Can ill-fitting dentures increase your oral cancer risk?

About 25 percent of adults age 60 and older no longer have any natural teeth, according to the CDC. As a result, the American College of Prosthodontists (ACP) estimates that 15 percent of the edentulous population has dentures made each year.

While dentures can serve practical and esthetic purposes, they also come with some risks. In 2015, researchers in Japan found that elderly patients who wore dentures while sleeping had a higher risk of developing pneumonia than those who removed their dentures before bed. The researchers also discovered that patients who slept with their dentures were more likely to have gum inflammation, tongue and/or denture plaque and other oral health issues.

Now, researchers in India have determined that dentures may also be associated with an additional health risk.

During a recent study, researchers conducted a systematic search of several medical databases, including MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Web of Science.

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They used search terms such as “oral cancer,” “mechanical irritation,” “risk factor,” “dental irritation” and “dental trauma,” among others. They ultimately included 22 studies that were relevant to their research.

During review of the literature, the researchers found multiple studies that showed an association between ill-fitting denture use and subsequent cancer formation. For instance, a population-based case-control study in Sweden showed that defective or malfunctioning complete dentures were significant risk factors for the development of oral squamous cell carcinoma. Another study found that 44 percent of the patients examined showed a correlation between the site of oral cancer development and the site of some form of chronic dental irritation. 

“From this review, we can conclude that chronic mucosal irritation resulting from ill-fitting dentures may be considered a risk factor for subsequent development of oral cancer. Such trauma-related cancers may be seen more often over the lateral border of tongue and also over the alveolus,” the study states.

Board-certified prosthodontist Dr. David A. Felton, who is the current editor-in-chief of the Journal of Prosthodontics, notes that while research suggests a correlation between ill-fitting dentures and oral cancer, there is currently no known process through which ill-fitting dentures cause oral cancer.

“While these studies show a potential risk, patients shouldn’t lose sight of the fact that well-fitting dentures are an important part of overall health. I conducted an extensive review of the literature and found that missing or unrestored teeth were a risk factor in a host of health conditions, including cancer, diabetes, dementia and COPD,” Dr. Felton says.

Following a recall schedule set by a dentist or prosthodontist is key to avoiding potential problems.

“At a minimum, patients should be strongly encouraged to see their dental health care provider on an annual basis in order to determine the fit of the prostheses and, most importantly, to do an oral cancer screening. It’s just good patient management,” Dr. Felton says.

“That being said, it is often challenging to get denture wearers back into the office for annual check-ups (if they don’t hurt, or aren’t broken, patients will often not return for annual visits). Steps that can be taken are to carefully assess the fit and retention of the dentures, to carefully assess the health of the oral denture supporting tissues and to evaluate the wear of the dentures (broken or missing teeth, sharp areas, etc.) in addition to doing the oral cancer screening.”

Dr. Felton, who is the author of a peer-reviewed article on a similar topic as the study done in India, says that more longitudinal studies on denture-wearing patients are needed.

“There are few studies that evaluate fit and retention of the dentures long-term, the use of denture adhesives (no studies are longer than six months in duration), to determine if dental implants can improve or reduce the rates of oral cancer in the denture-wearing patient, and only a few emerging retrospective case control studies on the relationship between the ill-fitting dentures and oral cancer,” he says. “Definitely, more prospective research needs to be done!”

The study, titled “The role of chronic mucosal trauma in oral cancer: A review of literature,” appeared in the Indian Journal of Medical Paediatric Oncology.