/ 3 July 2008

Brushing off cancer

Sex Pistols lead singer John Lydon has been pilloried for shelling out $22 000 to fix the decaying gnashers that inspired his nickname, Johnny Rotten. “It wasn’t vanity that sent me to the dentist,” he has said in his defence. “All those rotten teeth were seriously beginning to corrupt my system. I was feeling incredibly ill. I was permanently poisoning myself with gum infections. My gums were receding and I was starting to look seriously weird.”

Perhaps punk fans should go easy on him. It was reported in May, in a study published in Lancet Oncology, that periodontitis (gum disease) could be associated with an increased risk of lung, kidney, pancreatic and haematological cancers, while previous research has suggested a link with illnesses such heart disease, diabetes and stroke. But why would the state of your teeth affect the rest of your body?

In the latest study researchers at Imperial College, London, found that men with a history of gum disease had a 14% higher chance of getting cancer than those with no history of gum disease. One theory is that an immune system weakness causes both illnesses. There is even a possibility that the swallowing bad bacteria from infected gums might cause the cancer. But at this stage these are all mere possibilities.

Whether people with poor gum health should worry about stroke or heart disease is also not clear-cut. It might be that the bacteria that causes gum disease also causes an inflammation and narrowing of artery walls. Another theory is that some of us are predisposed to developing inflammation in response to both plaque and fatty deposits in blood vessel walls. Research that links gum disease with gestational diabetes has suggested the inflammation could interfere with the normal functioning of insulin, but this research is in its infancy, so while pregnant women should visit the dentist regularly, anxiety about diabetes would be overkill. What dentists know for sure is that people with diabetes are more likely to develop gum disease, as are smokers, because smoking also affects immune responses.

“I was permanently poisoning myself with gum infections”
There are two main forms of gum disease. Gingivitis is the inflammation and bleeding of the gums caused by bacterial plaque on the tooth’s surface (pink spit when brushing your teeth, red gums and bad breath are key signs). “Gingivitis is reversible with improved oral hygiene,” says Preshaw. “You need to see a hygienist who will remove the plaque that causes the inflammation and you then need to clean your teeth more effectively.” Indicators of periodontal disease include gum swelling, discharge or gaps opening up between the teeth.

The damage it causes is irreversible — but it can be stabilised with better brushing and a method of cleaning by a hygienist known as “root planing”, which removes plaque. In severe cases dentists might have to extract teeth, while some sufferers need gum surgery.

Gum disease can affect anyone — even those who brush angelically and visit their dentist regularly. Dental hygiene reduces your risk but some people are more genetically prone. Because gum disease is largely painless, people are often unaware of the problem. So next time you’re spitting blood, don’t ignore it, or you could end up resembling the old John Lydon. —