REVIEW article
Front. Med.
Sec. Gastroenterology
Tooth Loss and Infrequent Brushing Significantly Elevate Gastric Cancer Risk: An Updated Systematic Review and Meta-Analysis with Heterogeneity Exploration
Provisionally accepted
- 1Qilu Hospital, Shandong University, Jinan, China
- 2Shandong University School of Stomatology, Jinan, China
- 3First People's Hospital of Jinan, Jinan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: The association between oral hygiene—specifically, tooth brushing and tooth loss—and gastric cancer (GC) incidence risk remains inconclusive. Previous meta-analyses are outdated and insufficient in exploring heterogeneity. To address this gap, this study aims to perform an updated and comprehensive evaluation of this association. Methods: We systematically searched PubMed, Embase, and Web of Science, Scopus, and the Cochrane Library up to until April 2024 for studies examining tooth brushing frequency, tooth loss, and GC risk. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed were and explored via meta-regression and subgroup analysis. Results: Twelve studies were included. Infrequent tooth brushing was associated with a 55% significantly increased GC risk (OR 1.55, 95% CI: 1.17-2.05). Despite significant heterogeneity, largely attributable to study design, this association was robust in sensitivity analyses. Tooth loss also significantly increased GC risk (OR 1.25, 95% CI: 1.12-1.39). Notably, subgroup analyses identified geographic region as a key source of heterogeneity source, with the tooth loss-associated risk being substantially stronger in Europe and America Western (OR 1.68) than in Asian (OR 1.19) populations. Sensitivity analyses supported the robustness of these findings. Conclusion: This study solidifies poor oral hygiene as a significant risk factor for GC. The marked geographic disparity offers a novel insights for developing targeted primary prevention strategies, underscoring the importance of integrating oral health into general cancer prevention initiatives.
Keywords: gastric cancer, Meta-analysis, Systematic review, Tooth brushing, Tooth Loss
Received: 06 Dec 2025; Accepted: 05 Feb 2026.
Copyright: © 2026 Wu, Li, Ge, Cui and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Shuo Wu
Xiaoyan Li
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.