Gum Disease, Cancer, and Diabetes

If you are reading this, there’s a high chance you have gum disease.1 In previous posts we’ve discussed what gum disease is and how it can affect pregnancy and heart disease. This post will continue that discussion with a focus on cancer and diabetes.

Our hope through these posts is to help you understand how your oral health is a huge part of your overall well-being. Our information is always well researched, as you can see by our references at the bottom. Keep reading, and let us know if you have any questions or comments!

Oral Cancer

Oral cancer is the 8th most common type of cancer in the US, and the majority of head and neck cancer cases are found in the mouth, particularly the sides of your tongue.2 Cancer is one of the many things we screen for at every exam at Teuscher Dental, and part of why regular dental exams are so important and about more than just teeth and gums. Cancerous lesions appearing on the tongue are correlated with gum disease.3 And inflammation in general is thought to contribute to cancer development.  Oral cancer has a high incidence of malignancy, and even when successfully treated can require extensive facial reconstructive surgery to recover from, as exampled by oral cancer survivor Gruen Von Behrens’ before and after photos.4

As stated above, inflammation like that of gum disease can contribute to any type of cancer. That, along with pregnancy complications and heart disease, are just a few of the diseases and complications with direct correlation to gum disease. But research also has demonstrated gum disease links to colorectal cancer, gastrointestinal diseases, respiratory diseases, and Alzheimers to name a few. As more research is done it is all too likely the links will become more clear. Gum disease is no joke.

Diabetes

Both Type I and Type II diabetics are more prone to develop periodontal disease, the advanced form of gum disease, than non-diabetics.5,6 This is especially true for children with diabetes, where gum disease progression happens more quickly and is associated with longer duration of diabetes.7 In advanced gum disease, teeth can be lost due to breakdown of surrounding bone and tissue. Snowballing the problem, we know gum disease is associated with low grade inflammation and oxidative stress. These effects are also known to cause lower saliva output, causing dry mouth, increasing risk for dental caries (cavities) and further tooth loss.8 Aside from poor esthetics, tooth loss is is associated with increased likelihood for dysfunctional dentition- that is, teeth that don’t allow for proper nutritional intake.9 This is a particular problem for diabetic patients. It is a vicious cycle.

Don’t have diabetes? Studies have shown that we can actually predict whether a person is more likely to develop diabetes based on their periodontal health.10,11 While a diagnosis of diabetes depends on blood sugar levels, as with all health conditions there is a spectrum of glycemic control.  All aspects of our body’s health are interrelated.

Comprehensive research shows dental therapy for gum disease moderately decreases blood glucose levels in diabetics.12 . When we understand the strong correlation and the severity of issues associated with diabetes, it becomes clear that dental treatment for gum disease should be a part of a comprehensive diabetes medical treatment plan.

References

1. American Academy of Periodontology. “CDC: Half of American Adults Have Periodontal Disease.” CDC: Half of American Adults Have Periodontal Disease | Perio.org, 4 Sept. 2012, www.perio.org/consumer/cdc-study.htm.

2. “Oral Cancer Facts.” The Oral Cancer Foundation, 28 Feb. 2019, oralcancerfoundation.org/facts/.

3. Tezal, Mine, et al. “Chronic Periodontitis and the Risk of Tongue Cancer.” Archives of Otolaryngology–Head & Neck Surgery, U.S. National Library of Medicine, May 2007, www.ncbi.nlm.nih.gov/pubmed/17515503.

4. Henson, Brian J., et al. “Decreased Expression of MiR‐125b and MiR‐100 in Oral Cancer Cells Contributes to Malignancy.” Wiley Online Library, John Wiley & Sons, Ltd, 24 Apr. 2009, onlinelibrary.wiley.com/doi/abs/10.1002/gcc.20666.

5. Hodge, Penny J, et al. “Periodontitis in Non‐Smoking Type 1 Diabetic Adults: a Cross‐Sectional Study.” Wiley Online Library, John Wiley & Sons, Ltd, 31 Oct. 2011, onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-051X.2011.01791.x.

6. Haseeb, Muhammad, et al. “Periodontal Disease in Type 2 Diabetes Mellitus.” Journal of the College of Physicians and Surgeons–Pakistan : JCPSP, U.S. National Library of Medicine, Aug. 2012, www.ncbi.nlm.nih.gov/pubmed/22868018.

