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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