Dental Disease and Tooth Loss Tied to Higher Liver Cancer Risk in 5.9 Million Swedes

Edited by Hygienetown staff

Adults diagnosed with caries or periodontitis, and those with fewer remaining teeth, had a higher risk of primary liver cancer in a nationwide Swedish cohort study published online Oct. 25 in the Journal of Clinical Periodontology.

Researchers followed 5,893,325 adults registered in the Swedish Dental Health Register between 2009 and 2016, linking them to national registers to identify new liver cancer cases. Over a mean follow-up of 6.36 years, 2,374 primary liver cancers were diagnosed, including 1,856 hepatocellular carcinomas and 518 other primary liver cancers.

After adjustment for potential confounders, caries was associated with a 15% higher risk of primary liver cancer (hazard ratio, 1.15; 95% CI, 1.02–1.30) and periodontitis with a 25% higher risk (HR, 1.25; 95% CI, 1.12–1.39).

Risk rose as the number of remaining teeth fell. Compared with people who had more than 27 teeth, those with fewer teeth had hazard ratios ranging from 1.15 to 1.84.

The associations differed by cancer type. Caries was associated with non-hepatocellular liver cancers, periodontitis with hepatocellular carcinoma, and tooth loss more strongly with hepatocellular carcinoma. The findings were generally consistent in a sibling comparison designed to control for shared genetic and early-life environmental factors, as well as in subgroup and sensitivity analyses.

Qiaofeng Zhong of Fujian Cancer Hospital in China and Zengliang Ruan, Li Yin, Hans-Olov Adami, and Weimin Ye of Karolinska Institutet in Stockholm conducted the study, which was supported in part by the Swedish Cancer Society.

The authors concluded that caries, periodontitis, and tooth loss are associated with an elevated risk of primary liver cancer, with distinct patterns for different cancer types. The registry-based observational design cannot establish that dental disease causes liver cancer.

Sources:
Journal of Clinical Periodontology, “Diagnosed Dental Diseases, Tooth Loss and the Risk of Primary Liver Cancer in a Nationwide Swedish Cohort,” published online Oct. 25, 2026: onlinelibrary.wiley.com/doi/10.1111/jcpe.70219
National Library of Medicine, PubMed, PMID 42927980: pubmed.ncbi.nlm.nih.gov/42927980