7. Al-Khabbaz, Areej K, et al. “Periodontal Health of Children with Type 1 Diabetes Mellitus in Kuwait: a Case-Control Study.” Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre, S. Karger AG, 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC5586723/.

8. Bhattarai, Kashi Raj, et al. “The Imprint of Salivary Secretion in Autoimmune Disorders and Related Pathological Conditions.” Autoimmunity Reviews, U.S. National Library of Medicine, Apr. 2018, www.ncbi.nlm.nih.gov/pubmed/29428807.

9. Marina Leite Souza, and Karen Glazer Peres. “Association between Metabolic Syndrome and Tooth Loss.” Journal of the American Dental Association, JADA, Dec. 2019, jada.ada.org/article/S0002-8177(19)30522-7/abstract.

10. Taylor, G W, et al. “Severe Periodontitis and Risk for Poor Glycemic Control in Patients with Non-Insulin-Dependent Diabetes Mellitus.” Journal of Periodontology, U.S. National Library of Medicine, Oct. 1996, www.ncbi.nlm.nih.gov/pubmed/8910827.

11. Demmer, Ryan T, et al. “Periodontal Status and A1C Change: Longitudinal Results from the Study of Health in Pomerania (SHIP).” Diabetes Care, American Diabetes Association, May 2010, www.ncbi.nlm.nih.gov/pubmed/20185742.

12. Chee, B., et al. “Effect of Non-Surgical Periodontal Treatment on Glycemic Control of Patients with Diabetes: a Meta-Analysis of Randomized Controlled Trials.” Trials, BioMed Central, 1 Jan. 1970, link.springer.com/article/10.1186/s13063-015-0810-2.

The Importance of Being More Kissable!

Who knew that kissing has actual health benefits?  The scientific study of kissing is called “philematology” (philos in ancient Greek = earthly love).  A Nobel Prize-winning study reported that people who increased their frequency of kissing over a 6-week period had lower cholesterol blood levels. They also had less allergy symptoms and allergic reactions, relief from hives, and – not surprisingly – lower stress levels!  Kissing also stimulates your brain to release feel-good chemicals like dopamine, oxytocin and serotonin, which may also dilate blood vessels, thereby reducing headaches and cramps. Kissing is also shown to lower cortisol levels – a stress hormone also associated with difficulty losing fat.  Kissing can burn 5-26 calories per minute, and may also reduce the appearance of wrinkles by tightening and toning facial muscles!

Here’s the BAD news: studies also show that the biggest turnoff when it comes to kissing is – you guessed it – bad breath!  Missing teeth, cracked teeth and stained teeth are also rated as very off-putting. Kissing is a cultural indication of acceptance and affection. But research indicates that 2/3 of us would refuse to date someone with bad breath. 

A BIG problem is that most people with bad breath have NO IDEA so… that person could be you.  Bad breath can be a social barrier in everything from friendships to work relationships.  The bad-breath obstacles to kissing and close relationships can result in lower overall self-esteem in everyone from children to teens to adults. Sadly, those with bad breath may notice that others are avoiding them but not quite know why.

Bad breath can be more than just a social deterrent.  While breath odor is most often an oral health issue, there can be other causes. These include tobacco use, certain foods and medications, and medical issues such as infections in the nose, sinuses and throat, chronic reflux, some cancers and metabolic disorders. The Mayo Clinic adds that in young children an item such as food that’s stuck in a nostril may also cause bad breath, so it’s important for parents to pay attention.

So start with good oral hygiene habits that include regular cleanings and examinations by a dentist who is an expert in pro-active prevention. Obvious treatments like brushing with toothpaste or using mouthwash can be enough to cure bad breath at first. But bad breath can also indicate oral or respiratory infections as well as other GI issues like GERD, which can lead to more serious issues, including cancer. A “wait and see” approach doesn’t do you many favors (health-wise OR financially) when, very often, we can catch these things early on. This is when we can usually intervene with simple solutions and lifestyle change suggestions. This is only a small part of the reason regular dental cleanings and exams are so important!  

I am passionate about helping people get healthy and helping you to stay that way, so it would be my honor to help you be more kissable!  

Your grateful partner in health,

Dr. Mike