Mapping the Global Evidence: How Tobacco and Alcohol Shape Oral Health Risks
A scientometric look at more than a century of research on smoking, drinking, and diseases of the oral cavity
Why Tobacco and Alcohol Still Matter for Oral Health
Tobacco smoking and alcohol consumption have long been recognized as major threats to public health. Beyond their well-known links to heart disease and cancer, both habits play a crucial role in oral health problems, particularly oral cancer and precancerous lesions. Despite decades of research, the scientific landscape surrounding tobacco, alcohol, and oral health has rarely been examined as a whole.
To address this gap, a recent study published in the Journal of Dental Sciences takes a different approach not by testing patients or cells, but by systematically analyzing global research trends over time.
Looking at Science Itself: What Is a Scientometric Study?
Instead of focusing on clinical experiments, the researchers used scientometric analysis, a method that examines scientific publications to understand how knowledge evolves. By analyzing patterns such as publication volume, keywords, citations, and research topics, scientometrics helps identify where scientific attention has been concentrated and where it may be heading.
In this study, the authors retrieved all English-language articles related to tobacco use, alcohol consumption, and oral cavity health from the Scopus database, without restricting publication year or study type. This allowed them to capture research spanning more than a century.
What the Researchers Did
The research team analyzed:
2,529 papers on tobacco smoking and oral health
1,545 papers on alcohol drinking and oral health
Publications dated back as far as 1885 for tobacco-related studies and 1895 for alcohol-related studies. The researchers evaluated publication trends, citation patterns, frequently used keywords, research designs, and contributing countries and institutions.
They also identified the 100 most-cited papers in each category to assess long-term scientific influence.
Key Findings: Shared Risks, Distinct Research Paths
The analysis revealed that both tobacco and alcohol are consistently linked to similar oral health problems. Across thousands of studies, the most frequent disease-related keywords included:
Oral cancer
Mouth neoplasms
Oral leukoplakia
Periodontal disease
These shared keywords highlight the strong and persistent association between tobacco, alcohol, and oral cancer risk. Many studies point to genetic damage, altered gene expression, and disrupted cellular processes as underlying mechanisms.
However, the research focus differs between the two substances:
Tobacco-related studies frequently emphasized nicotine, smoking cessation, electronic cigarettes, DNA damage, and apoptosis.
Alcohol-related studies more often explored acetaldehyde, alcohol metabolism, enzyme activity, and pharmacokinetics.
This distinction reflects how tobacco and alcohol harm oral tissues through partly different biological pathways, even though their outcomes may overlap.
Global Trends and Scientific Influence
Over time, the number of publications on both smoking and drinking has steadily increased, particularly since the early 2000s. Tobacco-related research consistently outnumbered alcohol-related studies, suggesting that smoking remains the most intensively studied risk factor for oral diseases.
The most influential articles were often published in high-impact cancer journals, and the United States emerged as the leading contributor in both research areas.
Why This Study Matters
By mapping more than a century of research, this study offers a comprehensive overview of how scientific understanding of tobacco, alcohol, and oral health has developed. Importantly, it highlights that the combined use of tobacco and alcohol continues to pose a synergistic risk, significantly increasing the likelihood of oral cancer.
For policymakers and healthcare authorities, these findings reinforce the need for integrated tobacco and alcohol control strategies, tailored to the specific needs of different populations.
Conclusion
This scientometric analysis provides the first comprehensive overview of global research on tobacco, alcohol, and oral cavity health. By revealing shared themes, distinct mechanisms, and long-term research trends, the study helps clarify where scientific evidence is strongest—and where prevention efforts should be focused. Ultimately, reducing tobacco and alcohol use remains a critical step toward improving oral health worldwide.
Original Article Reference
Liu H, Yu Z, Xu Z, Liu T, Liu W. A scientometric study of tobacco and alcohol use as risk factors for oral cavity health. Journal of Dental Sciences. 2023;18:1883–1888.