We appreciate the data provided by Drs. Lehrer, Green and Rosenzweig regarding ecological associations of breast cancer death rates and reported tooth loss from decay or gum disease among adults over age 65. In our paper (1), we examined breast cancer incidence; we did not examine prognosis or mortality. Further, the exposure measure they used was different from our measure of reported diagnosis of periodontal disease; theirs focused on tooth loss included loss to decay.
As they note, their findings need to be cautiously interpreted given that it is not known if individuals in that survey with tooth loss are the ones who are dying of breast cancer. Further, confounding by other factors, which they were not able to control, might also impact the findings.
We concur that further research regarding the interplay between chronic disease of the oral cavity and incidence and mortality from other systemic diseases including breast cancer is warranted.
Footnotes
Conflict of Interest: Neither of the authors has any potential conflict of interest
References
- 1.Freudenheim JL, Genco RJ, LaMonte MJ, Millen AE, Hovey KM, Mai X, Nwizu N, Andrews CA, Wactawski-Wende J. Periodontal disease and breast cancer risk in the Women's Health Initiative Observational Study (WHI OS) Ca Epidemiol Biomarkers Prev. 2016;25(1):43–50. doi: 10.1158/1055-9965.EPI-15-0750. [DOI] [PMC free article] [PubMed] [Google Scholar]