Select Committee on Health Appendices to the Minutes of Evidence


APPENDIX 7

Memorandum by the British Dental Health Foundation (TB 15)

SUMMARY

  Oral cancer is one of the least known and yet potentially most lethal cancers in Britain today. It is also one of the biggest risks from tobacco use. Smoking also increases gum disease which also has a direct relationship with cardiovascular disease. The British Dental Health Foundation would like to see warnings on tobacco packaging about the risk to oral health, particularly cancer and gum disease with its associated health risks.

1.  THE BRITISH DENTAL HEALTH FOUNDATION

  1.1  The British Dental Health Foundation is a national charity devoted to the promotion of oral health awareness to the general public. One of its main concerns is the effect of tobacco use on dental and oral health.

2.  THE RISKS TO ORAL HEALTH OF TOBACCO USE

  2.1  Oral cancer;
  2.2  Increased tooth decay;
  2.3  Increased tooth loss;
  2.4  Increased risk of periodontal disease leading to other diseases;
  2.5  Increased tooth decay and loss in children of mothers who smoke;
  2.6  Increased risk of premature birth by gum disease in the mother;

3.  THE BDHF RECOMMENDATIONS

  3.1  The government to stress the risks to oral health in future health campaigns against tobacco;

  3.2  To use the risks to oral health in the government health warnings on cigarette and tobacco packaging.

4.  THE RISK OF ORAL CANCER

  4.1  Incidence rates of newly reported cancers per 100,000 population have been published for England and Wales during the 1980s. They show a total of 4.1 including males and females and all types of mouth cancer. (Downer et al 1999).

  4.2  Oral cancers represent about 1-2 per cent of the total incidence of cancers in the UK but morbidity and mortality rates are very high, with over 60 per cent of patients dying as a result of oral lesions. (ibid).

  4.3  Oral cancer is currently not subject to routine screening in the UK. Although the death rate from cervical cancer is much lower there is a screening programme in operation.

  4.4  The risk of death from oral cancer is so high because the pre-cancerous lesions are frequently painless and are not recognised by the patient as being dangerous. Early diagnosis leads to surgery of small lesions and has a very high recovery rate. The prognosis for larger lesions is, however, very poor. (ibid).

  4.5  Oral cancer is one of the least well known cancers among the UK general public. A recent survey showed that only 56 per cent of over 16s had heard of oral cancer compared to 97 per cent awareness of lung cancer, 96 per cent of skin cancer and 86 per cent of cervical cancer. (Warnakulasuriya et al 1999).

5.  OTHER RISKS

  5.1  Not only is smoking linked to cancers but there is also a risk to general dental health from the effects of tobacco. One Swedish study proved a direct link between smoking and tooth loss. (Axelsson et al 1998).

  5.2  Studies of smokers aged from 35 to 75 took place which showed that by the age of 50 there were significantly more missing teeth in smokers than in non-smokers. By the age of 75 the difference was over three times more in smokers. (ibid)

  5.3  The smokers also had fewer intact teeth surfaces with 35-year-olds showing a 26 per cent increase in decay or fillings. (ibid)

  5.4  Smokers suffer an increased incidence of periodontal (gum) disease which has been proved to be linked to other diseases. Coronary heart disease is a major cause of death in the UK. Periodontal disease is a significant risk factor in coronary heart disease. (Seymour & Steele 1998).

6.  THE RISKS TO CHILDREN'S ORAL HEALTH FROM SMOKING MOTHERS

  6.1  Studies have shown a link between levels of tooth decay in pre-school children and whether or not their mothers smoke. Higher tooth decay levels were found in children with smoking mothers. (ORCA 1999)

  6.2  The study involved data from 763 children aged 3 to 4.5 years and took into account tooth brushing frequency, weekly expenditure on confectionery and maternal smoking habits.

  6.3  The data were isolated from the effects of tooth brushing frequency and confectionery consumption to confirm the link was with smoking and not other factors although the reason for the link is not known.

REFERENCES

  Axelsson P, Paulander J, & Lindhe J. (1988) Relationship between smoking and dental status in 35-, 50, 65, and 75-year-old individuals. Journal Clin Periodontol. 25: 297-305.

  Downer M C, Bedi R & Wray D. (1999) Oral Health—Diet and Other Factors, The Report of the British Nutrition Foundation Task Force. Elsevier.

  Seymour R A & Steele J G. (1998) Is there a link between periodontal disease and coronary heart disease? British Dental Journal. 184: 33-38.

  ORCA—European Organisation for Caries Research (1999) Report to International Dental Conference by Leeds Dental Institute.

  Warnakulasuriya K A A, Harris C K, Scarrott D M, Watt R, Gelbier S, Peters T J & Johnson N W (1999) Oral Cancer—a survey of the general public. British Dental Journal. 187: 319-322.



 
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