Gum Disease Linked to Head and Neck Cancer Risk

Gum disease, or periodontal disease, is a disorder that involves the periodontium (oral soft tissue and bone support structures of your teeth). When you have good oral hygiene and health, typically your gums will snugly hug each tooth, providing support along with the bones of the jaw.

When you develop gum disease, your gums will pull away from your teeth. As gum disease worsens, you risk your teeth falling out as the gums and bones that support your teeth become damaged.

While this may sound scary, know that prevention is fairly simple—proper oral hygiene is key. A few minutes each day to brush, floss, and rinse can reduce your risk.

Where Gum Disease Starts

Gum disease occurs in the adult population at an alarmingly high rate, with 50 to 90 out of 100 adults experiencing gingivitis. It can come on relatively quickly, starting within ages 10 to 21, and stems from changes in oral hygiene practices.

You'll likely notice these signs of gum disease:

• Gums that are red, swollen, or tender
• Pain while chewing
• Bleeding when you floss between your teeth
• Persistent bad breath
• Teeth that are loose or sensitive
• Gum line that is receding/appearance of longer-than-normal teeth

Your mouth is normally moist with saliva and full of bacteria (referred to as normal flora). Throughout the day, saliva, bacteria, and other particles form a substance called plaque. When the plaque is not removed by brushing or flossing your teeth, the plaque can form tartar on your teeth.

While plaque can be removed by brushing and flossing, tartar can only be removed by a professional dentist or dental hygienist. The plaque and tartar can eventually cause inflammation of your gums due to bacteria-induced gingivitis.

Gingivitis, fortunately, is reversible most of the time. At this mild stage of gum disease, your teeth are intact and your gum and bone structures supporting your teeth will all be intact.

To prevent worsening of gum disease, you should regularly do the following to reverse gingivitis:

• Brush your teeth
• Floss your teeth
• Receive a professional cleaning by your dentist

Untreated gingivitis can eventually lead to a more progressive gum disease called periodontitis, or inflammation around your teeth. Unlike gingivitis, periodontitis can damage the support structures of your teeth.

During this stage of gum disease, your gums will pull away from your teeth and may form "pockets" that become a place for plaque to accumulate; however, brushing and flossing alone cannot remove plaque that is deposited in these pockets. Periodontitis is the most common cause of tooth loss in adults.

Risk Factors for Gum Disease

Aside from not regularly brushing or flossing your teeth, other factors can increase your risk of developing gum disease including:

• Smoking (two times more likely to develop gum disease)
• Genetic predisposition
• Diabetes
• Weakened immune system
• Xerostomia; dry-mouth (medication-induced, or disease-induced)
• Oral contraceptives, pregnancy or other causes of female hormonal changes

Head and Neck Cancer Risk

Cancer of the head and neck has many cases each year throughout the world, most of which occur in the mouth or in middle part of the throat (oropharynx). While there are many causes that can be associated with the development of a head and neck cancer, oral hygiene habits have also been associated with modifying your risk of developing cancer.

Imbalance of the normal bacterial flora in your mouth as a result of gum disease is thought to be the main reason for increased risk of head and neck cancer. Studies link the following oral conditions to the development of head and neck cancers:

• Gum disease present (not differentiated between gingivitis or periodontitis)
• Five or more teeth missing
• Brushing teeth less than once a day
• Visiting the dentist less than once per year

The above conditions increase your risk for both gingivitis and periodontitis. There are two main rationales considered for the development of head and neck cancer from gum disease:

1. The first reason is related to bacteria associated with gingivitis. Porphyromonas gingivalis is the main bacteria associated with gingivitis and has been identified in high quantities of head and neck cancerous tumors.
2. The second reason that gum disease is considered to be a risk factor for the development of head and neck cancer is related to inflammation. Periodontitis causes a significant amount of inflammation to the gums and other dental structures due to the bacterial release of toxin from pockets around the teeth where the gums have pulled away from each tooth. This toxin causes chronic inflammation which can cause the release of chemicals and oxidative free radicals which are carcinogenic (cancer-causing).

Treatment

In order to help prevent cancer of the head and neck related to gum disease, you need to ensure that you are maintaining good oral hygiene practices. If gum disease is at the stage of gingivitis, you can follow the treatment guidelines listed above.

However, if your gum disease has advanced to periodontitis, treatment for gum disease and reducing your risk for head and neck cancer will require more aggressive therapy than you can do on your own, including:

• Plan regular dental exams (at least once per year; preferably twice)
• Brush your teeth (at least once a day, preferably twice) to reduce plaque buildup
• Floss your teeth (at least once a day)

Your dentist will measure the pockets around your teeth at each visit to assess healing progress. If your gum disease is too advanced or healing is not occurring, surgery may be required.

Once periodontal disease treatment has occurred, be sure to maintain good oral hygiene practices at home and keep up with regular periodontal maintenance via frequent regular cleanings and periodic deep cleanings to continue to manage the disease.