Poor dental hygiene may lead to cancer and early death. A Swedish study initiated back in 1985 included 1,390 randomly selected adults ages 30 to 40 who had no signs of gum disease when they enrolled. The participants were followed by periodic checks of their oral health and smoking habits until 2009. Over the 24 years of the study, 58 participants died, 35 of them from cancer. After the data were analyzed, the researchers found that age, being male and the amount of dental plaque documented at the dental checkups were principal predictors of death. The researchers suggested that the cancer link may have been due to toxins and enzymes associated with increased plaque that could have entered the bloodstream, possibly raising the risk of malignancies. They reported that the participants who died had exhibited significantly worse dental health at their check ups than the survivors. The study was published online in BMJ Open on June 11, 2012. The researchers noted that more studies will be needed to determine whether poor dental health is a significant contributor to the cancers that caused the deaths seen in this study.