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Open Access Research article

Using NHANES oral health examination protocols as part of an esophageal cancer screening study conducted in a high-risk region of China

Bruce A Dye1*, Ru Wang2, Ruth Lashley3, Wenqiang Wei4, Christian C Abnet5, Guoqing Wang4, Sanford M Dawsey5, Wei Cong2, Mark J Roth5, Xiaojie Li2 and Youlin Qiao4

Author Affiliations

1 Centers for Disease Control and Prevention/National Center for Health Statistics, Hyattsville, MD, USA

2 Dalian Medical University, School of Dentistry, Dalian, China

3 U.S. Public Health Service, Alderson, WV, USA

4 Cancer Institute Chinese Academy of Medical Sciences, Beijing, China

5 National Institutes of Health/National Cancer Institute, Rockville, MD, USA

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BMC Oral Health 2007, 7:10  doi:10.1186/1472-6831-7-10

Published: 17 July 2007

Abstract

Background

The oral health status of rural residents in the People's Republic of China has not been extensively studied and the relationship between poor oral health and esophageal cancer (EC) is unclear. We aim to report the oral health status of adults participating in an EC screening study conducted in a rural high-risk EC area of China and to explore the relationship between oral health and esophageal dysplasia.

Methods

National Health and Nutrition Examination Survey (NHANES) oral health examination procedures and the Modified Gingival Index (MGI) were used in a clinical study designed to examine risk factors for esophageal cancer and to test a new esophageal cytology sampling device. This study was conducted in three rural villages in China with high rates of EC in 2002 and was a collaborative effort involving investigators from the National Institutes of Health and the Cancer Institute of the Chinese Academy of Medical Sciences.

Results

Nearly 17% of the study participants aged 40–67 years old were edentulous. Overall, the mean number of adjusted missing teeth (including third molars and retained dental roots) was 13.8 and 35% had 7 contacts or less. Women were more likely to experience greater tooth loss than men. The average age at the time of first tooth loss for those with no posterior functional contacts was approximately 41 years for men and 36 years for women. The mean DMFT (decayed, missing, and filled teeth) score for the study population was 8.5. Older persons, females, and individuals having lower educational attainment had higher DMFT scores. The prevalence of periodontal disease (defined as at least one site with 3 mm of attachment loss and 4 mm of pocket depth) was 44.7%, and 36.7% of the study participants had at least one site with 6 mm or more of attachment loss. Results from a parsimonious multivariate model indicate that participants with poor oral health wemore likely to have esophageal dysplasia (OR = 1.59; 95% CI 1.06, 2.39).

Conclusion

This report describes the first use of NHANES oral health protocols employed in a clinical study conducted outside of the United States. The extent and severity of poor oral health in this Chinese study group may be an important health problem and contributing factor to the prevalence of EC.