Could gum disease be linked to oral cancer? New research to investigate

Researchers at the University of Plymouth are exploring possible links between the bacteria that cause gum disease and the progression of oral cancer.

Cancer needs blood vessels to grow and spread. Now the team from the University’s Institute of Translational and Stratified Medicine (ITSMed) is aiming to build on evidence that shows how bacteria which cause periodontitis (or gum disease), are linked to blood vessel formation (a process called angiogenesis).

The project, led by Dr Louise Belfield, is funded by a Colgate Robin Davies Dental Care Professionals award, part of the Oral and Dental Research Trust.

The researchers will grow mini tumours and blood vessels in the laboratory, and add bacteria to identify what effect they have on the blood vessels, and how they operate.

Blood vessels that supply a tumour grow and work differently to normal blood vessels. If the research ascertains that bacteria make the blood vessels grow more rapidly and similarly to those associated with tumours, and identify the exact process by which they do this, it could form the basis of a new screening programme to treat or detect the cancer risk earlier.

Dr Belfield, who is based in Peninsula Dental School at the University of Plymouth, said:

“We know that tumours in the mouth, unlike many other tumours, are in constant contact with bacteria, but we don’t know exactly how the bacteria affect tumour and vessel growth yet.

"The bacteria may not cause the cancer, but they may do something to make the progression of the cancer speed up. One way they could do this is via the blood vessels, encouraging them to grow more rapidly or in a way which helps the tumour to grow. So if we find out what this is and how it works, it can help us develop and put screening processes in place to detect and reduce the numbers of those bacteria.

“Cancer cannot grow more than 2mm in diameter without blood vessels, and existing evidence suggests that bacteria found in gum disease can stimulate blood vessel growth, so we’re hopeful about the results.

“In addition, bacteria that cause gum disease could gain a portal of entry to the bloodstream – and therefore the rest of the body – via the gum line. So by addressing gum disease in the first instance, it could prevent other inflammatory diseases too.”

The work is taking place within the Oral Microbiome Research Group in ITSMed, which explores all living organisms in the mouth.

Co-investigator Dr Zoe Brookes, Clinical Lecturer in Undergraduate Dental Studies at the University of Plymouth, said:

“Oral cancer is seriously underfunded within the UK – especially as it affects as many people as leukaemia.

“Treatments for oral cancer haven’t changed or progressed in the same way others have, so it would be a positive step to help tackle prospective cases.

“Whatever this research shows, the evidence all points towards maintaining good oral hygiene to lower the risk of gum disease, and keep a healthy bacteria balance in the mouth.”

The Oral Microbiome Research Group is a multidisciplinary team of scientists, clinicians and educationalists, investigating the immunological and vascular mechanisms by which oral bacteria (causing gum disease) promote diseases such as cancer, hypertension and sepsis. We are undertaking clinical trials in human participants, and with human tissue, as well as laboratory based studies utilising molecular biology, tissue culture techniques and tissue engineering models.

Our group is committed to antibiotic stewardship, with the objective of reducing antimicrobial resistance.

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