Studies have long suggested a link between periodontal disease and an increased risk of other inflammatory diseases. However, recent research points to a potential connection between periodontal disease and certain types of cancer.
Scientists have believed that inflammation was the link between periodontal disease and systemic diseases like respiratory disease, chronic kidney disease, rheumatoid arthritis, and metabolic syndrome. The thought process was that just as periodontal disease contributes to a buildup of plaque on the teeth; it also can contribute to a buildup of plaque in the arteries, which increases the risk of heart disease. While this may still be the case, other studies are now finding connections between periodontal disease and specific forms of cancer, such as esophageal and gastric cancers.
What is periodontal disease?
Periodontal disease is an inflammatory disease that causes ongoing gum infection. It affects the soft and hard structures that support the teeth and can lead to tooth loss. Often the result of poor brushing and flossing habits, periodontal disease occurs after plaque has built up and hardened. It's important to note that there are four stages of periodontal disease, and only the first stage (gingivitis) is reversible.
When gingivitis is left untreated, it can advance to periodontitis. In patients with periodontitis, the inner layer of the gum and bone pull away from the teeth and form pockets. Debris can collect in these small spaces and become infected. As the plaque spreads and grows below the gum line, the body's immune system fights the bacteria. During this stage, toxins produced by the bacteria in plaque, as well as the body's enzymes involved in fighting infections, start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen, and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, and tooth loss occurs.
What's the connection to cancer risk?
We each have billions of benign bacteria living in our mouths that are known collectively as "oral biofilm." When these bacteria become trapped in plaque between the teeth, they produce pathogens that cause infection and inflammation of the gums. Pathogenic bacteria produce toxins that can get into your bloodstream. Your immune system reacts to the pathogens and their toxins by causing the liver to produce C-reactive proteins (CRP). The increase in CRP levels results in chronic, low-grade inflammation throughout your body as it stays in a constant state of preparedness to fight the infection. If the periodontal disease remains untreated, your body adjusts to this heightened inflammatory state, making your immune system less responsive. Over time, your immune system can suffer irreversible damage, and this damage is thought to be a key factor in the link between periodontitis and cancer. However, the exact connection between the two diseases has yet to be defined.
In July 2020, Harvard published the findings of a long-term study that showed people with a history of periodontal disease were 43% more likely to develop esophageal cancer and 52% more likely to develop gastric cancer compared with people whose gums were healthier. Additionally, patients who developed esophageal or gastric cancer also had a presence of dysbiotic oral microbiome, which suggests a link between oral health and these cancers.
What does this mean?
It's important to note that the Harvard study was observational and doesn't prove that gum disease causes cancer. Further research is definitely needed, but it could mean that in the future, gum health will be included in a patient's overall cancer risk assessment. Fortunately, gum disease can be prevented with good oral hygiene and regular dental visits.
We encourage you to contact our team with any questions or concerns about periodontal disease and its potential connection to the increased risk of oral cancer or other diseases.