For years, medical scientists have made the link between heart disease and gum disease, but the latest research has found that, if you’re a woman, the state of your mouth may also play a big part in whether or not you develop breast cancer.
New evidence discovered by researchers at the State University of New York at Buffalo, Houston School of Dentistry and the University of Michigan suggests that women with periodontal disease—when the gums become infected and inflamed by dental plaque—are more likely to suffer from breast cancer, especially if they’re past the menopause.
The researchers based their findings on data from nearly 74,000 women participating in the Women’s Health Initiative (WHI) Observational Study, who were healthy at the start of the research and then tracked for seven years.1 Some 26 per cent of the women reported periodontal disease and, by §the study’s end, 2,124 women had developed cancer.
When the scientists examined both conditions more closely, they discovered that the women with periodontal disease were 14 per cent more likely to develop breast cancer.
If they’d been smokers at any time during the previous 20 years, they were 12 per cent more likely to develop the cancer, an even higher risk than if they were still smokers. The Buffalo team found that even women who’d quit 20 years earlier had a 36 per cent greater chance of having breast cancer compared with 32 per cent for those who hadn’t quit.1
These are just the latest findings to connect cancer with an unhealthy mouth. Earlier research has linked periodontal disease with oesophageal, head, neck, pancreatic and lung cancers.
In a separate study of women who’d developed lung disease—the Buffalo OsteoPerio Study—the same Buffalo team found that the longest and heaviest smokers were more likely to have periodontal disease.2 Among WHI participants, the researchers also uncovered an amplified effect between periodontal disease and smoking intensity on the development of lung cancer: having both conditions raised the risk “beyond that expected from the sum of each effect separately”, wrote the researchers.3
Indeed, just a 1-mm loss in gum height nearly doubles the risk of lung cancer. In contrast, those who had bad gums, but had never smoked didn’t face a raised risk of lung cancer.2
Men with unhealthy gums face a similar risk of cancer. A major analysis by Imperial College London examined the role of periodontal disease in a variety of cancers by following more than 48,000 men over nearly 18 years and comparing their dental health against their cancer incidence. Of the nearly 6,000 cancers recorded, those men with a history of periodontal disease had a 14 per cent increase in total cancer risk (the same risk women face with breast cancer), with the five most common cancers being melanomas (a type of skin cancer),
and colorectal, lung, prostate and bladder cancers.
The most dramatic increases in risk associated with gum disease included pancreatic cancer (by 54 per cent), kidney cancer (by 49 per cent), lung cancer (36 per cent) and cancers of the blood like leukaemia (30 per cent).
What’s more, losing teeth raised the risk of lung cancer too: those with 16 or fewer teeth increased their risk by 70 per cent compared with those who had 25 or more teeth. And unlike women, men with bad gums increased their chances of getting cancer even if they’d never smoked; periodontal disease on its
own raised the overall risk of cancer by 21 per cent.4
Other previous research has also found connections with poor dental and gum health and pancreatic cancer.5
Heart disease risk
Although the link between gum health and cancer is still relatively new, scientists have linked poor oral health with coronary heart disease for at least a decade.
In Harvard’s ongoing Health Professionals Follow-Up Study—which included a national survey of more than 44,000 men, more than half of whom were dentists—those with 10 or fewer teeth and pre-existing periodontal disease had a 67 per cent greater risk of developing heart disease, an association that also had little to do with diet.6
In addition, a study by the Harvard School of Dental Medicine found an increased risk of stroke related to tooth loss.7 Korean researchers likewise found that patients with periodontitis quadruple their risk of developing ischaemic stroke (the type caused by a blood clot), so facing the same risk as those with high blood pressure, and doubling the risk posed by diabetes.8
Even infertility problems may be traced back to the state of your gums. One study of nearly 4,000 women by researchers at the University of Western Australia discovered that those with gum disease took at least seven months to conceive—two months longer than women with healthy gums.9
To date, the exact biological mechanism connecting periodontal disease and all these conditions continues to elude researchers. An association has long been drawn between periodontal disease and atherosclerosis—the hardening and narrowing of arteries due to fatty deposits—a link confirmed by a review of 31 published studies.10 Likewise, patients with arterial plaques have been found to have significantly poorer gum health than those with healthy arteries.11
Consequently, researchers have theorized that oral bacteria adhere to fatty plaques in the rest of the body, particularly in the coronary arteries, so affecting blood flow and hampering the delivery of vital nutrients needed for healthy gums.
