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.
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.
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.
>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.
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.
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]
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'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.
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.
Nor your eyes for some reason either.
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, in the US at least.
Here's an article about the history of that:
https://www.nbcnews.com/better/health/reason-your-dental-wor...
Are you thinking universal health care would help, with respect to this article, even if people can't remember to brush their 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?
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.
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. :)
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.
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/
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.