Men could be compromising their health more substantially than they realise by neglecting preventative medical procedures such as dental check ups. Research shows that men are less willing to consult medical and mental health care providers, or use preventative health care. Worryingly a survey carried out in 2012 revealed that 32 per cent of men had not visited the dentist within the year (compared to 25 per cent of women). In the same survey, 22 per cent of men who provided a reason for infrequent visits stated that they are able to take sufficiently good care of their teeth independently or that they believed they had nothing wrong with their teeth. These findings conclude that men may be more confident about their health but that there is a significant need to ensure information reaches men more effectively.
Research has found that periodontal disease is more prevalent in men (56.4 per cent) than in women (38.4 per cent). This may be because men are less likely to go to the dentist or because they have more indicators for poor periodontal health than women, (such as higher incidence of dental plaque, tartar and bleeding on probing). Whatever the reason, it is increasingly urgent to advise men about preventing and treating periodontal disease and to ensure that they are sufficiently informed of the possible links to a variety of other health conditions, including prostatitis.
Dental professionals are aware that people with poor oral health are potentially putting themselves at risk not only of periodontal disease but also other chronic inflammatory diseases such as diabetes and cardiovascular disease, respiratory disease and osteoporosis. However some people may not realise that maintaining good oral care may
impact on their overall health. Additionally, oral problems such as periodontal disease are often asymptomatic; men may not be aware that they have a problem until it becomes serious.
Prostate-specific antigen (PSA) is an enzyme that is created in the prostate and normally secreted in very small amounts. When the prostate becomes inflamed, infected or affected by cancer, PSA levels rise in the blood. Prostate-specific antigen levels are particularly useful for early detection and monitoring of prostate cancer and for evaluating the risk of its development in men. Recent research has shown that men with indicators of periodontal disease and prostatitis have higher levels of PSA than men with only one of these conditions.
In a study in 2010 researchers selected 35 men, most of whom had mild to severe periodontitis and, in some cases, also suffered from prostate cancer. None of the men had undergone dental work for at least three months and were given an examination to measure their gingival health. The results found that those patients with the most severe form of prostatitis also showed signs of periodontitis. In further studies patients were divided into groups of mild to no periodontitis and moderate to severe periodontitis – the PSA levels in the bloodstreams of those patients with more severe periodontal disease were higher than the normal range and of those without or with a very mild form of the condition. These findings indicated that prostate health may be associated with periodontal health and vice versa.
Of further interest, androgendeprivation therapy (ADT) is commonly used in the treatment of prostate cancer. Although ADT is effective at suppressing prostatespecific antigen (PSA), stabilising the disease and potentially prolonging survival, it is not without serious consequences for a patient’s overall health. Androgen-deprivation therapy is associated with an increased risk of skeletal fracture, incipient diabetes and cardiovascular-related mortality. Research also confirmed that men with prostate cancer undergoing ADT were more likely to have periodontal disease. The prevalence of periodontal disease was 80.5 per cent in men on ADT compared to 3.7 per cent who were not.
Dental professionals can help scores of men to fight periodontal disease by providing fast and effective treatment. Mechanical removal of bacterial deposits and calculus from the subgingival environment is the foundation of periodontal treatment, however root surface debridement (RSD) cannot completely eliminate plaque from the root surface, especially when periodontal pockets are deep.
Tools are available to help though. For example PerioChip is proven more effective at reducing the depths of periodontal pockets compared to RSD alone. It is a biodegradable gelatine based insert that is placed subgingivally at the base of the pocket, and begins to work almost immediately to eliminate 99 per cent of periopathogenic bacteria.
Some may believe that the link between periodontal disease and prostate cancer is tenuous but larger studies may substantiate it in the very near future. What is probable, however, is that by treating a man with periodontal disease you could be saving them from developing a far more sinister health condition.
References available on request.