Breast Cancer and the Connection with Oral Hygiene

WE ALL HAVE MOUTHS! RELATIONSHIP BETWEEN BREAST CANCER AND ORAL HYGIENE 

Comedy is now a multi-billion naira industry in Nigeria. A new couple could pay a comedian one million naira to perform at their wedding, but argue furiously against paying a surgeon one hundred thousand naira to perform a caesarian section to save two lives. Comedy is also the cheapest possible start-up, because the mouth is the sole physical investment of the trade. Thus a popular comedian rejoices in the name of Basket mouth. Another is called Elenu, meaning ‘mouth owner’ in the Yoruba / Anago language. But although we are not all comedians, we are all elenus – we all have mouths and our mouths are far more important for our overall health than we may realize.

October is dedicated to advocacy and creating awareness on Breast Cancer, the most common cancer in women globally (including Nigeria). Breast cancer also occurs in men, but it is 100 times more common in women. However, because most people are not aware that breast cancer can occur in men, the disease tends to be picked up much later and is often more fatal in men than in women.

According to the International Agency for Research on Cancer (IARC), over 18 million people develop cancer yearly with 9.6 million deaths. Unfortunately, 70% of cancer deaths occur in developing countries like Nigeria, due to late detection. Latest WHO data shows that globally, there were over 2 million new cases of breast cancer and over 600,000 deaths from the disease, in 2018. Every day, Nigeria records 32 deaths from breast cancer.

As we mark the October Breast Cancer Awareness Month, it is necessary to look at an aspect of the disease of which most people are unaware – the relationship between breast cancer and oral hygiene.

The better known risk factors for breast cancer include: female gender, increasing age, family history of breast cancer, early onset of menses, late menopause, ethnicity and alcohol/tobacco use.

However, scientific research has recently demonstrated a link between breast cancer and oral health. Women with poor oral hygiene and periodontitis (inflammation of the gum), are up to three times more likely to develop breast cancer. The risk is greater in smokers.

Poor dental hygiene and gum disease has also been linked to increased risk of other cancers (including prostate cancer, throat cancer, lung cancer, gallbladder cancer, melanoma and pancreatic cancer) and of several general health conditions (such as pneumonia, stroke, heart disease, problem pregnancy and Diabetes mellitus).

The prevention and early diagnosis of periodontitis are therefore, very important not only for the patients' oral health, but also for their overall wellbeing.

Periodontitis is a serious bacterial infection of the gum that damages the soft tissue and destroys the bone that supports the teeth. In the early stages, it often presents as bleeding or swollen or painful gums (gingivitis) and sometimes as halitosis (bad breath). The main causes of periodontal disease are poor oral hygiene and tobacco use. The bacteria most often associated with periodontitis (Treponema denticola and Porphyromonas gingivalis) enter the bloodstream through the gum. Later, the bacterial infections become associated with co-infection by viruses such as Epstein-Barr virus and Cytomegalovirus. These viruses act together with the bacteria to suppress the body’s immune response, leading to a proliferation of cancer cells in the body.

Fortunately, it is possible to prevent the occurrence of periodontitis which may predispose to cancer. The best way to achieve this is by following the 2-2-2-2-2-2-2 rule of dental hygiene, including:

Brush your teeth 2 times a day – last thing at night and at least one other time during the day
Brush your teeth for at least 2 minutes each time
Use 2 tools for personal oral hygiene – a fluoride-containing toothpaste and medium textured tooth brush
Each time you brush clean between the teeth with dental floss or an interdental brush, which ensures that bacteria is removed from all areas of the mouth.
Go for a dental checkup at least 2 times a year
During your dental checkup, have your teeth professionally cleaned (scaling and polishing or S & P)
Your child should start brushing his own teeth and visiting the dentist from the age of 2.

Observing the following DONTS OF DENTAL CARE would further enhance your oral health:
Don’t use a hard toothbrush – use a medium texture toothbrush for adults and a soft texture toothbrush for children
Don’t use toothpick – use dental floss instead
Don’t open bottles with your teeth
Don’t wait until you have dental problems before you visit your dentist. Visit your dentist every six month for a dental check-up and S&P. Also, consult your dentist if you have toothache, bad breathe, cracked teeth, holes in your teeth and between gums and teeth, or if you notice any strange thing in your mouth.

In addition to predisposing you to other cancers (such as breast cancer), poor oral hygiene also predisposes to cancers that occur primarily in the mouth and throat, with tobacco, alcohol and Human papillomavirus (HPV) infections being among the leading risk factors of oral cancer. Human Papilloma virus also causes cancer in more than twelve parts of the body, including the cervix (cervical cancer).

Moreover, there are over 120 medical conditions, which can be detected in the early stage by dentists. Therefore, the dentist can be the first line of defense against gum disease and other systemic diseases including cancer.

It is for this reason that mass medical mission, a foremost champion for preventive health care and national cancer control, now has dental aspect of its free outreaches. This involves the use of the Mobile Dental Centre (nicknamed the PinkDentist), to facilitate access to preventive dental services for all.

Other life-saving initiatives of mass medical mission include:

Mission PinkCruise (free community-based health outreaches with the PinkCruise)
Mission PinkVISSION (the eye aspect of the free community outreach using Mobile Ophthalmic unit aka PinkVISSION), where “VISSION” stands for Voluntary Integrated Sight Saving Initiative Of Nigeria)
Free screening at the Lagos centre every Wednesday (Wellness Wednesday) and Friday (Family Friday)
Vaccine Fair to promote access to the quadrivalent vaccine which can prevent the various cancers caused by HPV (this Fair holds every last Friday and Saturday of the month at the Lagos centre).

To mark the October International Cancer Awareness Month and World Sight Day, members of the general public are invited to the ongoing free cancer, eye and dental screening taking place every Wednesday and Friday at mass medical mission House, 31 Bode Thomas Street, Surulere, Lagos.

Groups could also apply to be included as hosts in the 2020 schedule of the free community-based outreaches (Mission PinkCruise), by sending an email to info@pinkcruise.org.

Dr Abia Nzelu, info@pinkcruise.org