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?
It's a really unfortunate historical accident, especially in the US.
Dentistry evolved relatively late compared to regular medicine, and early oral procedures were mostly tooth extractions, which ended up being predominantly done by barbers, who would also do surgery (!). These procedures were often considered crude and beneath that of a trained doctor, and they were generally performed by self-trained practitioners. There were several attempts in the 1800s to integrate dentistry into mainstream medicine, but they failed, both because the doctors of the time didn't think of dentistry as being a real science, but also because, as dentistry started to legitimize itself, the dentists themselves preferred being separate.
For some reason the same separation also evolved in the U.K., but it's more integrated in other countries. For example, basic dental coverage is part of national healthcare in Germany and Japan. In the U.S., dentists have their own schools and licensing boards and so on, which isn't the case in the rest of the world, where dentistry is usually accepted as a regular branch of medicine and taught at the same universities.
I literally remember one of my elderly relatives pulling out a tooth at home with a thread tied around a door handle as if this was nothing special. DIY all the way! Early 1990s, former Soviet Union rural-or-so area.
As of today, we have moved to a different situation where dental care in that same country is ample, but the price lists are rarely transparent, making many not-so-well-off people avoid going to dentists altogether.
The health insurance system gives something like 60€ yearly to an adult for fixing teeth. Dental care for children up to 19yo is for free, though, which is great.
>I literally remember one of my elderly relatives pulling out a tooth at home with a thread tied around a door handle as if this was nothing special. DIY all the way! Early 1990s, former Soviet Union rural-or-so area.
Some form of this type of tooth pulling was common for baby teeth in the 90s. I’m sure it still is today. I don’t know about recommending it for adult teeth.
Yeah my kid asked me to do some form of this for a baby tooth because She didn’t want to wait for an appointment and it was really bothering her. It worked! Definitely not recommended for an adult tooth. Baby teeth are barely hanging on and don’t have deep roots really
In Germany, basic dental is very basic. It basically covers only acute scenarios and one checkup a year. Since so much of dentistry is maintenance and prevention, most people get supplementary insurance or pay out of pocket or do without.
Here is the list of covered services in Croatia:
- tooth extraction
- periodontal treatment
- tartar removal up to twice a year
- prosthetic work (e.g. dental crowns, partial and total dentures, depending on age)
- composite (white) fillings for front teeth
- amalgam fillings for other teeth
- composite (white) fillings for children up to 18 years of age for all teeth
- braces for children up to 18 years of age
It's not just in the US. In all the EU countries I lived it was also excluded from standard health insurance and government programs except in cases of acute damage.
Australia, despite having basically universal medicare (otherwise) still considers teeth "luxury bones" in the sense that they're not really necessary to health care (else they would be covered by medicare)
True but the profits and regulatory capture lie more with pharma companies than with dentists.
There's an incentive for pharma to want people not to take care of their teeth, I don't know if they ever act on this incentive but I wouldn't be surprised.
They don't generally cover normal vision needs. Your regular glasses and/or contacts aren't covered.
Eye injury or cancer, though? Usually covered. I honestly can't recall anyone getting denied for a possible scratch on the eye, either here in Norway or the US (Am from the US). Expenses for eye issues with MS or Diabetes? Usually covered. In these cases, you often go to a specialist MD instead of the normal eye doctor (if you see an MD at all). More is generally covered for eyes than teeth - if teeth were covered like eyes, it would be an improvement. A lot of acute care and infections and stuff would be covered.
As a glasses wearer, not covering glasses feels reasonable to me, although I can't quite put my finger on why.
I guess I see glasses at least partially as a fashion accessory--a necessary one for sure, but then so are shoes, and I don't expect those to be covered by insurance.
It's supposed to be insurance and most dental services don't cost enough to be worthwhile insuring as a risk. Everyone needs them, more or less, so any insurance would just be a (costly to run) payment plan.
Proper civilized countries do provide free to the consumer dental services, at least for children and poor people.
It's not your employer's "health care" plan. It's an insurance plan. And dental care doesn't really fit the insurance model since the vast majority of spending is expected and regular (checkups, cleaning, etc).
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.
It definitely would just by making sure cavities are taken care of earlier. They are caused by bacteria, and an active tooth infection is spreading and multiplying that bacteria at a much faster rate than it would be otherwise which exponentially increases the decay rate and number of cavities of all their other teeth.
