Meta-analysis on the association between toothbrushing and head and neck cancer

SummaryBackgroundEpidemiological studies have focused on the association between toothbrushing and head and neck cancer (HNC). However, the question of whether toothbrushing is associated with decreased risk of HNC remains unanswered. Since there is currently no systematic review or meta-analysis available to provide quantitative findings on this important clinical question; we consequently performed this meta-analysis to investigate the association between toothbrushing and HNC risk.MethodsWe searched PubMed and Embase up to January 13 (updated on October 20), 2014 to identify observational studies that investigated the association between toothbrushing and HNC. After study section and data extraction, the meta-analysis was conducted using RevMan 5.2 software.ResultsA total of 18 case-control studies involving 7068 cases and 9990 controls were included. The meta-analysis showed that compared with highest toothbrushing frequency, lowest level was significantly increased risk of HNC 2.08 times (odds ratio = 2.08, 95% confidence interval = 1.65-2.62). This significant association remained consistent after adjusting for smoking status and alcohol consumption. No publication bias was detected.ConclusionsThis meta-analysis found frequency of toothbrushing was significantly associated with HNC risk. Effective toothbrushing may be potentially important for the prevention of HNC and we suggest that the frequency be twice per day (morning and night).