Poor oral health and oral dysbiosis: A link to systemic diseases and cancer

The aMMP-8 rapid test can noninvasively measure and assess active periodontal adhesive tissue loss and the risk of its progression within five minutes in the dental chair. The test complements the diagnosis, follow-up, and maintenance treatment of periodontitis and peri-implantitis, explains Dr. Sorsa.¹¹ 

More about oral-systemic health … How antibacterial photodynamic therapy improves oral health in patients with Sjögren’s syndrome

Advanced approaches for treating oral diseases

Periodontal and peri-implant diseases are conditions that affect the supporting structures of teeth and dental implants, and they can lead to tooth loss if left untreated. Gum infections can develop for various reasons. One key factor is the build-up of bacterial plaque (biofilm) on the surfaces of teeth due to inadequate oral hygiene.⁹

While tooth decay is the most common disease in the world, and inflammation of the supporting tissues of the teeth is the sixth most common disease worldwide, the medical community struggles to find new solutions to combat these infections. Dr. Sorsa notes that dental plaque bacteria are responsible for a staggering 95% of oral ailments. He also highlights the significance of modern antibacterial methods in promoting good oral hygiene and effective plaque removal. Research shows antibacterial photodynamic therapy (aPDT) to be a promising approach to treat bacterial infections, even ones that don’t respond well to antibiotics.¹²

Until recently, aPDT treatment for improving oral health was solely available at dental clinics, frequently at a substantial cost. Dr. Sorsa highlights the work of Finnish scientists who have pioneered an at-home oral health-enhancing device based on aPDT, which provides a drug-free alternative for the management and prevention of oral and gum diseases.

Poor oral health is linked to more than 200 chronic diseases, stresses Tommi Pätilä, MD, PhD, a researcher and cardiac and organ transplant surgeon at the New Children’s Hospital in Helsinki, Finland’s largest hospital focusing on demanding specialist pediatric medical care.

aPDT technology enhances oral hygiene when it is administered regularly in addition to brushing and flossing, and research shows it can also enhance the effectiveness of professional dental care. It may even reduce the need for conventional medications such as antibiotics and chlorhexidine in the treatment of oral and gum diseases. Based on a light-activated antibacterial effect, the patented home-use device slows down plaque formation and significantly reduces the burden of harmful bacteria in the mouth. aPDT treatment administered regularly at home is suitable for patients of all ages, but it is particularly recommended for those with a history of problems caused by common oral diseases, tooth decay, and gum disease.⁹

The crucial role of oral hygiene in cancer care

Brushing and flossing regularly to remove dental plaque from the surfaces of teeth and interdental spaces are keys to maintaining a healthy mouth. But that’s not always enough. Good oral hygiene requires adequate motor and mental skills. Studies show that even the most effective electric toothbrush removes only about 65% of harmful oral bacteria from the mouth.¹³

The key to overall well-being is good oral hygiene. For cancer patients, this is even more important because they must maintain a high-calorie diet to fight the disease, notes Tuomas Waltimo, DDS, PhD, from the University of Basel. Dr. Waltimo also serves as a private dentist at a clinic that offers dental services to patients with special dental needs, including patients undergoing cancer treatments. He emphasizes that cancer treatments often bring along side effects that can require special attention. Mucositis, for example, can lead to generalized infection and even be life-threatening.

Mucositis is the painful inflammation and ulceration of the mucous membranes lining the digestive tract. It can occur anywhere along the gastrointestinal tract, but oral mucositis refers to the inflammation and ulceration that occurs specifically in the mouth. Maintaining good oral hygiene habits is a prerequisite for treating oral mucositis.

“Good oral hygiene is also of paramount importance in the management of oral mucositis. Initial findings suggest a light-activated antibacterial treatment (Lumoral) may help prevent and potentially treat oral mucositis, but this hypothesis requires further scientific research to confirm. We are, therefore, starting a new PhD study to examine the topic at the University of Helsinki,” says Dr. Waltimo.

Editor’s note: This article first appeared in Through the Loupes newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles and subscribe to Through the Loupes.

References

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3. Gastrointestinal cancers global burden expected to rise. National Cancer Institute. Division of Cancer Epidemiology & Genetics. April 10, 2020. https://dceg.cancer.gov/news-events/news/2020/global-burden-gastro
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8. Pancreatic cancer. NHS Inform. Updated November 14, 2023. https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/pancreatic-cancer/
9. Pakarinen S, Saarela RKT, Välimaa H, et al. Home-applied dual-light photodynamic therapy in the treatment of stable chronic periodontitis (HOPE-CP)—three-month interim results. Dent J (Basel). 2022;10(11):206. doi:10.3390/dj10110206
10. Sorsa T, Gursoy UK, Nwhator S, et al. Analysis of matrix metalloproteinases, especially MMP-8, in gingival creviclular fluid, mouthrinse and saliva for monitoring periodontal diseases. Periodontol 2000. 2016;70(1):142-163. doi:10.1111/prd.12101
11. Sorsa T, Nwhator SO, Sakellari D, et al. aMMP-8 oral fluid PoC test in relation to oral and systemic diseases. Front Oral Health. 2022;3:897115. doi:10.3389/froh.2022.897115
12. Liu Y, Qin R, Zaat SAJ, Breukink E, Heger M. Antibacterial photodynamic therapy: overview of a promising approach to fight antibiotic-resistant bacterial infections. J Clin Transl Res. 2015;1(3):140-167.
13. Aggarwal N, Gupta S, Grover R, Sadana G, Bansal K. Plaque removal efficacy of different toothbrushes: a comparative study. Int J Clin Pediatr Dent. 2019;12(5): 385-390. doi:10.5005/jp-journals-10005-1669

Nina Garlo-Melkas, MSc, is a health and science journalist who works as communications manager at Koite Health Ltd., a quickly growing health technology company and innovator in light-activated antibacterial solutions for treating and preventing oral diseases.