The second microbiome
Another plausible theory suggests that bacteria in the mouth don’t just inflame the gums, but also travel throughout the body, causing the systemic inflammation, which is now linked to conditions as diverse as arthritis, diabetes and Alzheimer’s. This idea is bolstered by Italian research showing that patients with even mild gum disease have high levels of inflammatory markers in their carotid arteries and thickening of blood vessel walls, a sign
of hardened arteries.12
Increasingly, though, researchers like the Buffalo team are looking into the role of certain pathogenic microorganisms in the second most important site of the body’s microbiome, the oral equivalent of the population of bacteria residing in your gut. Specifically, they are targeting possible culprits like the so-called “orange complex” (Fusobacterium nucleatum, Prevotella intermedia and Campylobacter rectus) and “red-complex” (Porphyromonas gingivalis and Tannerella forsythia) periodontal bacteria. These pathogens come in three traffic-light colours—green, orange and red—with red (like red lights) associated with bleeding on probing, an important clinical test of periodontal destruction.
While the red-complex pathogens got the all-clear, the University of Buffalo researchers found “borderline” associations between orange-complex pathogens and both total cancer and lung cancer risk. Nevertheless, they are quick to point out that their study had just a small number of cancer cases and could only assess the five bacterial species mentioned above.13
What is clear is that the mouth is an important weathervane of the state of health in the rest of your body, which is why it’s more important than ever to keep your gums and teeth in the pink.
Increasing the cancer risk
In a study of more than 48,000 men by Imperial College London, those with a history of periodontal disease had a 14 per cent increased risk of getting any cancer.
The most dramatic increases in risk included pancreatic cancer (by 54 per cent), kidney cancer (by 49 per cent), lung cancer (36 per cent) and cancers of the blood like leukaemia (30 per cent).
Losing teeth raised the risk of lung cancer too: those with 16 or fewer teeth increased their risk by 70 per cent compared with those who had 25 or more teeth.
Keeping your gums in the green zone
Besides avoiding allergens, sugar and simple carbohydrates, the following have been known to help clean up periodontal disease.
Take coenzyme Q10 (CoQ10), deficiencies of which have been linked to periodontitis and heart disease. There’s evidence that virtually everyone with gum disease has below-normal levels of CoQ10.1
Suggested daily dosage: 50 mg/day, although some studies show that patients improve on 150 mg/day taken for at least two months
Up your vitamin C. Low levels of this supervitamin have been linked with periodontitis, and vitamin C is also known to be helpful for both heart disease and cancer. Even tiny amounts of the vitamin (70 mg/day) can lead to major improvements.
Suggested daily dosage: 1–3 g/day
Don’t forget omega-3 fatty acids. Research shows that the higher your levels of these good fats, known to be anti-inflammatory, the lower the incidence of periodontal disease.
Suggested daily dosage: at least 1,000 mg/day for men and 600 mg/day for women; one study suggests 2,000 mg/day for positive gum changes2
Swish some propolis around your mouth. A mouthwash using this sticky stuff, made by bees from plant resins, has some evidence in resolving plaque and inflammation in just three months.3 One such product is made by BeeVital (www.beevital-uk.com).
Go green. Opt for drinking green tea, which contains antioxidant antimicrobials called ‘catechins’, which destroy bad bacteria in the mouth.4
Avoid tooth drilling and amalgam fillings. Research shows that drilling teeth can damage the surrounding gums and teeth, as can amalgam fillings. The latest evidence reveals that teeth can actually reverse decay, so try other means before rushing to have fillings done