Tobacco Consumption and the Development of Oral Cancers in Patients With Dental Prostheses

Tobacco consumption is a significant global health issue, responsible for over eight million deaths annually. Various forms of tobacco, including cigarettes, hookah, smokeless tobacco, and electronic cigarettes, have been linked to oral cancer, particularly squamous cell carcinoma. Individuals wearing dental prostheses, whether removable or fixed, are at an increased risk due to chronic mucosal irritation, which may accelerate carcinogenic processes when combined with tobacco exposure. Accordingly, this systematic review explored the relationship between tobacco consumption and oral cancer in patients with dental prostheses, with a focus on different tobacco types and their respective carcinogenic mechanisms. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science, covering publications from January 2000 to March 2023. Studies examining adult prosthesis users, their tobacco consumption patterns, and oral cancer outcomes were included in this review. The final analysis encompassed twenty-two studies of case-control, cohort, and cross-sectional designs. The findings consistently demonstrated that tobacco use amplifies oral cancer risk in prosthesis wearers due to the synergistic effects of chronic mechanical irritation, inflammation, oxidative stress, and microbial dysbiosis. Notably, different tobacco products exhibited varying carcinogenic mechanisms. While cigarette and hookah smoke led to polycyclic aromatic hydrocarbon exposure, smokeless tobacco caused prolonged mucosal nitrosamine contact, and e-cigarette aerosols induced oxidative DNA damage. This review highlights the critical need for routine oral examinations, prosthesis maintenance, and integrated tobacco cessation interventions to mitigate oral cancer risks in this vulnerable population. Future research should focus on identifying high-risk subgroups, evaluating innovative prosthetic materials with lower inflammatory potential, and elucidating the molecular pathways.