Breast Cancer and Oral Health

Most people realize the major risk factors of cancer.

 

These include smoking, alcohol use and others. The surprising fact is how your oral health has a connection to breast cancer. You may be 11 times more likely to develop breast cancer if you have poor oral health or gum disease. Journal of Breast Cancer Research and Treatment conducted a survey of 3,273 people and found that individuals with chronic periodontal disease (gum disease) had a higher occurrence of breast cancer.

Another study was reported by the World Health Organization (WHO) and was conducted between 1985 to 2001. This study also concluded that gum disease increases the risk of breast cancer.

Gum disease has been linked to several general health chronic illnesses, including pneumonia, prostate cancer, stroke, heart disease, problem pregnancy, diabetes and breast cancer.

·         Pneumonia: Bacteria in the oral cavity can be aspirated into the lungs and cause respiratory diseases including pneumonia.

·         Prostate cancer: In 1986, over 48,000 men were involved in a study conducted by Dr. Dominique Michaud, Imperial College of London. The study concluded gum disease increases the risk of prostate cancer by 14 percent.

·         Diabetes: According to the American Academy of Periodontology, diabetic patients are more likely to develop gum disease, which in turn can increase the risk of infection.

·         Heart disease: Researchers have found that people with gum disease are almost twice as likely to suffer with coronary artery disease as those without it. As oral bacteria enters the blood stream, it attaches to fatty plaques in the heart blood vessels and contributes to clot formation. These blood clots can then obstruct normal blood flow, which can lead to heart attack.

·         Pregnancy problems: Pregnant women who have gum disease may be more likely to have babies that are born too early and too small.

Connecting the Dots
In general, gum disease causes inflammation. Inflammation has been found to be the precursor of heart disease, stroke, pregnancy problems and over all fatigue. In other words, it is a marker for generalized ill-health. This has been confirmed through blood work and C-reactive protein. C-reactive protein is a inflammation marker which decreases when gum infection is brought under control, and increase with advanced gum disease.

Inflammation: The Warning Sign Not to be Ignored
The first sign of gum disease is inflammation. You’ll know when this is present as your gums appear slightly red, tender, and may even bleed when you brush or floss. The main cause of inflammation is bacteria that form a film called plaque, and stick to the gum and teeth surfaces. If this plaque is not removed at least once per day, the problem can advance to severe gum disease. As inflammation advances, the disease effects destruction of the gums and eventually bone. The teeth develop tooth decay, become loose and may have to be extracted. This is why dental visits are very important at least every three months to monitor the health and condition of your teeth and gums, especially with the presence of cancer.

The bacteria that causes gum disease forms a thin biofilm called plaque and accumulates on the gums and teeth. This same bacteria is found in hardened plaque in arteries that lead to arteriosclerosis. A study by the Karolinska Institute reported the bacteria in gum disease can result in the Epstein-Barr virus and cytomegatocirus. These viruses may result in the suppression of the body’s immune system, which can contribute to the incidence of breast cancer.

There are other connections between breast cancer and oral health. Chemotherapy and radiation may be used to kill or slow breast cancer cells by interfering with growth and multiplication of cells. If chemotherapy or radiation is prescribed as part of treatment for breast cancer, side effects can be severe and include:

·         Mucositis, a severe form of inflammation of the mouth.

·         Increase risk of infection in the mouth. If the drug suppresses white cells, which normally protect against infection, deep cleanings and other invasive procedures such as tooth extraction can result in infection.

·         Difficulty in swallowing.

·         Taste alterations ranging from unpleasant to tasteless.

·         Due to dry mouth, difficulty with speech and eating.

·         Oral yeast infection from the fungus candida.

·         Poor nutrition due to difficulties in eating, dry mouth or loss of taste.

·         Deep aching and burning pain that mimics toothache.

Most patients are treated with chemotherapy or radiation. However, some patients may be treated with bisphosphonates, such as Fosamax, Boniva, and others. Recent studies from University of Southern California suggest long-term use of such bisphosphonates may develop into destruction of the jaw bone. The risk is low but increases with chemotherapy.

How to Minimize Side Effects
Most people are aware of hair loss with chemotherapy. But most don’t realize that more than one-third of people being treated for breast cancer can develop complications that affect the mouth. These complications can affect your quality of life. Preexisting or untreated oral disease can even complicate cancer treatment. This is one reason to make sure you visit your dentist at least one month before beginning cancer treatment.

The mouth is made of cells that renew themselves daily. Since chemotherapy and radiation target certain types of cells that regenerate quickly even under normal circumstances, your mouth will be susceptible to damage. If you minimize bacterial plaque buildup by practicing good hygiene, you can decrease the side effects of treatment for breast cancer. The following recommendations are important to follow:

1.    Brush with a soft toothbrush or sponge brush to clean your teeth and gums.

2.    Floss gently.

3.    Only use alcohol-free mouthwash, preferably one free of saccharin, but one containing xylitol.

4.    When white blood cells counts are reported by your physician to be low, avoid dental treatment.

5.    Avoid dental treatment for about a week after chemotherapy.

6.    Inflammation starts with red gums that may bleed. Even slight bleeding should not be ignored.

7.    Use toothpaste and chewing gum with xylitol.

8.    Regular dental visits to identify problems before they develop.

9.    If you wear dentures, make sure you keep them clean and that they fit well. Make sure to take them out at night.