Oral health links breast cancer.

Sir,

The interaction between oral and systemic health are bidirectional and complex, involving many pathways. Much research on the inflammatory process and its relationship to oral and systemic disease is currently underway. More than 120 medical conditions, some of which are life threatening can be detected in the early stage by dentists.[1] Periodontitis is a destructive inflammatory disease of the supporting tissues of the teeth and is caused either by specific microorganisms or by a group of specific microorganisms, resulting in progressive destruction of periodontal ligament and alveolar bone with periodontal pocket formation, gingival recession, or both.[2] One of these mechanisms is based on the potential effects of the inflammatory phenomenon of periodontitis on the systemic dissemination of the locally produced mediators, such as C-reactive protein (CRP), interleukins-1 beta (IL-1β) and -6 (IL-6), and tumor necrosis factor-alpha (TNF-α).[3] Recently periodontal disease is associated with increased prevalence of breast cancer. Recent study in the Sweden stated that the chronic periodontal disease indicated by missing molars seemed to associate statistically with breast cancer.[4] The study puts forward the idea that the risk of a woman developing breast cancer could be amplified by chronic gum disease. The study analyzed and evaluated over 3000 women between the ages of 30 and 40 years over a 16-year period. Among the women studied for the research, those who reported that they had suffered from chronic gum disease or had lost teeth due to periodontal disease were found to be more than two times as likely to be diagnosed with breast cancer as compared to those who had healthy gums.[4] Due to poor oral hygiene and gram-negative anerobic bacterial infection, chronic periodontitis is closely associated with human cytomegalovirus and Epstein-Barr virus co-infection. It is supposed that these viruses act together to control immune response to bacterial challenges; these viruses and bacteria act together to lead to low-degree chronic inflammation and carcinogenesis. Periodontal disease is associated with an increased production of reactive oxygen species which, if not buffered sufficiently, cause damage to the host cells and tissues.[5] The byproducts of the oral inflammation enter the bloodstream, which may enhance cellular proliferation and mutagenesis, allowing for the development and spread of cancer.