The Link Between Gum Disease and Head and Neck Cancer Risk

Gum Disease Increases Your Risk for Some Head and Neck Cancers

Dentist examining a woman's teeth.
Dentist examining a woman's teeth. Glow Wellness / Getty Images

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 unappealing, 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 Does Gum Disease Start?

Gum disease occurs in the adult population at an alarmingly high rate, with 50 to 90 out of 100 adults experiencing gingivitis. and can start relatively quickly, starting within 10 to 21 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 through brushing and flossing, tartar can only be removed by a professional dentist or their 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
  • professional cleaning at your dentist's

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 for developing gum disease including:

  • smoking - 2 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

    Why Gum Disease Increases Your Risk for Head and Neck Cancer

    Cancer of the head and neck accounts for approximately 500,000 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 for 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 for 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 peridontitis)
    • 5 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 peridontitis. There are 2 main rationales considered for the development of head and neck cancer from gum disease. 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. 

    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).

    Treating Gum Disease

    In order to help prevent cancer of the head and neck related to gum disease, you need to ensure that your 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 peridontitis, 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.

    • scaling and root planing
    • 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

    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 treatment has occurred, be sure to maintain good oral hygiene practices to reduce your risk of recurrence.

    Sources:

    American Dental Association. (2012). Periodontal Disease. Accessed on December 23, 2016 from http://www.ada.org/en/~/media/ADA/Publications/Files/ADA_PatientSmart_Perio_Disease.

    Centers for Disease Control and Prevention. (2016). Smoking, Gum Disease, and Tooth Loss. Accessed on December 23, 2016 from https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html.

    Hashim, D, Sartori, S, Brennan, P, Curado, MP, Wunsch-Filho, V ... Boffetta, P. (2016). The role of oral hygiene in head and neck cancer: results from International Head and Neck Cancer Epidemiology (INHANCE) consortium. Annals of Oncology. 27: 1619–1625. doi:10.1093/annonc/mdw224.

    National Institute of Dental and Craniofacial Research. (2013). Periodontal (Gum) Disease: Causes, Symptoms, and Treatments. Accessed on December 23, 2016 from https://www.nidcr.nih.gov/oralhealth/Topics/GumDiseases/PeriodontalGumDisease.htm.

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