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Missing molar and 12X increase in breast cancer – probable vitamin D link Aug 2011

Low vitamin D status likely contributes to the link between periodontal disease and breast cancer.

Grant WB, Sunlight, Nutrition, and Health Research Center (SUNARC), P.O. Box 641603, San Francisco, CA, 94164-1603, USA, wbgrant at infionline.net.
B. J. Boucher; Centre for Diabetes, Bart’s & The London School of Medicine and Dentistry, Queen Mary University of London, Blizard Institute of Cell and Molecular Science, 4 Newark Street, London E1 2AT, UK e-mail: bboucher at doctors.org.uk
Breast Cancer Res Treat. 2011 Aug;128(3):907-8. Epub 2011 Mar 25.
PMID: 21437609

To the Editor,

The recent article by So¨ der et al. 1 found a statistically significant correlation between periodontal disease, related tooth loss and incidence of breast cancer. Periodontal disease with any missing molar teeth was associated with nearly a 12-fold increased risk of breast cancer than no missing molars. It was suggested that the bacterial infection associated with periodontal disease was the risk factor for breast cancer through effects of infection and inflammation.

Overlooked from the article as a risk factor for both periodontal disease and breast cancer was inadequate vitamin D repletion. Low solar ultraviolet-B (UVB) doses have been associated with increased risk of tooth loss since 1865 2; a role of vitamin D in reducing risk of dental caries was known in 1928 3 and, by 1935, increased solar UVB exposure was associated with reduced risk of dental caries 4.

Vitamin D deficiency has also been linked to periodontal disease risks 5, 6. The likely mechanisms by which vitamin D reduces risks of dental caries and periodontal disease include induction of cathelicidin and defensins, which have antibacterial properties 7, 8 and reduced production of matrix metalloproteinases 9, 10. Further- more, vitamin D deficiency has also been linked to increased risk of breast cancer 11–15.

An additional benefit of vitamin D is reduced inflam- mation, primarily through modifying the production of cytokines from pro- to anti-inflammatory factors 16 and inflammation is a risk factor for breast cancer 17.

Thus, this interesting study of So¨ der et al. 1 supports the need for further research to examine the role of vitamin D deficiency, as an avoidable risk factor, in those with periodontal disease and breast cancer.

Acknowledgments WBG receives or has received funding from the UV Foundation (McLean, VA), the Sunlight Research Forum (Veldhoven), Bio-Tech-Pharmacal (Fayetteville, AR), and the Vitamin D Council (San Luis Obispo, CA).


1. So¨ der B, Yakob M, Meurman JH, Andersson LC, Klinge B, So¨ der P-O¨ (2010) Periodontal disease may associate with breast cancer. Breast Cancer Res Treat. doi:10.1007/s10549-010-1221-4
2. Lewis JR (1865) Exemptions from military service on account of loss of teeth. Dental Cosmos 7:240–242
3. Mellanby M, Pattison CL (1928) The action of vitamin D in preventing the spread and promoting the arrest of caries in children. Brit Med J 2:1079–1082
4. Mills CA (1937) Factors affecting the incidence of dental caries in population groups. J Dent Res 16:417–430
5. Amano Y, Komiyama K, Makishima M (2009) Vitamin D and periodontal disease. J Oral Sci 51(1):11–20
6. Grant WB, Boucher BJ (2010) Are Hill’s criteria for causality satisfied for vitamin D and periodontal disease? Derm Endocrinol 2(1):30–36
7. Gombart AF (2009) The vitamin D-antimicrobial peptide path- way and its role in protection against infection. Future Microbiol 4(9):1151–1165
8. Hewison M (2011) Antibacterial effects of vitamin D. Nat Rev Endocrinol. doi:10.1038/nrendo.2010.226
9. Tetlow LC, Woolley DE (2001) Expression of vitamin D receptors and matrix metalloproteinases in osteoarthritic cartilage and
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