dental problems within the 7 days prior to the survey, and number of teeth lost.

Researchers also examined data on age, sex, marital status, marijuana use, cigarette smoking, and oral sex habits, all of which influence HPV infection. They found that being male, smoking cigarettes, using marijuana, and engaging in oral sex increased the likelihood of oral HPV infection. Selfrated oral health also was found to be an independent risk factor for infection, because that association did not change whether or not people smoked or had multiple oral sex partners.

The authors speculate that because HPV must enter through a wound in the mouth to infect the oral cavity, poor oral health can play a role by leading to ulcers, mucosal disruption, or chronic inflammation; however, more research is needed to confirm this theory.

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