American scientists have discovered a link between gum disease, which is usually caused by poor oral hygiene, and pancreatic cancer in men.

"Our study provides the first strong evidence that periodontal disease may increase the risk of pancreatic cancer," said Dr Dominique Michaud of the Harvard School of Public Health in Boston, who led the research.

The study is published in the latest issue of the Journal of the National Cancer Institute.

Dr Minaud and colleagues examined the periodontal disease data from the Health Professionals Follow-Up Study (HPFS), which began collecting health related data on a cohort of over 51,000 men recruited from a range of health professions in 1986.

They found that men with a history of periodontal disease had a 64 per cent increased risk of pancreatic cancer than men with no such history. And increased severity of periodontitis, for example with recent tooth loss, had the greatest risk. No significant links were found between other types of oral health problems such as tooth decay and cancer of the pancreas.

Other studies have found links between tooth loss or periodontitis and pancreatic cancer risk. They have shown that people with periodontal disease have an increased level of inflammatory markers such as C reactive protein (CRP) in their blood. These markers are part of an early immune system response to persistent inflammation and have been linked to the development of pancreatic cancer.

This study has contributed new information in that the researchers believe it is possible that another link may exist between periodontal disease and risk of pancreatic cancer. This link would be between the high levels of carcinogenic compounds that are present in the mouths of people with periodontal disease and risk of pancreatic cancer.

Perhaps the carcinogenic compounds (or nitrosamines to be more precise) and bacteria react with digestive chemicals in the gut to create conditions that favour development of pancreatic cancer, they said.

Every year about 32,000 people in the US and 60,000 in Europe are diagnosed with cancer of the pancreas. Because the symptoms of early development are often a common cause of other ailments (loss of appetite, stomach pains, weight loss), early diagnosis is very unusual. The contribution this study makes is to emphasise the importance of good oral hygiene, not only for oral health but also as a way to reduce the risk factor of a cancer that has the highest fatality rate among American men and women where less than 5 per cent of patients survive more than 5 years after diagnosis.

Periodontitis is one of two common types of gum inflammation, the other being gingivitis. Gingivitis is where the soft tissue around the teeth becomes inflamed, whereas Peridontitis is a deeper condition that affects the tissue that support the teeth and is also associated with loss of bone around the base of the teeth. About 50 per cent of Americans over 30 years of age have periodontitis.

The two diseases are linked in that persistent gingivitis can lead to periodontitis. Gingivitis comes from bacteria that get into the soft gum tissue and infect it. The bacteria live in the plaque that builds up around the base of teeth due to poor dental hygiene. Plaque is a gradual accumulation of food debris, saliva and minerals.

As the plaque gets harder and thicker, it becomes what is known as dental calculus or tartar, a hard calcified layer that is virtually impossible to shift with normal brushing, you would have to get the dental hygienist to do it. It can even descend into pockets around the base of teeth inside the gums.

This provides an ideal environment for the bacteria to breed and cause gum inflammation. For many people the symptoms are mild, with some bleeding but little pain or irritation, so it can be quite advanced before it is detected. It can also be associated with bad breath.

Good oral hygiene consists of brushing your teeth twice a day with a recommended fluoride toothpaste, cleaning every day between the teeth using floss or interdental brushes, eating a balanced diet, avoiding snacks between meals, and having your teeth professionally checked and cleaned on a regular basis.

Written by: Catharine Paddock