Tooth Count May Predict Survival After Pancreatic Cancer Surgery, Study Finds

Researchers at Hiroshima University have found that the number of natural teeth a person has may offer clues about how long they survive after surgery for pancreatic ductal adenocarcinoma (PDAC), one of the deadliest forms of cancer. The findings were published in the Journal of Hepato-Biliary-Pancreatic Sciences.

The study included 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 received a dental examination before surgery, and researchers assessed oral health using two measures: the number of natural teeth remaining, and the status of occlusion, or contact between the upper and lower teeth, of the premolars and molars.

Patients with 21 or more natural teeth had a median overall survival of 60.7 months, compared with 39.1 months for those with 20 or fewer teeth, a difference of nearly two years. The relationship remained statistically significant even after the researchers accounted for established prognostic factors, including tumor stage, lymph node metastasis, surgical margins, chemotherapy and nutritional status.

Chewing function itself, evaluated through posterior teeth occlusion, was not independently associated with survival, corresponding author Kenichiro Uemura said, suggesting tooth loss may reflect more than oral function alone — potentially chronic inflammation, frailty, nutritional condition and other systemic factors accumulated over decades. Uemura noted that several studies have suggested periodontal pathogens such as Porphyromonas gingivalis may contribute to pancreatic cancer development and progression, though it had remained unclear whether oral health itself influenced survival after surgery. Because the study was conducted at a single center among patients of Japanese ethnicity, the researchers say the findings will need to be tested in larger, multicenter and international studies.