I've been saying what we actually need is universal dental care vs universal health care for over 15 years. Giving out universal health care without dental care is like changing the oil in a car but failing to see the tires aren't even on.
I heard horror stories from my mom who worked in a periodontist office (as receptionist) growing up. Really got me to care about oral health early on. Health really starts at the mouth. If you don't have a healthy mouth you'll never have a healthy body.
I find it completely strange that dental care isn't just considered part of standard healthcare. Like, so my employer's health care plan covers every part of my body except my mouth? Why does my mouth specifically need its own plan?
We can agree on that but how about spreading more widely the simple advice - floss thoroughly & daily, clean your teeth twice a day and don't let sugars hang around in your mouth for extended periods. We know these pathogenic oral bugs can be related to heart disease (fibrosis for one) but maybe other dysfunction as well as prostate. A catchy meme might do the trick to remind us all.
The association between pathogens and cancer is under-appreciated, mostly due to limitations in detection methods.
For instance, it is not uncommon for cancer studies to design assays around non-oncogenic strains, or for assays to use primer sequences with binding sites mismatched to a large number of NCBI GenBank genomes.
Another example: studies relying on The Cancer Genome Atlas (TCGA), which is a rich database for cancer investigations. However, the TCGA made a deliberate tradeoff to standardize quantification of eukaryotic coding transcripts but at the cost of excluding non-poly(A) transcripts like EBER1/2 and other viral non-coding RNAs -- thus potentially understating viral presence.
People are talking about dental hygiene in this thread, but it’s only mentioned once in the article, and only to suggest that a small portion of the microbes associated with cancer were also associated with dental disease. We literally don’t know if using mouthwash or brushing for 30 seconds longer (the main differences in dental hygiene habits among people reading this) has any effect on cancer risk, so what’s the point of even posting this?
[2] 7 days chlorhexidine mouthwash → 90% reduction in oral nitrite, BP increased 2-3.5 mmHg
Free Radical Biology & Medicine, 2013
[3] Daily mouthwash → OR 1.31 for head/neck cancer
European Journal of Cancer Prevention, 2016
[4] Listerine Cool Mint increased Fusobacterium nucleatum and Streptococcus anginosus (bacteria linked to colorectal cancer) Journal of Medical Microbiology, 2024
Because keeping your mouth clean is both cheap and easy. If there’s a minuscule chance that it will reduce any risk in cancer, why not? Besides, who wants bad breath?
It's unsurprising that certain strains would lead to increased cancer risk. We've known about this with bacteria (H. Pylori and stomach cancer), viruses (HPV and genital cancers) and fungi (carcinogenic liver toxins) for a long time.
But I do somewhat wonder about the dental profession's "nuke it all" approach to the oral microbiome. We've largely moved away from that for other outside-facing body parts - it's recognised that for organs like skin, gut, vagina, scalp etc that there is such a thing as a healthy, balanced microbiome. I expect they'll get around to discovering the same for the mouth at some point - that if you have the right bacteria and don't overfeed them with massive amounts of glucose and fructose, that's broadly a healthier mouth than blasting everything to oblivion at every opportunity.
>1) I find numbers like “3-fold increased risk” a bit meaningless without knowing the baseline risk.
Yeah, I don't see this talked about enough. If it's three fold from 33% baseline to 99%, thats a big deal. If it's a three fold increase from 0.000000033% to 0.000000099%, even the new number is minuscule.
It's why, say, blue M&M's increasing risk of cancer by 75% isn't necessarily as big a problem as it sounds.
My father-in-law who died of pancreatic cancer in 2016 had excellent oral health. In fact, he never had a single cavity in his entire 76 years of life.
This is, among other things, a quirk of both statistics (models with relative effect measures are better behaved/easier than ones with absolute measures outside toy examples) and early causal inference where we underestimated just how bad smoking is for you.
> scientists have uncovered a mechanism that could help explain this connection, finding that bacteria can travel through swallowed saliva into the pancreas
Except, this study didn't do that. It did shotgun sequencing and found a correlation between certain microbial species (some were fungal, not bacterial) and cancer risk. It *did not* demonstrate anything about mechanism.
Based on the way it's phrased, maybe this article is saying that previous studies have found a mechanism, and this study found the microbial culprits. Unfortunately, I don't have access to the full study to see if that's the case in its introduction or discussion. Even so, that's an incredibly misleading opening to the article.
To me the title of this article, and several points contained within, where overly broad.
They give the impression that _having_ microbes in your mouth and on your skin is a cancer risk, which is most definitely not the case.
The connection between the microbiome and cancer and heart disease is coming more to light. And the articles point that certain microbes may contribute to cancer risk sounds like another significant new finding.
But having a sterile environment in the mouth or on the skin is certainly detrimental to health.
Like the gut microbiome, it's the content that counts, not whether to have one or not...
The wording seems causational, while the data indicates a correlation.
"Altogether, the entire group of microbes boosted participants’ chances of developing the cancer by more than threefold."
I feel like you would need a study that observes the effect of introducing or remove these microbes from a population before you can draw this conclusion.
> But having a sterile environment in the mouth or on the skin is certainly detrimental to health.
Can you point to a study that suggests this? I have no opinion one way or another but making statements like this without any backing is misinformation.
I am sure many more will be linked to our mouths and we will regret that countries with good free public healthcare don't include dental. People just cannot afford to go until it hurts which often means it is very bad already.
which begs the question that which daily mouthwash is a) broadband effective against many including the right pathogens c) long-time, safe/tolerable for long time daily use. Candidate being Chlorhexidine 0.06% - are there opinions on it?
People forget Breathing through the mouth is a recipe for poor oral microbes. This became mainstream when we gained softer foods and transitioned living to indoor places with high indoor air pollution. Normalize nose breathing again.
