ORAL HYGIENE, DIET, AND
ORAL CANCER
BACKGROUND ON THE ORAL CAVITY
The oral cavity contains millions of different
species of microbes
 Good oral hygiene practices are important

BASIC ORAL HYGIENE
Brushing
 Flossing
 Replace toothbrush
 Regular dental visits

WHAT HAPPENS WHEN BAD ORAL
HYGIENE IS PRACTICED?
Dental Caries
 Gingivitis
 Halitosis (Bad Breath)
 Oral Cancer

HOW MANY SPECIES OF BACTERIA
DO YOU THINK CALL THE ORAL
CAVITY HOME?
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

IMPORTANT BACTERIA/FUNGUS WITH
KNOWN FUNCTIONS IN THE MOUTH
Streptococcus mutans
 Porphyromonas gingivalis
 Capnocytophaga gingivalis
 Prevotella melaninogenica
 Streptococcus mitis
 Candida albicans

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
PORPHYROMONAS GINGIVALIS

P. gingivalis has been found to be associated
with periodontal (gum) diseases
Slots and Ting 2000
CAPNOCYTOPHAGA GINGIVALIS,
PREVOTELLA MELANINGOGENICA,
STREPTOCOCCUS MITIS
AND
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
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
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?

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

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
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
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

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

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
SURVIVAL
Five-year survival rates are roughly 50%
 This number increases to 80-90% when
discovered early

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
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
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
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
HOW DOES DIET PLAY A ROLE IN
ORAL CANCER?

Results
Increased Risk
Reduced Risk
•Meats high in fat and
cholesterol
•Refined cereals and
sugar
•Rice
•Fruits
•Vegetables
•Fish
Lucenteforte et al. 2009
ACTIVITY-TEST
WHAT YOU’ VE LEARNED
Increases Risk
Reduces Risk
Burger
Strawberries
Orange
Broccoli
White Bread
Raspberries
Steak
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

MORE INFORMATION
American Dental Association www.ada.org
 National Cancer Institute www.cancer.gov
 Oral Cancer Foundation
www.oralcancerfoundation.org
