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 ResearchResearch AreasRelationship of Oral Pathogens to Systemic DiseaseTezal     May 31, 2016  

Relationship of Oral Pathogens to Systemic Diseases

MINE TEZAL, DDS, PhD personal profile

The Role of Periodontal disease on Oral HPV Infection and Head and Neck Cancers

A steady increase in the incidence of oropharyngeal cancers has been observed over the last three decades despite a significant decline in tobacco consumption during the same period. This increase has been mainly attributed to oral infection with human papillomavirus (HPV) type 16.  A highly effective vaccine is available to prevent cervical HPV infection, which is recommended for females aged 9 to 26 years and males aged 9 to 21 years prior to potential exposure. However, oral HPV infection can be transmitted at or any time after birth. Oral HPV DNA has been found in 4%-87% of newborns and children age 3-11 years, albeit with low levels of transcription suggesting that is a transient event. Therefore, the vaccine has no protective effect in the large percentage of the population that has already been exposed to the virus. Identifying factors associated not only with the acquisition but also with the persistence of the virus will improve both prevention and treatment of HPV-related diseases, benefiting also those who are already infected.

Our studies have demonstrated that periodontitis, a chronic inflammatory disease, was associated with increased risk of oral potentially malignant disorders and head and neck squamous cell carcinoma (HNSCC). A history of periodontitis also predicted poorly differentiated tumor status in the oral cavity. These associations remained statistically and clinically significant in never smokers and never drinkers. In addition, a history of periodontitis was a significant predictor of the tumor HPV-16 status among patients with oral cavity, oropharyngeal and laryngeal cancer patients.  Presently, we are investigating the role of dental caries on HNSCC, and the potential interaction between periodontitis and dental caries. In addition, epidemiologic studies assessing the role of local inflammation on oral HPV infection in healthy young population are underway.