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Exploring the Link Between Periodontal Disease and Esophageal Cancer

Dental researchers have long known about the connection between the bacteria that cause periodontal disease and other health conditions, but a new study from the Laura and Isaac Perlmutter Center at the New York University Langone Health has now linked these strains of bacteria to a higher risk of developing esophageal cancer.

The study was published in Cancer Research, a journal of the American Association for Cancer Research, and outlines a new investigation between gum disease and esophageal cancer, the eighth most prevalent cancer in the world.

Previous research into the bacteria that cause periodontal disease has connected it to other types of cancers, including oral, breast and stomach cancer. The NYU Langone Health study sought to find connections to the development of two kinds of esophageal cancer in particular: esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC).

During the study, the researchers gathered oral wash samples from 122,000 participants through two health studies: the National Cancer Institute Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial and the American Cancer Society Cancer Prevention Study II Nutrition Cohort.

Over a 10-year period, researchers followed the participants to monitor them for the development of esophageal cancer. Of the 122,000 participants, 106 developed esophageal cancer.

Researchers also extracted DNA from participants and sequenced the oral wash samples to compare the oral environments of the participants who developed esophageal cancer cases and those who did not.

They found that several strains of bacteria contributed to a higher risk of developing esophageal cancer. The participants who had the strain of bacteria Porphyromonas gingivalis had a higher risk of developing ESCC.

Another strain, Tannerella forsythia bacteria, led to a 21 percent greater risk of developing EAC.

Both types of bacteria are known to cause periodontal disease.

Researchers hope their findings can lead to earlier detection of esophageal cancer.

In addition to finding a connection between the presence of some bacteria and a higher risk of developing esophageal cancer, the researchers also found that some strains of bacteria, such as Neisseria, also lowered the risk of developing esophageal cancer.

The study authors theorize that Neisseria and other bacteria that lowered the risk of esophageal cancer could have a protective effect against the disease.

The findings could pave the way for future studies and treatments to both prevent esophageal cancer and treat periodontal disease.

Current treatments for periodontal disease include the use of oral antibiotics, removing the bacteria through scaling and root planing, and gum surgery to remove impacted tissue.

“One of the best ways to treat periodontal disease is to work to prevent it,” said Dr. Stefania Caracioni, L.V.I.F., a Topeka dentist.

“Practicing good oral hygiene habits like regular brushing and flossing can keep dental plaque in check and prevent bacterial overgrowth,” she said.

If bacteria can grow in the mouth unchecked, periodontal disease begins to develop, and patients experience symptoms such as redness, swelling and bleeding of the gums.

Periodontal disease can also cause bad breath and make eating and drinking difficult.

In addition to practicing good oral hygiene to prevent periodontal disease, the American Dental Association suggests that people visit their dentist every six months for a dental cleaning.

“Brushing and flossing remove food debris that bacteria feed on and help to remove bacteria and plaque from the teeth physically, but routine dental cleanings do a more thorough job,” Caracioni said.

It also gives the dentist an opportunity to monitor patients with periodontal disease, and if periodontal disease is detected early, plot a plan of treatment to halt or even reverse the damage caused by the condition.

Sources:

American Association for Cancer Research. “Oral microbiota indicates link between periodontal disease, esophageal cancer.” ScienceDaily. ScienceDaily, 1 December 2017.

American Cancer Society. Key Statistics for Esophageal Cancer. 4 January 2018.