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Oral Health-Oral Cancer Conundrum

Posted Sep 18 2013 10:42am

Late last month, you might have noticed a lot of whoop-de-doo about a study which found a link between poor oral health and oral HPV infection. More than one headline suggested that brushing and flossing might lower your risk of cancer.

“The finding,” however,

is a “modest association,” said Aimée R. Kreimer, an epidemiologist at the National Cancer Institute who was not involved in the study. “We don’t know if poor oral health causes HPV infection and would go on to cancer,” she said.

The abstract is available here .

While this study claims to be the first to directly link HPV infection with oral health status, the findings aren’t actually all that surprising. For what one of its authors suggests “might be happening” – that inflamed gums, sores or other “openings in the mouth…might provide entry for HPV” – has been discussed before.

Travel back with us to those thrilling days of yesteryear – 2012, to be exact, when a Head & Neck Oncology paper on links between oral sex (a key route of HPV transmission) and oral cancer mortality noted,

gum_diseaseIt must be remembered that the oral cavity is a battlefield of healing mucosal micro abrasions which could in the right circumstances of altered local host defenses allow viral inculcation, infection and entrenchment leading to somatic genetic change. Changes in immuno-tolerance at these “special” immuno-modulating sites…combined with further environmental triggers then lead to cancerous changes. Basically, viral “genes load the gun and environment pulls the trigger.”

Nearly a decade earlier, research presented at the 2003 San Antonio meeting of the American Association of Dental Research similarly showed an association between periodontal disease and oral cancer , again suggesting the vulnerability of unhealthy tissues in the mouth.

Indeed, it would be surprising to find that the diseased mouth were less vulnerable to infection! The soft tissues of the mouth are delicate to begin with. How much more so when weakened by oral infection?

That said, another recent epidemiological study reports that those with more cavities have a lower risk of developing head and neck cancers.

Thinking back to last week’s series on the extracellular matrix, we might then ask: Is it the virus, is it the hygiene…or is it the terrain?

Image via Gum Disease Blog


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