Could there be an interplay between periodontal changes and pancreatic malignancies?

The term"periodontal disease"refers to a group of chronic inflammatory illnesses caused by specific microorganisms from subgingival biofilm,that affect the toothsupporting tissues.Recent research has also shown that periodontal infection plays a role in aggravating systemic disease states at distal sites,reinforcing the significance of the oral cavity for general health.Additionally,it has been suggested that gastroenterological malignancies may be promoted by hematogenous,enteral or lymphatic translocation of periopathogens.In the past 25 years,the global burden of pancreatic cancer(PC)has more than doubled,making it one of the major causes of cancer-related mortality.Periodontitis has been linked to at least 50%increased risk of PC and it could be considered a risk factor for this malignancy.A recent study performed on 59000 African American women with a follow up of 21 years showed that participants who had poor dental health had higher chances of PC.The findings,according to researchers,might be related to the inflammation that some oral bacteria trigger.Regarding the mortality of PC,periodontitis considerably raises the chance of dying from PC.Microbiome alterations in the gut,oral cavity and pancreatic tissues of PC patients occur when compared to healthy flora,demonstrating a link between PC and microecology.Inflammation may also contribute to PC development,although the underlying pathway is not yet known.The function of the microbiome in PC risk has drawn more focus over the last decade.Future risk of PC has been linked to the oral microbiome,specifically increased levels of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans and decreased relative abundance of Leptotrichia and Fusobacteria,suggesting that it may have an impact on the inflammatory condition by expanding,altering,and regulating the commensal microbiome.Patients who received periodontal treatment had significantly decreased incidence rate ratios for PC.By analyzing patterns in the microbiome composition throughout PC development and establishing strategies to enhance the cancerassociated microbial system,we can increase the efficacy of therapy and eventually find an application for the microbial system.The development of immunogenomics and gut microgenomics in the life sciences will result in a significant advancement in our understanding of how microbial systems and immunotherapy interact,and it may also have intriguing therapeutic implications for extending the lifetime of PC patients.

Diabetes and Periodontal Diseases: An Established Two-Way Relationship

Background: Periodontal diseases (PD), including periodontitis, are chronic inflammatory pathologies caused by bacteria in the subgingival biofilm which affect the periodontal tissues. PD is now considered a localized, chronic, oral infection that activates the host immuno-inflammatory responses both locally and systemically, and also constitutes a source of bacteraemia. It is a known fact that periodontal diseases exercise an important influence on the pathogenesis of numerous systemic diseases, including diabetes mellitus (DM). In the mid-nineties, sufficient scientific evidence emerged to confirm an association between DM and periodontitis, which then began to be regarded as the sixth complication of DM. Current scientific evidence points to a two-way relationship between DM and periodontal disease, whereby DM is associated with an increase in the incidence and progression of periodontitis, while periodontal infection is associated with worsening glycemic control in diabetic patients. This two-way relationship points to a need to promote oral health in DM patients, and to implement a joint management protocol between endocrinologist and dentist that aims to create adequate conditions for early diagnosis and the effective treatment of both diseases.