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Cancer connection

Researchers have found a strong link between gum disease and pancreatic cancer.

By TARA PARKER-POPE
Published March 27, 2007


In our quest for better health, there's a key body part many of us are neglecting: the mouth.

The link between oral health and overall health has been discussed in medical and dental journals for years, but the issue has yet to resonate with most doctors and patients.

But in January, Harvard researchers reported a surprising but powerful link between poor gum health and one of the deadliest diseases, pancreatic cancer.

In a study of 51,529 male doctors over a 16-year period, the men with a history of gum disease were at 64 percent higher risk for pancreatic cancer, compared with those with healthy mouths. The comparison was drawn after adjusting the results for age, smoking, diabetes, body mass index and other factors.

Pancreatic cancer is the fourth-leading cause of deaths from cancer.

The study is the latest in a series of reports showing that the health of your mouth, teeth and gums may have a powerful impact on your overall health. Gum disease is linked with heart disease, stroke, diabetes and pregnancy problems.

A person suffering from gum disease has a mouth teeming with Porphyromonas gingivalis and other bacteria found in plaque, the sticky film that forms on teeth. These bacteria not only cause gums to become inflamed, but they can also invade other parts of the body, including cells in coronary arteries.

Nobody knows why gum disease may be linked with pancreatic cancer. It may be that chronic infection in the gums triggers inflammation throughout the body, which can fuel the growth of cancer.

Or it may be that oral bacteria trigger a chemical process in the body that results in high levels of nitrosamines, cancer-causing compounds that also are in tobacco smoke.

"People think of gum disease as being in their mouth," says Dominique Michaud, the study's lead author and an assistant professor at the Harvard School of Public Health. "But when it gets severe, it's not just in the mouth. It's probably in the entire body.

"Most convincing was our finding that (people who had gum disease but had never smoked) had a two-fold increase in risk of pancreatic cancer," she said.

This would confirm previous studies identifying smoking as a high-risk factor for developing pancreatic cancer.

It is estimated that at least 35 percent of adults have some form of gum disease, and about one-third of those have a moderate to severe form.

Brushing and flossing regularly do not always prevent gum disease. It is thought that about one-third of the population may have a genetic predisposition to the problem.

Certain medications, including oral contraceptives, antidepressants and heart medicines, can also affect oral health.

Treatment for gum disease can include an oral antibiotic or antibiotic gels applied directly into the diseased pocket between the tooth and gum. The most common nonsurgical treatment is "scaling and root planing," an intensive teeth cleaning above and below the gum line that often requires a local anaesthetic.

For advanced cases, doctors cut away the diseased gum tissue and sometimes take grafts from the roof of the mouth to help rebuild the gum line.

One problem is that insurance coverage for dental procedures typically is limited, and as a result, many patients don't seek regular dental care. However, health plans are beginning to cover more dental treatment and preventive services, particularly among patients at high risk, such as pregnant women or patients with diabetes.

 

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Assess your risk

The American Academy of Periodontology offers a tool to help you gauge your personal risk for gum disease at www.perio.org.