Fewer Natural Teeth Linked to Shorter Pancreatic Cancer Survival, Study Finds

A person's remaining teeth may offer a clue to how long they survive after pancreatic cancer surgery, according to a new study from Hiroshima University. Researchers found that patients with at least 21 natural teeth survived nearly two years longer, on average, than those with fewer, after surgery for pancreatic ductal adenocarcinoma (PDAC), an aggressive form of pancreatic cancer. The findings were published in the Journal of Hepato-Biliary-Pancreatic Sciences.

The team examined 339 consecutive patients who underwent radical pancreatectomy, surgery to remove all or part of the pancreas, at Hiroshima University Hospital between 2014 and 2022. Every patient had a dental exam before surgery recording their natural tooth count and posterior occlusion, or how well their back teeth met during chewing. Patients with 21 or more teeth had a median overall survival of 60.7 months, compared with 39.1 months for those with 20 or fewer — a difference that held even after adjusting for tumor stage, lymph node spread, surgical margins, chemotherapy and nutritional status.

Chewing function itself was not independently linked to survival, a result the researchers called surprising. "This suggests that tooth loss may represent more than oral function alone," said Kenichiro Uemura, associate professor at Hiroshima University's Graduate School of Biomedical and Health Sciences and the study's corresponding author. "It may reflect lifelong chronic inflammation, frailty, nutritional condition, lifestyle factors, and overall systemic vulnerability accumulated over decades... The mouth may reflect the body's long-term resilience."

Uemura noted that earlier studies have linked periodontal bacteria such as Porphyromonas gingivalis to pancreatic cancer development, though it was previously unclear whether oral health affected survival after surgery. The study was conducted at a single hospital among patients of Japanese ethnicity, and the researchers say larger studies across multiple hospitals and more diverse populations are needed to confirm the association.