Screening and prophylaxis of periodontitis in the prevention of oral cavity cancer and its complications

Periodontitis is a complex, multifactorial infectious disease, which affects a high proportion of the global population. Recent studies show that periodontal disease has strong negative impact on the homeostasis of the oral cavity but has also been associated with several systemic diseases. Although some correlation mechanisms between periodontitis and certain systemic disease have been described further extensive investigations are needed to establish causality. Periodontitis could be involved in the onset and progression of some types of cancers, especially oral cancer due to chronic inflammation. The release of citokines and inflammatory markers at a local level and in the blood stream can disregulate the variables of the body and can be directly involved in the mechanim of tumorigenesis. Another hypothesis relies on the role of disbiosis of the oral microbiome and the structural and functional alterations of the subgingival flora which define periodontitis in the oral cancer development. The prevalence of oral cancer is very high and continous increase at an alarming rate globally. The rapid progression and aggressive behavior of oral cancer, the high mortality rate, the comorbidities and negative effect on the quality of life after cancer treatment but most importantly the low survival rate on the long term highlight the need to supress all the potential risk factors in order to prevent this disease. Periodontal status evaluation and periodontal therapy should be initiated in patients undergoing cancer therapy in order to lower the risk of complications associated with radiation- and chemotherapy. Also on the long run treatment of periodontal disease could prevent the development of a new oropharyngial carcinoma.