Yes, it would help to know that I could see a dentist who would inform me of cavities and gingivitis that I am (or am not, depending on genes), developing as a result of my brushing habits (and through that feedback help refine said habits), rather than merely hoping and doing nothing more for lack of funds.
And many people will require regular teeth cleanings to avoid gum pockets and consequent gingivitis despite their best efforts at brushing and flossing.
There are other situations where tooth infections can move to the brain in a matter of days, risking death if left untreated. Regular checkups reduce that risk considerably.
The other side of your argument would imply that the existence of toothpaste renders the entire field of dentistry inessential.
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
Yes, thats plausible and the INHANCE consortium even suggested this. However the mechanism for the effect on BP can be explained by antiseptic rinses impairing the nitrate‑nitrite‑NO axis
Kissing a middle age woman (or other high risk person)? Very true, but it antecedes as often as it succeeds kissing, depending on whether it antecedes or succeeds marriage vows. Ever smell a husband’s breath?
The research doesn’t really imply any conclusion. You can’t cherry pick 4 studies that show an association (not causal connection) and use it as a plausible argument.
Fair point about association vs causation. To clarify, these studies don’t prove mouthwash causes these conditions, but the pattern across multiple independent studies in different populations suggests we shouldn’t assume ‘more cleaning = automatically better.
If “for nothing” includes an increase in disease from eradicating an otherwise healthy oral microbiome by over-cleaning/washing, well I don’t think I need to answer that. Since we don’t know either way, best avoid drawing a conclusion.
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?
Because we don’t know either way. There’s also a minuscule chance that doing extra cleaning might lead to the opposite effect, as evidenced by another reply here. We don’t know. This article mentions nothing about halitosis.
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.
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.
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.
> 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.
It is the initial purpose of a microbiome to be at least commensal, in that it is usually prohibitively expensive to maintain a sterile environment so the odds of a true pathogen colonizing a system is greatly reduced if you simply have a crowded space of neutral participants.
Once that's true it does seem there's a lot of host and microbiome interactions we've only begun to explore, but it shouldn't be surprising that co-evolution of the microbiome and host begins to take over as soon as you have one. One great example is short-chain-fatty-acid (SCFA) producing bacteria in the human gut. [1] These seem to be essential, and if there was a general takeaway to improve health, it would be to eat your roughage so they can do their job.
This is also why high alpha-diversity (community richness in particular) is such a dead-ringer for healthy vs diseased states. And frustratingly, is often exactly where the story ends for a lot of observational studies.
Also, in case you are curious, artificially sterile mice (gnotobiotic mice) tend to act differently than other mice, which is pretty odd to be honest, and why the gut-brain axis is a plausible mechanism to research further. [2]
Cavities are caused by corrosion from acid produced by a bacteria called streptococus mutans, they digest the sugar in your mouth and produce acid, they thrive in slightly acidic environments. If you have other types of bacteria in your mouth, they will leave less sugar to be digested and will also produce byproducts that make leave your mouth ph less acidic.
tl;dr > The oral microbiome usually exists in the form of a biofilm. It plays a crucial role in maintaining oral homeostasis, protecting the oral cavity, and preventing disease development.
That NIH article also refers to some fields that are experiencing wide recent advances: the gut/brain axis, and communication from the skin microbiota that stimulates the first immune responses to pathogenic organisms.
This link describes some aspects of the skin microbiome:
I up-voted your post. I don't think there should be a penalty for asking for a reference. Although, I'm not always in the mood to dig up _good_ links on subjects that I've read enough to form an opinion.
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.
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.
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?
It has always seemed suspect to me. Nuking the microbiome in your mouth seems equivalent to taking a daily broad spectrum antibiotic. It's gonna kill everything, good, bad, or indifferent.
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.
I don't know why this is always controversial in modern society, but it's always important to do the math, rather than immediately go all in on whatever supports your current lifestyle or the lifestyles of the people that you admire or fetishize.
There are plenty of good reasons to give people medical care. Clean mouths may be beneficial in many other ways other than allowing me to be within 5' of you when your mouth is open. Militant advocacy for innumeracy is a worse disease than pancreatic cancer, though.
I once had a gum infection so bad that the uncontrollable diarrhea it gave me had me so dehydrated, I was afraid I was going to pass out and die alone in my apartment (as has happened to many, many people.) I went to the emergency room and I had to beg them to pay attention to me at all. They recommended a dentist appointment. I could barely stand. Finally, one that wasn't mentally disabled recognized my distress and gave me an IV. Do you think this would change if I said that it might triple my risk of pancreatic cancer from nearly nothing to nearly nothing?
