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Posted by: The Probe 16th February 2021
Around 55,000 women and 370 men are diagnosed with breast cancer every year in the UK. It is the most common cancer in women and it is estimated that one person is diagnosed every 10 minutes in England. Thanks to earlier detection through screening and improvements in treatments and care, breast cancer survival rates have doubled in the last 40 years. It is important for dental professionals to remain abreast of the latest research regarding the association between periodontal disease and breast cancer in order to do their part in helping patients reduce their risks.
The link between periodontal disease and breast cancer
At present, the mechanism through which cancer may develop in individuals with periodontal disease is not clear. However, infection is known to promote inflammation and inflammation has been identified as a crucial enabler of the biological capabilities necessary for malignant change to occur. Periodontitis is an advanced inflammatory gum disease caused by oral bacterial dysbiosis. Research suggests that the inflammatory mediators produced during periodontitis development could mediate carcinogenesis or periodontal bacteria can exert its effect directly in transforming cells. Certainly, periodontal pathogens (such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans) release enzymes and other bacterial components that are toxic to tissues and may cause direct DNA damage, thereby inducing mutations to neighbouring cells.2 Additionally, some findings indicate that oral bacteria may enter the circulatory system through the gums which may affect breast tissue.
While more research is needed to better understand the mechanisms at work, the association between periodontitis and breast cancer has been observed in many situations. A study conducted in 2017 revealed that women diagnosed with periodontitis had two to three times higher odds of breast cancer than women without periodontitis.4 It is therefore imperative that dental professionals help patients to understand that gum disease is not always confined to the mouth, whilst ensuring that patients are aware of the potentially serious effects it could have on their health.
Who is at risk?
As some form of gingival disease affects most people during their lives, everyone should heed the warning about the links with breast cancer. As the dental team knows, gingival diseases are the body’s reaction to the bacteria that accumulates in the mouth, which can be stopped and reversed if caught early. If left untreated, periodontitis can cause severe inflammation, destroying the tooth supporting apparatus, which can lead to tooth loss as well as other health problems.
Reducing the risk
To help reduce the risk of developing gingival disease – and consequently various other health conditions like breast cancer – it is important to practise good oral hygiene. Most people understand that they need to brush their teeth twice a day with fluoride toothpaste to achieve this. However, the vast majority (68%) of British adults do not floss daily. Therefore, it is important to explore the barriers that prevent patients from cleaning interdentally, extend advice and offer solutions.
One of these may be a misunderstanding about the importance of interdental cleaning. Although NHS guidance states that from the age of 12, people should clean the teeth interdentally as part of their daily oral health routine, some people still believe that it is a waste of time. As professionals, we know this is not the case when performed correctly. Also, when patients first begin to floss the gums may bleed, which some find alarming and hence inclined to stop. Dental professionals can reassure these patients by telling them what to expect and encouraging this as a positive change to their routine.
A considerable number of patients do not clean interdentally because they find string floss or interdental brushes difficult or painful. The gentle but effective Waterpik® Water Flosser is therefore the perfect alternative. This device is highly recommended for reducing plaque, gingivitis and bleeding as it uses a combination of water pressure and pulsations to clean deep between the teeth and below the gumline. The Waterpik® Water Flosser is clinically proven to be more effective than traditional brushing and flossing for removing plaque and improving gum health and patients will find it much quicker and easier to improve their oral hygiene routine.
At a time when it is so important to look after our health, efficient oral hygiene routines that include effective interdental cleaning are essential. Not only will this help to improve the health of the mouth, but it will also reduce the risk of developing life-threatening conditions like breast cancer.
For more information on Waterpik® products please visit www.waterpik.co.uk. Waterpik® products are available from Amazon, Asda, Costco UK, Argos, Boots Superdrug online and in stores across the UK and Ireland.
To book a free Waterpik® Professional Lunch and Learn – available as a webinar or in-person where it is safe to do so – visit www.waterpik.co.uk/professional/lunch-learn/
Maxwell O’Neill, professional educator for Waterpik
 Breast Cancer Now. Facts and Statistics 2020. https://breastcancernow.org/about-us/media/facts-statistics# [Accessed 26th October 2020]
 Nwizu N. Periodontal disease and cancer: Epidemiologic studies and possible mechanisms. Periodontology 2000/ June 2020. 83(1) 213-233. https://onlinelibrary.wiley.com/doi/full/10.1111/prd.12329 [Accessed 26th October 2020]
 Hoare A. et al. Chronic inflammation as a link between periodontitis and carcinogenesis. Mediators of Inflammation, vol. 2019, Article ID 1029857, https://www.hindawi.com/journals/mi/2019/1029857/ [Accessed 26th October 2020]
 Sfreddo C.S. et al. Periodontitis and breast cancer: a case-control study. Community Dentistry and Oral Epidemiology. 2017;45(6):545-551. https://pubmed.ncbi.nlm.nih.gov/28653758/ [Accessed 26th October 2020]
 YouGov. Brushing Teeth. GB Sample 9th-10th October 2017. https://d25d2506sfb94s.cloudfront.net/cumulus_uploads/document/d2l37lsj1t/Brushing%20teeth.pdf [Accessed 26th October 2020]
  Barnes C.M et al. Comparison of irrigation to floss as an adjunct to tooth brushing: effect on bleeding, gingivitis, and supragingival plaque. J Clin Dent. 2005;16(3):71-7. https://pubmed.ncbi.nlm.nih.gov/16305005/ [Accessed 2nd November 2020]
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