Periodontitis linked to increase risk of cancer

A recent article by Dr. Bicuspid discusses some research that found an increased cancer risk in periodontitis patients.

January 16, 2018 -- Patients with severe periodontal disease have a 24% greater risk of developing cancer than patients with no or mild periodontal disease, according to a new study in the Journal of the National Cancer Institute (January 12, 2018).

The researchers also reported that patients who were edentulous had a 28% greater risk of developing cancer overall but an 80% greater risk of developing colon cancer. They also found that even patients who never smoked had more than double the risk of lung cancer if they had severe periodontal disease.

This long-term study was the largest of its kind to date, noted lead study author Dominique Michaud, ScD, in a statement.

"This is the largest study addressing the association of gum disease and cancer risk using dental examinations to measure gum disease prior to cancer diagnosis," stated Michaud, a professor of public health and community medicine at the Tufts University School of Medicine.

Suggested link

The researchers drew participants from the Atherosclerosis Risk in Communities Study, which included more than 15,700 participants between the ages of 44 and 66. All the participants had a baseline examination and were invited for follow-up visits over 10 years from the late 1990s until 2012.

At the fourth visit, 7,466 participants had a clinical dental examination. Those with a previous history of cancer were excluded. The current study differed from previous studies in that it included this dental examination, the authors noted.

During the examination, probing depth and gingival recession were measured at six sites on all teeth. These two values were summed for attachment loss as a measure of periodontal destruction. The categories included no/mild periodontitis (less than 10% of sites with attachment loss of 3 mm or less), moderate, severe (30% or more of sites with attachment loss greater than 3 mm), and edentulous.

January 16, 2018 -- Patients with severe periodontal disease have a 24% greater risk of developing cancer than patients with no or mild periodontal disease, according to a new study in the Journal of the National Cancer Institute (January 12, 2018).

The researchers also reported that patients who were edentulous had a 28% greater risk of developing cancer overall but an 80% greater risk of developing colon cancer. They also found that even patients who never smoked had more than double the risk of lung cancer if they had severe periodontal disease.

This long-term study was the largest of its kind to date, noted lead study author Dominique Michaud, ScD, in a statement.

"This is the largest study addressing the association of gum disease and cancer risk using dental examinations to measure gum disease prior to cancer diagnosis," stated Michaud, a professor of public health and community medicine at the Tufts University School of Medicine.

The researchers reported an 80% increase in the risk of colon cancer for patients who were edentulous at baseline. Interestingly, the risk for lung cancer also increased twofold for those with severe periodontitis who had never smoked, compared with those participants with no or mild periodontitis.

The researchers found that not smoking apparently did not alleviate the risk for lung cancer, according to co-author Elizabeth Platz, ScD, deputy chair of the department of epidemiology at the Johns Hopkins Bloomberg School of Public Health.

"When we looked at data for the people who had never smoked, we also found evidence that having severe periodontal disease was related to an increased risk of lung cancer and colorectal cancer," she stated.

The researchers did not find any links between periodontitis and increased risks of breast, prostate, or blood/lymphatic cancers. However, they reported that the association between severe periodontitis and total cancer risk was stronger in men and null in women, compared with those participants with no or mild periodontitis. Also, links were generally weaker or not apparent among black participants, with the exception of lung and colorectal cancers, for which associations were similar by race.

Reducing cancer deaths

The authors cited the size of the study population as the main limitation of their study. Also, the dental examination took place at the fourth visit, which was nine years into follow-up. In addition, they noted that classification of periodontal disease might be imperfect.

However, they noted that their study provides further evidence that cancer risk is higher in individuals with periodontitis. But more research is needed to understand the cancer site-specific and racial differences, they added.

"Additional research is needed to evaluate if periodontal disease prevention and treatment could help alleviate the incidence of cancer and reduce the number of deaths due to certain types of cancer," Michaud stated.

American Dental Association In Action

Every year the American Dental Association has an annual meeting. They rotate which city will host it, and this year it was Washington DC's turn to play host. I, along with the rest of the board of the Utah Dental Association, took advantage of the location this year to visit with our state senators and congressmen to discuss some bills and resolutions that we are fighting for to improve dental coverage for our patients.

There are 3 bills/resolutions in particular that we are pushing. I'll give you a quick summary of each bill.

1- we are trying to repeal the McCarron Ferguson act that was passed 60 years ago. It gives insurance companies exemption from anti-trust laws. Basically insurance companies can collude to price fix and do other illegal things that end up hurting the patient. They don't have to play by the same rules as everyone else and we want the playing field leveled. Once this happens patients will see an increase in innovation and as a result their insurance benefits will improve, costs will shrink, and efficiency will improve. 

2-we are seeking changes to the ERISA laws that were passed back in the 1970's. Long story short is that insurance companies are unfairly denying patients their rightful benefits at times, and when we try to prosecute them through the state insurance commission the insurance companies hide behind this federal law. An unintended consequence of the law is that it allows insurance companies to bully their patients and get away with it. We want our patients to rightfully receive the benefits they have been paying the insurance company for.

3-The federal government won't allow federal student loans to be refinanced more than once and are locking students into rates that are far above market value. We want this law changed to allow student loans to be treated more like mortgages are. After all, many dental students are now graduating with $450,000 in student loans. If a person has a home mortgage it can be refinanced multiple times to get a better interest rate. Student loans don't have that option unfortunately, and as a result they miss out on tremendous savings opportunities. 

It's an uphill battle for all three but we have to try.