No. This study is something to add a completely spurious and inconsequential fact to toothpaste commercials, that's it. It reaches no conclusion that could help anyone with anything. If they intend to isolate the particular microbes that are more associated, and if those have an association with something that may also have an association with pancreatic cancer; or anything other than the p-hacking that this sounds like, it would be a different story.
> And yet HN commenters are easily manipulated into thinking that suddenky oral health is a big driver of pancreatic cancer.
This isn't happening, this is you starting from a solipsist axiom that you're smarter than everyone else, who comparatively must be automatons about receiving information.
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?
It's a really unfortunate historical accident, especially in the US.
Dentistry evolved relatively late compared to regular medicine, and early oral procedures were mostly tooth extractions, which ended up being predominantly done by barbers, who would also do surgery (!). These procedures were often considered crude and beneath that of a trained doctor, and they were generally performed by self-trained practitioners. There were several attempts in the 1800s to integrate dentistry into mainstream medicine, but they failed, both because the doctors of the time didn't think of dentistry as being a real science, but also because, as dentistry started to legitimize itself, the dentists themselves preferred being separate.
For some reason the same separation also evolved in the U.K., but it's more integrated in other countries. For example, basic dental coverage is part of national healthcare in Germany and Japan. In the U.S., dentists have their own schools and licensing boards and so on, which isn't the case in the rest of the world, where dentistry is usually accepted as a regular branch of medicine and taught at the same universities.
I literally remember one of my elderly relatives pulling out a tooth at home with a thread tied around a door handle as if this was nothing special. DIY all the way! Early 1990s, former Soviet Union rural-or-so area.
As of today, we have moved to a different situation where dental care in that same country is ample, but the price lists are rarely transparent, making many not-so-well-off people avoid going to dentists altogether.
The health insurance system gives something like 60€ yearly to an adult for fixing teeth. Dental care for children up to 19yo is for free, though, which is great.
>I literally remember one of my elderly relatives pulling out a tooth at home with a thread tied around a door handle as if this was nothing special. DIY all the way! Early 1990s, former Soviet Union rural-or-so area.
Some form of this type of tooth pulling was common for baby teeth in the 90s. I’m sure it still is today. I don’t know about recommending it for adult teeth.
Yeah my kid asked me to do some form of this for a baby tooth because She didn’t want to wait for an appointment and it was really bothering her. It worked! Definitely not recommended for an adult tooth. Baby teeth are barely hanging on and don’t have deep roots really
In Germany, basic dental is very basic. It basically covers only acute scenarios and one checkup a year. Since so much of dentistry is maintenance and prevention, most people get supplementary insurance or pay out of pocket or do without.
Here is the list of covered services in Croatia: - tooth extraction - periodontal treatment - tartar removal up to twice a year - prosthetic work (e.g. dental crowns, partial and total dentures, depending on age) - composite (white) fillings for front teeth - amalgam fillings for other teeth - composite (white) fillings for children up to 18 years of age for all teeth - braces for children up to 18 years of age
It's not just in the US. In all the EU countries I lived it was also excluded from standard health insurance and government programs except in cases of acute damage.
Australia, despite having basically universal medicare (otherwise) still considers teeth "luxury bones" in the sense that they're not really necessary to health care (else they would be covered by medicare)
I remember reading a survey, where they determined that dentists are the most highly-compensated medical providers.
Seems like the status quo is just fine for a whole bunch of folks that make enough to buy regulatory capture.
True but the profits and regulatory capture lie more with pharma companies than with dentists.
There's an incentive for pharma to want people not to take care of their teeth, I don't know if they ever act on this incentive but I wouldn't be surprised.
Nor your eyes for some reason either.
That line is Really fuzzy.
They don't generally cover normal vision needs. Your regular glasses and/or contacts aren't covered.
Eye injury or cancer, though? Usually covered. I honestly can't recall anyone getting denied for a possible scratch on the eye, either here in Norway or the US (Am from the US). Expenses for eye issues with MS or Diabetes? Usually covered. In these cases, you often go to a specialist MD instead of the normal eye doctor (if you see an MD at all). More is generally covered for eyes than teeth - if teeth were covered like eyes, it would be an improvement. A lot of acute care and infections and stuff would be covered.
As a glasses wearer, not covering glasses feels reasonable to me, although I can't quite put my finger on why.
I guess I see glasses at least partially as a fashion accessory--a necessary one for sure, but then so are shoes, and I don't expect those to be covered by insurance.
