As breast cancer awareness month comes to a close, I thought it was best to highlight the relationship between breast cancer and oral health. Worldwide, breast cancer is the most common type of cancer amongst women and the second most common type of cancer overall. In 2018, there were over 2 million new cases of breast cancer worldwide. In Jamaica, 60% of breast cancer diagnosis were amongst women between the ages of 25 and 29, while 25 % were women of the age of 60 (CHIN, 2018). Let us not forget that breast cancer also affects men, however it is very rare and only less than 1% of all breast cancer cases develop in men.
Research that individuals with very poor oral health have higher risks of developing breast cancer. Research done by the Oral Health Foundation have shown that women who suffer from severe periodontal (gum) disease had up to three times higher odds of developing breast cancer. Researchers believe that the link could support the theory that breast cancer could be triggered as a result of systemic inflammation. Systemic inflammation may originate in the infected gums. Bacteria from the infected gums may enter the bloodstream and initiate a systemic inflammatory response.
Another study done by the Karolinska Institute reported that bacteria found in gum disease can result in the Epstein Barr virus which causes the suppression of the immune system and can contribute to the incidence of breast cancer.
It is therefore important that individuals with severe gum disease practice good oral health and schedule regular cleanings and check ups with their dentists. It is also recommended that these individuals visit their doctors for frequent medical check-ups, as controlled periodontal disease will depend on the systemic conditions of such individuals.
Breast Cancer Treatment and Oral Health
Therapies involved in the treatment of breast cancer such as chemo, radio, hormone and target therapy are normally very invasive and may destroy healthy cells in the process of destroying bad cells. Individuals undergoing these types of treatment are more susceptible to gum disease along with other oral health problems, which include:
- Mucositis – Radio and chemotherapy cause the destruction of mucosal tissue responsible for the secretion of mucus to help in the process of digestion. Mucositis may result in pain while swallowing, nutritional problems (due to inability to swallow without pain) and increase the risk of infections and sores.
- Xerostomia – The decreased production of saliva which causes dry mouth and can lead to bad breath, tooth decay, speech and eating difficulties and mouth infections. Radiotherapy and chemotherapy can lead to the destruction of salivary glands.
- Increased risk of Fungal and Viral infections
- Increased incidence of periodontal disease due to radio and hormonal therapy.
- Dysguesia (distortion of the sense of taste) and Dysphagia (difficulties swallowing).
- Osteonecrosis of the Jaw (Literally ‘bone death’) is a condition that is associated mainly with intravenous antiresorptive drugs that are sometimes used during chemotherapy.
Maintain your oral hygiene during and after treatment to reduce some of the side effects associated with these treatments. In addition to routine check-ups and cleanings it is important that you brush twice per day using a soft toothbrush and you don’t forget to floss.
Steven Moore is a General Dentist practicing in Jamaica. He graduated from the University of the West Indies in 2015 and completed a Dental Residency (AEGD) with the NYU Lutheran Medical Centre in 2017. He enjoys playing video games and practicing judo.