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.
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.
Seems like the status quo is just fine for a whole bunch of folks that make enough to buy regulatory capture.
Proper civilized countries do provide free to the consumer dental services, at least for children and poor people.
https://www.nbcnews.com/better/health/reason-your-dental-wor...
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.
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.
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. :)
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
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.
2) Here is an audio interview with one of the authors of the study: https://edhub.ama-assn.org/jn-learning/audio-player/19004027
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.
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.
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...
"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.
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.
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...
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.
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.
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.
- 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.
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.