Every health care plan I've had (US, New York specifically) has covered optometry, is that unusual?
Same for me. It's always an add-on but same provider and policy.
This has been true with multiple providers on the east and west coast.
Yes, but the point is it is an add-on. Administratively (and in terms of deductible, etc.) it is different from the medical plan.
Yes, in the US at least.
It's supposed to be insurance and most dental services don't cost enough to be worthwhile insuring as a risk. Everyone needs them, more or less, so any insurance would just be a (costly to run) payment plan.
Proper civilized countries do provide free to the consumer dental services, at least for children and poor people.
It's not your employer's "health care" plan. It's an insurance plan. And dental care doesn't really fit the insurance model since the vast majority of spending is expected and regular (checkups, cleaning, etc).
Here's an article about the history of that:
https://www.nbcnews.com/better/health/reason-your-dental-wor...
Cats can have systemic problems from dental issues.
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.
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.
Are you thinking universal health care would help, with respect to this article, even if people can't remember to brush their teeth?
It definitely would just by making sure cavities are taken care of earlier. They are caused by bacteria, and an active tooth infection is spreading and multiplying that bacteria at a much faster rate than it would be otherwise which exponentially increases the decay rate and number of cavities of all their other teeth.
Yes, it would help to know that I could see a dentist who would inform me of cavities and gingivitis that I am (or am not, depending on genes), developing as a result of my brushing habits (and through that feedback help refine said habits), rather than merely hoping and doing nothing more for lack of funds.
And many people will require regular teeth cleanings to avoid gum pockets and consequent gingivitis despite their best efforts at brushing and flossing.
There are other situations where tooth infections can move to the brain in a matter of days, risking death if left untreated. Regular checkups reduce that risk considerably.
The other side of your argument would imply that the existence of toothpaste renders the entire field of dentistry inessential.
That's a great point. (I didn't have an argument; I just wondered how the parent comment was thinking.)
You're proposing dental hygienists that do house calls and brush lazy people's teeth?
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.
Enjoy the rabbit hole. :)
can you translate this to English?
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?
Actually, research implies the opposite conclusion may be true and overcleaning your mouth may increase disease risk.
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
People lie about smoking and drinking also use mouthwash to help conceal their secret(s). Plausible?
Yes, thats plausible and the INHANCE consortium even suggested this. However the mechanism for the effect on BP can be explained by antiseptic rinses impairing the nitrate‑nitrite‑NO axis
They might also use mouthwash after another activity that involves possible HPV transmission.
Kissing a middle age woman (or other high risk person)? Very true, but it antecedes as often as it succeeds kissing, depending on whether it antecedes or succeeds marriage vows. Ever smell a husband’s breath?
The research doesn’t really imply any conclusion. You can’t cherry pick 4 studies that show an association (not causal connection) and use it as a plausible argument.
Fair point about association vs causation. To clarify, these studies don’t prove mouthwash causes these conditions, but the pattern across multiple independent studies in different populations suggests we shouldn’t assume ‘more cleaning = automatically better.
I wonder how many mouthwash users do so because they are trying to compensate for another issue.
What if we helped everybody look better and smell better and it turned out it was all for nothing?
If “for nothing” includes an increase in disease from eradicating an otherwise healthy oral microbiome by over-cleaning/washing, well I don’t think I need to answer that. Since we don’t know either way, best avoid drawing a conclusion.
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?
Because we don’t know either way. There’s also a minuscule chance that doing extra cleaning might lead to the opposite effect, as evidenced by another reply here. We don’t know. This article mentions nothing about halitosis.
Yes, but it’s so cheap and easy to do both time-wise and cost wise that it’s a completely moot point.
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.
Do you mean that brushing your teeth with toothpaste blasts everything to oblivion? I have a hard time believing that.
Probably meant antibacterial mouth washes.
I see, but that hasn't been standard care for at least a decade as far as I know?
This has not been my experience with dentistry. If anything they advise against alcohol-based mouthwashes etc.
1) I find numbers like “3-fold increased risk” a bit meaningless without knowing the baseline risk.
2) Here is an audio interview with one of the authors of the study: https://edhub.ama-assn.org/jn-learning/audio-player/19004027
>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.
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.
https://pubmed.ncbi.nlm.nih.gov/20010205/
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.
And there are chain smokers without lung issues. Anecdata really doesn't provide us much information.
> 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.
