Study: gum diseases and the risk of smoke -related cancer in never smoking men

Michaud DS, Kelsey KT, Papathanasiou e, Genco Ca, Giovannucci E. periodontal disease and risk of all types of cancer in male nieryards: an updated analysis of the Health Professionals Follow-up Study. ann oncol . 2016; 27 (5): 941-947.

prospective cohort study over a period of 26 years with the aim of examining the connection between periodontitis and the risk of all types of cancer in male nerves.

postal questionnaires were sent to male participants aged 40 to 75 who were members of the health professions (e.g. resident dentists, veterinarians, pharmacists, opticians, osteopathic doctors, podiatrists). The final count consisted of 19,933 men and was limited to men who had never smoked a cigarette, cigar or pipe.

The postal questionnaires were filled out by the participants at the beginning of the course and then every two years. They were asked for a prehistory of periodontitis with bone loss and the number of natural teeth, which were present at the beginning of the study and at every subsequent questionnaire. All newly diagnosed cancer reported by the participants themselves were confirmed by obtaining the medical records of the participants. Another differentiation was made by identifying smoke -related and non -shrub -related cancer.

periodontitis at the beginning of the course was associated with a 13 % higher risk for all types of cancer. Men with advanced periodontitis (with less than 17 remaining teeth) had a 44 % increased risk of cancer. The risk of the most common types of cancer in this cohort (ie prostate, colon cancer, melanoma) was not increased; However, the risk of smoking cancer increased by 33 % [lung, bladder, oropharyngeal, esophageal, kidney, stomach, and liver; HR: 1.33; 95% Confidence interval (CI): 1.07-1.65]. Men with advanced periodontitis had a stronger association (HR: 2.57; 95 % AI: 1.56-4.21). Advanced periodontitis was particularly with an increased risk of esophageal and head-neck carcinomas (HR: 6.29; 95 %-KI: 13–18.6, based on 5 cases) and bladder cancer (HR: 5.06; 95 %-KI: 2.32–11.0, based) connected in 9 cases).

This study, which was carried out in the United States, showed a 2.5-fold increase in the cancer caused by smoking in the case of nie smokers with periodontitis. In view of the prevalence rate of periodontitis in the United States, this finding is very clinically relevant. According to the survey data of the Center for Disease Control and Prevention (CDC), almost half of the Americans aged 30 and over suffer from any form of periodontitis. The prevalence rate is over 60 % of smokers, in adults who live below the poverty line and in adults without a university degree. The prevalence rates reach 70 % for over 65 year olds.

There is a known connection between cancer and periodontitis.

parodontitis is a continued infection of the gums, which leads to inflammation and erosion of the tooth keeping apparatus, the gingiva and the alveolar bone tissue. The presence of the pathogen alone is not enough to trigger periodontitis. The proposed mechanisms of periodontitis include the presence of an unbalanced dysbiotic flora in the mouth, the genetic predisposition of the host and the actual dysregulation of the host's immune response through bacteria that manipulate the components of the immune system (such as neutrophils and complement) to their advantage. Due to the interaction between the landlord and oral bacteria, the inflammation continues and continues to destroy the tissue.

inflammation products caused by periodontitis can get into the bloodstream and wander through the rest of the body. For example, inflammatory cytokines such as tumor necrosis factor alpha (TNF-alpha), interleukin-1 (IL-1) and interleukin-6 (IL-6) are released and stimulate other inflammatory mediators. This chain reaction of inflammatory processes increases the susceptibility of the body for other infections and, not surprisingly, is associated with a variety of systemic inflammation. Rheumatoid arthritis, osteoporosis and pregnancy complications (such as early contractions and low birth weight). In addition, systemic diseases can in turn make parodontitis worse.

There is a known connection between cancer and periodontitis. Further studies dealt with breast cancer in women 5 and pancreatic cancer, 6 among others. There is a clear connection between cancer and inflammation, which explains why systemic inflammation through periodontitis is involved in cancer. Increased systemic inflammatory markers in patients with chronic periodontitis include the same that are observed in cancer, such as IL-6, TNF alpha and fibrinogen.

This study excluded smoking (a well-known risk factor for gum diseases) from the data analysis and only determined an increase in cancer caused by smoking. The authors suggest that periodontitis in particular increases the risk of smoke -related cancer, since periodontitis and smoking trigger the same immune paths. There is also an epigenetic context. Smoking is associated with changed DNA methylation patterns associated with the immune response. Some bacterial metabolites can also cause an immune response from regulatory T (TREG) cells that are involved in carcinogenesis.

What does that mean for clinical providers? We can improve the chronic condition of our patients by asking them a simple question: When was your last visit to the dentist? Prevention is the key; advise you on risk reduction, e.g. B. Avoiding excessive alcohol consumption and smoking, including passive smoking, 9 and promote good oral hygiene, including regular brushing and dental floss. Dry the mouth, which can be caused by medication (including some common over -the -counter medication such as antihistamines and decongestant agents), can also favor caries. Promote a plant-based, low-sugar diet for a healthy microbiome. 10 Probiotics can be particularly helpful lactobacilli Species. 11 The assessment of inflammatory markers is important, since C-reactive protein is also a marker for periodontitis. Inhibitory agents, including antioxidants and traditional plant substances, can be of use in the treatment. Options include vitamin C, zinc, vitamin A, coenzyme Q10 (COQ10), vitamin E and folic acid as well as vegetable substances such as turmeric preparations. 13 aloe vera, 14 fifteen and tea tree oil.

restrictions

The study only identified a small number of participants with advanced periodontitis. Periodontitis was given itself. No data was available for pocket depth, gingival attack loss or periodontal treatment. No female participants and a few non -white participants were included.

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