Overall, Americans are keeping their teeth longer. In 1962, 49% of Americans aged 65-74 had lost all their teeth. By 2012, that rate had dropped to just 13%, and it’s expected to continue declining. Better techniques for preventing and treating cavities have led to the ability to keep more teeth longer. This means that the rate of denture wear is declining even as the population of denture wearers may be increasing.
But there’s one aspect of oral health that’s not improving among the elderly, and that’s oral cancer. Oral cancer rates are increasing for men. Although early detection and treatment techniques are also improving, it may someday be that oral cancer, not tooth decay or gum disease, is the main reason why people wear dentures.
Oral Cancer Bucks the Trend
Overall, cancer rates in the US are declining. And cancer deaths are decreasing even faster. In fact, the rate of cancer deaths have fallen by 25% since 1991, from 215 per 100,000 to just 161 per 100,000. The credit goes to declining smoking rates and better early detection and treatment. The biggest declines were in lung, breast, prostate, and colorectal cancers.
But oral cancer rates aren’t declining. In fact, they’re increasing. Oral cancer rates increased by 15% from the mid 1970s until 2004. And they’ve increased nearly 50% since then. This is despite the fact that smoking rates are declining, which should have a positive impact on oral cancer as well as lung cancer. But part of the impact on oral cancer is the use of smokeless tobacco use, which has not declined the way that smoking rates have declined. In some places, smokeless tobacco usage has increased as a substitute for smoking. Smokeless tobacco is a serious risk factor for oral cancer. Alcohol use also contributes to oral cancer risk, and since most people in the US continue to drink alcohol, this contributes to the high incidence of oral cancers.
And because men are the primary users of alcohol and smokeless tobacco, this can also account for the difference in oral cancer rates. Men are about three times more likely to develop oral cancer and to die from it.
Oral Cancer and Tooth Loss
Oral cancer can lead to tooth loss, although it is typically a secondary complication. Oral cancer and its treatment can lead to an increased risk of gum disease and tooth decay by impacting saliva production and immune system function.
Doctors and dentists may also decide it’s better to remove questionable teeth before oral cancer treatment. Marginal teeth that might otherwise be saved are extracted instead, leading to increased tooth loss.
Oral Cancer and Dentures
Oral cancer can also make it more likely that you’ll get dentures instead of dental implants. If you have radiation therapy for oral cancer, dentists may be reluctant to place dental implants. Dental implants can cause certain complications after radiation therapy. To avoid these complications, dentists may recommend against dental implants. Which means that people with a history of oral cancer may be the only population where denture use is actually increasing in the future.