It is the initial purpose of a microbiome to be at least commensal, in that it is usually prohibitively expensive to maintain a sterile environment so the odds of a true pathogen colonizing a system is greatly reduced if you simply have a crowded space of neutral participants.
Once that's true it does seem there's a lot of host and microbiome interactions we've only begun to explore, but it shouldn't be surprising that co-evolution of the microbiome and host begins to take over as soon as you have one. One great example is short-chain-fatty-acid (SCFA) producing bacteria in the human gut. [1] These seem to be essential, and if there was a general takeaway to improve health, it would be to eat your roughage so they can do their job.
This is also why high alpha-diversity (community richness in particular) is such a dead-ringer for healthy vs diseased states. And frustratingly, is often exactly where the story ends for a lot of observational studies.
Also, in case you are curious, artificially sterile mice (gnotobiotic mice) tend to act differently than other mice, which is pretty odd to be honest, and why the gut-brain axis is a plausible mechanism to research further. [2]
[1]: https://pmc.ncbi.nlm.nih.gov/articles/PMC10180739/ [2]: https://www.sciencedirect.com/science/article/pii/S088915912...
Just like the gut you have to have the right bacteria. Not none. This is a study on Psoriasis which is caused by systematic inflamation.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9076720/
Cavities are caused by corrosion from acid produced by a bacteria called streptococus mutans, they digest the sugar in your mouth and produce acid, they thrive in slightly acidic environments. If you have other types of bacteria in your mouth, they will leave less sugar to be digested and will also produce byproducts that make leave your mouth ph less acidic.
This one only discusses the benefits of the microbiome in broad terms, but it has a bunch of interesting introductory info:
https://pmc.ncbi.nlm.nih.gov/articles/PMC6503789/
tl;dr > The oral microbiome usually exists in the form of a biofilm. It plays a crucial role in maintaining oral homeostasis, protecting the oral cavity, and preventing disease development.
That NIH article also refers to some fields that are experiencing wide recent advances: the gut/brain axis, and communication from the skin microbiota that stimulates the first immune responses to pathogenic organisms.
This link describes some aspects of the skin microbiome:
https://www.news-medical.net/news/20250402/How-your-skine280...
I up-voted your post. I don't think there should be a penalty for asking for a reference. Although, I'm not always in the mood to dig up _good_ links on subjects that I've read enough to form an opinion.
Or maybe a compromised inmune system is what allow candida to flourish…
Perhaps an issue like diabetes in which the high blood sugar provides an inviting environment for candida and also weakens the immune system.
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.
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.
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?
Mouthwash is probably bad for you:
https://pmc.ncbi.nlm.nih.gov/articles/PMC7125030/
It has always seemed suspect to me. Nuking the microbiome in your mouth seems equivalent to taking a daily broad spectrum antibiotic. It's gonna kill everything, good, bad, or indifferent.
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.
I don't know why this is always controversial in modern society, but it's always important to do the math, rather than immediately go all in on whatever supports your current lifestyle or the lifestyles of the people that you admire or fetishize.
There are plenty of good reasons to give people medical care. Clean mouths may be beneficial in many other ways other than allowing me to be within 5' of you when your mouth is open. Militant advocacy for innumeracy is a worse disease than pancreatic cancer, though.
I once had a gum infection so bad that the uncontrollable diarrhea it gave me had me so dehydrated, I was afraid I was going to pass out and die alone in my apartment (as has happened to many, many people.) I went to the emergency room and I had to beg them to pay attention to me at all. They recommended a dentist appointment. I could barely stand. Finally, one that wasn't mentally disabled recognized my distress and gave me an IV. Do you think this would change if I said that it might triple my risk of pancreatic cancer from nearly nothing to nearly nothing?
No. This study is something to add a completely spurious and inconsequential fact to toothpaste commercials, that's it. It reaches no conclusion that could help anyone with anything. If they intend to isolate the particular microbes that are more associated, and if those have an association with something that may also have an association with pancreatic cancer; or anything other than the p-hacking that this sounds like, it would be a different story.
Not just pancreatic cancer, but heart disease, heck even general quality of life. It's hard to get good nutrition without teeth.
so what was the baseline risk that was increased 3-fold?
You know the numbers are bullshit when they never tell you:
- 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.
> And yet HN commenters are easily manipulated into thinking that suddenky oral health is a big driver of pancreatic cancer.
This isn't happening, this is you starting from a solipsist axiom that you're smarter than everyone else, who comparatively must be automatons about receiving information.