Oral Hygiene, Diet, and Oral Cancer

1. Oral Hygiene, Diet, and Oral Cancer

2. Background on the Oral Cavity • The oral cavity contains millions of different species of microbes • Good oral hygiene practices are important

3. Basic Oral Hygiene • Brushing • Flossing • Replace toothbrush • Regular dental visits

4. What Happens When Bad Oral Hygiene is Practiced? • Dental Caries • Gingivitis • Halitosis (Bad Breath) • Oral Cancer

5. How Many Species of Bacteria Do You Think Call the Oral Cavity Home?

6. Why Do These Problems Occur? • Over 600 different bacterial species • 100 million microbes in 1 milliliter of saliva • Most microbes of the mouth are harmless and aid in digestion • Bacteria utilize the sugars and carbohydrates in the mouth to produce acids

7. Important Bacteria/Fungus With Known Functions in the Mouth • Streptococcus mutans • Porphyromonas gingivalis • Capnocytophaga gingivalis • Prevotella melaninogenica • Streptococcus mitis • Candida albicans

8. Streptococcus Mutans • Streptococcus mutans (S. mutans) has been found to cause tooth decay • Elevated diets with sucrose, increase this bacteria, which causes more plaque formation Loesche 1986

9. PorphyromonasGingivalis • P. gingivalis has been found to be associated with periodontal (gum) diseases Slots and Ting 2000

10. CapnocytophagaGingivalis, PrevotellaMelaningogenica, and Streptococcus Mitis • High levels found in oral cancer patients • Link between bacteria and cancer • If more bacteria are present, this could lead to earlier detection Mager et al. 2005

11. Candida Albicans • Type of yeast found in the oral cavity • Strains are usually resistant to antifungal agents • May invade oral epithelium and may be involved in oral leukoplakia (white patches or plaque) • Candidal leukoplakias have been found to develop into 9-40% of oral cancer cases • However the carcinogenic mechanisms are not known Meurma 2010

12. Oral Cancer • What is it? • Who is at risk? • What are the signs and symptoms? • How is it diagnosed? • What are the treatments? • What are some ways to prevent it?

13. Quick Numbers • 30,000 Americans diagnosed each year • In 2011, 39,400 new cases and 7,900 deaths • 350,000-400,000 new cases diagnosed worldwide each year • Five year survival rates ~54% • Oral cancer kills one person every hour • Incidence in young adults (<40) is increasing

14. Oral Cancer • What is it? • Cancers that form in the tissues of the oral cavity or the oropharnyx • This includes the lips, tongue, cheek linings, hard and soft palates, salivary glands, gums, and throat

15. Oral Cancer • Who is at risk? • African American males • People over the age of 40 • Smokers and tobacco users • Heavy alcohol users • Men are three times more at risk than women

16. Signs and Symptoms • Sores, lumps, or ulcers in the mouth • Pale or discolored tongue, lips, or area around the mouth • Chewing problems • Painful swallowing • Swollen lymph nodes in neck • Tongue problems • Red or white patches in the mouth

17. Diagnosis • Dental or doctor examinations • Sores found on lip, tongue, or around mouth • Ulcers or bleeding in the mouth • Tests used to confirm findings • Gum biopsy • Tongue biopsy • X-rays, CT scans, MRIs, or PET scans can be done to determine if the cancer metastisized • Determination of the stage • Early Cancer • Advanced Cancer

18. Treatment • Early Cancer • Surgery to remove the tumor • Typically not done if cancer has spread to the neck • May need reconstructive surgery after • Radiation therapy • Advanced Cancer • Chemo and radiation therapy • Targeted therapy • Speech therapy • Improves movement, chewing, swallowing, and speech

19. Survival • Five-year survival rates are roughly 50% • This number increases to 80-90% when discovered early

20. Prevention • Practice good oral hygiene • Do not use tobacco products • Do not drink alcohol heavily • Men=more than 2 drinks/day • Women=more than 1 drink/day • Eat a well balanced diet

21. How Does Diet Play a Role in Oral Cancer? • Nutrient-based dietary patterns and the risk of oral and pharyngeal cancer • Methods • Study conducted from 1992-2005 • 804 patients admitted to hospitals with confirmed oral or pharyngeal cancer • Control group consisted of 2080 patients admitted to same hospitals for unrelated reasons • Given a food frequency questionnaire • Five major diets were identified • 29 major macronutrients and micronutrients were examined Edefonti et al. 2010

22. How Does Diet Play a Role in Oral Cancer? • Results • Animal product diets were positively correlated to oral cancer • Starch-rich diet had no significant risk • Vitamins and fiber were inversely associated to oral cancer • Unsaturated fats were inversely associated to oral cancer • Retinol and niacin were not associated to oral cancer • Overall, protective affects were seen with a diet rich in fruit, vegetables, cereals, and olive oil Edefonti et al. 2010

23. How Does Diet Play a Role in Oral Cancer? • Dietary factors and oral and pharyngeal cancer risk • Methods • Meta-analysis of studies done up until 2008 • Examined how different food groups related to oral cancer Lucenteforte et al. 2009

24. How Does Diet Play a Role in Oral Cancer? • Results Lucenteforte et al. 2009

25. Activity-Test what you’ve learned Increases Risk Reduces Risk Orange Broccoli Burger Strawberries White Bread Steak Raspberries

26. Conclusions • Reduce Risk of Oral Cancer • Good oral hygiene • Understanding the bacteria found in the oral cavity • Consuming a well balanced diet to reduce bacteria growth • High in fruits, vegetables, olive oil, and fish • Low in high fat and cholesterol meats, rice, and refined grains

27. More Information • American Dental Association www.ada.org • National Cancer Institute www.cancer.gov • Oral Cancer Foundation www.oralcancerfoundation.org