One thing that I learned from meeting with our representatives is that together we can accomplish our goals. Government may be slow and frustrating at times, but the best way to get stuff done is to work together.

Implants vs Bridges

Unfortunately sometimes a tooth needs to be pulled for various reasons. Two of the best options to replace a missing tooth are implants and bridges.  Each has some pros and cons.  This cool image breaks down some of it easily.

In our office a bridge costs about the same as an implant, so price is not an issue. This is good because it allows us to better decide on which is the best treatment option for the situation.  Most of the time we will recommend an implant because it's the better option, but there are times when we will recommend a bridge.  Here are a few examples: severely medically compromised individuals (i.e. uncontrolled diabetes, history of bisphosphonates, etc.), severe bone loss where there is no longer sufficient bone for an implant, or for esthetic reasons. In these situations it is better in the patients interest to forego the implant and pursue a bridge.

The majority of the time though implants are the better option because they are easier to clean and maintain. Bridges are very difficult to keep clean as you need to thread the floss underneath the bridge which can be cumbersome and time consuming.  Implants are less invasive on the other teeth. Bridges require grinding down one tooth in front and one tooth behind the missing tooth, and we try to avoid grinding down good teeth, whereas implants don't need to bother or change the teeth next to them.  Implants last must longer than a bridge. Bridges tend to last a mere 10 years. If the bridge is resting on a tooth that has had a root canal, that time frame goes down even more.  Implants on the other hand can last a lifetime if you keep them clean.  Also, implants help to preserve the bone. Jaw bone is funny and unlike any other bone in the body. It thinks its only purpose is to support teeth. When the teeth are gone, the bone resorbs and shrinks in size. This can affect how you look. Implants are bone stabilizers. When an implant is placed, it preserves the jaw bone.

Implants can look incredibly life like. Esthetically they are difficult to distinguish from your natural teeth. Technological advancements have really improved the look, feel and durability of implants.

So if you are missing teeth, feel free to ask us which option would best benefit you to replace the missing teeth. Contact us for more info or visit our website to learn more about your options.

Cosmetic Dentistry

Cosmetic Dentistry is a buzz phrase often heard in our industry. Dentists use the phrase to describe a style of dentistry they offer, and patients reference it when discussing what type of dentistry they are interested in. So what is cosmetic dentistry?
Cosmetic dentistry is any procedure that can improve the aesthetics of your smile. Whether it is something as simple as whitening your teeth or as complex as a full mouth makeover, cosmetic dentistry can improve your smile. Many people have teeth that are chipped, discolored, misshapen or even missing and as a result don't smile with the confidence they would prefer. That is when they pursue some of the treatment options that we can provide.
At Park City Dentistry we offer a variety of these cosmetic services. Some of the most popular are our 1 hour in office teeth whitening procedures, porcelain veneers that look incredibly life-like, implants to replace missing teeth, crowns for misshapen teeth, gum therapy for patients suffering from periodontitis, and even realistic dentures for patients who have lost all of their teeth.
Our goal is to help our patients leave here with beautiful, natural looking teeth. We aim for the type of teeth that will make your family and friends wish they had your smile. We take great satisfaction in providing cosmetic procedures that even many of the most trained eyes can't detect if they are natural or not.
One added benefit of cosmetic dental procedures extends beyond even the aesthetics of your smile. Cosmetic dental options can even improve many of your oral health problems like your bite and gum health.
If you have any questions about the procedures we offer or about what options you would have with your smile, feel free to call our office and set up an appointment for a consultation.

New Guidelines for Artificial Joint Patients

Have you had a joint replacement in the past and felt confused on whether or  not you should take antibiotics prior to your dental treatment?  Well you are not alone.  Many in the medical industry have been confused with the changing guidelines recommended for joint replacement patients.  It has been recommended that patients with prosthetic joints should pre-medicate for life.  It has also been recommended to pre-medicate for 2 years after the surgery.  Confusing, right? Now the American Dental Association (ADA) and the American Academy of Orthopedic Surgeons (AAOS) have clarified the issue and determined that patients with prosthetic joints no longer need to pre-medicate.
Their reasons for this recommendation are based on their findings that there is no association between dental procedures and the occurrence of prosthetic joint infections. Factors also considered in the recommendation included:
1- Antibiotic resistance due to overuse of these drugs.
2- Adverse drug reactions such as anaphylaxis, nausea, vomiting and development of allergy like symptoms.
3- Cost.  The results of a 2013 report revealed that the annual cost of amoxicillin administered to patients with joint prostheses before dental procedures in the U.S. probably exceeded $50 million!

So the bottom line is that if you have had a joint replacement you no longer need to pre-medicate for dental visits.  These new guidelines do not apply however to pre-medication for patients with cardiac issues that were outlined in 2007.

Why good dental hygiene is important

A few recent studies published by NYU, Harvard, and the University of Bristol have shed light on the need for good oral hygiene.  You can read a summary of the reports here.

Most people are aware that poor dental hygiene can lead to cavities, gum disease and bad breath.  But there are other problems that can result from neglecting your mouth.  The studies mention that Alzheimer's disease, pancreatic cancer, and heart disease can possibly be caused by poor oral hygiene.

Take care of your mouth, and it will take care of you.  If you need to schedule a cleaning and check up, feel free to call our office today at 435-649-4343 and let us help you improve both your oral health and your overall health.

The Power of a Smile

Dr. Steven Lin gave a powerful TEDx talk on the power of a smile.  Enjoy!