The real question always is: assuming causation, if you drastically improve the oral health of 1000 people, how many would you save from pancreatic cancer? The answer to this question in associative studies is very often in the single figures, or lower (i.e. fractions of people.)
Anything to create an excuse to provide better dental care for people, though. The chance of getting a gum infection that spreads to your brain and/or goes septic is actually quite high.
Dental health is also correlated with a number of other illnesses and there is some literature suggesting different pathogens as a cause. Instead of looking at just one illness/death prevented it may be a much higher number if all forms are considered.
dham|5 months ago
I heard horror stories from my mom who worked in a periodontist office (as receptionist) growing up. Really got me to care about oral health early on. Health really starts at the mouth. If you don't have a healthy mouth you'll never have a healthy body.
Wowfunhappy|5 months ago
ChrisMarshallNY|5 months ago
I had a cat die of kidney failure, precipitated by a gum infection.
Friend of mine just spent a few grand for an operation on their cat, where they had to remove its teeth, because of a rare autoimmune problem.
vixen99|5 months ago
jjtheblunt|5 months ago
tiahura|5 months ago
panabee|5 months ago
For instance, it is not uncommon for cancer studies to design assays around non-oncogenic strains, or for assays to use primer sequences with binding sites mismatched to a large number of NCBI GenBank genomes.
Another example: studies relying on The Cancer Genome Atlas (TCGA), which is a rich database for cancer investigations. However, the TCGA made a deliberate tradeoff to standardize quantification of eukaryotic coding transcripts but at the cost of excluding non-poly(A) transcripts like EBER1/2 and other viral non-coding RNAs -- thus potentially understating viral presence.
Enjoy the rabbit hole. :)
edem|5 months ago
TaupeRanger|5 months ago
Jimmc414|5 months ago
I’m guessing it might be explained by the hygiene hypothesis.
The oral microbiome needs balance, not sterilization.
[0] Mouthwash ≥2x/day → 55% increased diabetes risk Nitric Oxide journal, 2017
[1] Mouthwash ≥2x/day → 117% increased hypertension risk Blood Pressure Journal, 2020
[2] 7 days chlorhexidine mouthwash → 90% reduction in oral nitrite, BP increased 2-3.5 mmHg Free Radical Biology & Medicine, 2013
[3] Daily mouthwash → OR 1.31 for head/neck cancer European Journal of Cancer Prevention, 2016
[4] Listerine Cool Mint increased Fusobacterium nucleatum and Streptococcus anginosus (bacteria linked to colorectal cancer) Journal of Medical Microbiology, 2024
lq9AJ8yrfs|5 months ago
chaostheory|5 months ago
Earw0rm|5 months ago
But I do somewhat wonder about the dental profession's "nuke it all" approach to the oral microbiome. We've largely moved away from that for other outside-facing body parts - it's recognised that for organs like skin, gut, vagina, scalp etc that there is such a thing as a healthy, balanced microbiome. I expect they'll get around to discovering the same for the mouth at some point - that if you have the right bacteria and don't overfeed them with massive amounts of glucose and fructose, that's broadly a healthier mouth than blasting everything to oblivion at every opportunity.
cinntaile|5 months ago
zemvpferreira|5 months ago
layer8|5 months ago
2) Here is an audio interview with one of the authors of the study: https://edhub.ama-assn.org/jn-learning/audio-player/19004027
glenstein|5 months ago
Yeah, I don't see this talked about enough. If it's three fold from 33% baseline to 99%, thats a big deal. If it's a three fold increase from 0.000000033% to 0.000000099%, even the new number is minuscule.
It's why, say, blue M&M's increasing risk of cancer by 75% isn't necessarily as big a problem as it sounds.
lisbbb|5 months ago
Fomite|5 months ago
https://pubmed.ncbi.nlm.nih.gov/20010205/
MillironX|5 months ago
Except, this study didn't do that. It did shotgun sequencing and found a correlation between certain microbial species (some were fungal, not bacterial) and cancer risk. It *did not* demonstrate anything about mechanism.
Based on the way it's phrased, maybe this article is saying that previous studies have found a mechanism, and this study found the microbial culprits. Unfortunately, I don't have access to the full study to see if that's the case in its introduction or discussion. Even so, that's an incredibly misleading opening to the article.
johnea|5 months ago
They give the impression that _having_ microbes in your mouth and on your skin is a cancer risk, which is most definitely not the case.
The connection between the microbiome and cancer and heart disease is coming more to light. And the articles point that certain microbes may contribute to cancer risk sounds like another significant new finding.
But having a sterile environment in the mouth or on the skin is certainly detrimental to health.
Like the gut microbiome, it's the content that counts, not whether to have one or not...
ortusdux|5 months ago
"Altogether, the entire group of microbes boosted participants’ chances of developing the cancer by more than threefold."
I feel like you would need a study that observes the effect of introducing or remove these microbes from a population before you can draw this conclusion.
blindriver|5 months ago
Can you point to a study that suggests this? I have no opinion one way or another but making statements like this without any backing is misinformation.
donperignon|5 months ago
djmips|5 months ago
anonzzzies|5 months ago
semessier|5 months ago
mrtesthah|5 months ago
https://pmc.ncbi.nlm.nih.gov/articles/PMC7125030/
mannanj|5 months ago
pessimizer|5 months ago
Anything to create an excuse to provide better dental care for people, though. The chance of getting a gum infection that spreads to your brain and/or goes septic is actually quite high.
pixl97|5 months ago
elric|5 months ago
edem|5 months ago
ekianjo|5 months ago
- the baseline risk
- the increased risk
In the same article. And yet HN commenters are easily manipulated into thinking that suddenky oral health is a big driver of pancreatic cancer.