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

Abstract

The recent article by Soder 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]. Furthermore, vitamin D deficiency has also been linked to increased risk of breast cancer [11–15]. An additional benefit of vitamin D is reduced inflammation, primarily through modifying the production of cytokines from proto anti-inflammatory factors [16] and inflammation is a risk factor for breast cancer [17]. Thus, this interesting study of Soder 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.