The Link Between Oral Health and Alzheimer’s Disease

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Andrew Slavin, DMD, FACS

Andrew Slavin, DMD, FACS

July 21, 2022

Alzheimer’s disease (AD) is the leading cause of dementia among older adults worldwide. AD is characterized by progressive memory loss and cognitive impairment, eventually leading to death. It affects more than five million Americans and is the sixth leading cause of death in the United States. Unfortunately, there are currently no known cures for this devastating disease. However, recent research has shown that oral health may play a role in preventing or slowing down the progression of AD. This article explores the link between oral health and AD.

Alzheimer’s disease (AD) is a neurodegenerative disorder that affects memory and cognitive functions. AD is characterized by progressive loss of neurons and synapses in the brain, leading to dementia. It usually starts after age 60 and affects nearly half those older than 80. Other risk factors for developing Alzheimer’s include family history, head injury, stroke, diabetes, hypertension, smoking, obesity, low education level, physical inactivity, and depression. Symptoms include confusion, trouble speaking and walking, depression, anxiety, hallucinations, and personality changes. In addition to the aging population, the number of people diagnosed with AD has increased over the past few decades. According to the World Health Organization, approximately 50 million people worldwide are currently affected by this disease. The diagnosis of Alzheimer’s disease is based on symptoms and medical tests. A doctor may order blood tests, urine tests, CT scans, MRI scans, PET scans, spinal taps, and genetic testing.

The relationship between oral health and Alzheimer’s disease is not well understood. However, research suggests that poor dental hygiene may increase the risk of developing AD. One way is through the bacteria in your mouth. These bacteria live in harmony with your body’s natural flora. However, if they become overgrown, they can cause inflammation and infections. This is due to the fact that bacteria from the mouth can enter the bloodstream through the gums and travel to the brain, where they cause inflammation. As a result, the immune system attacks the brain cells, causing damage and eventually leading to Alzheimer’s disease.

1. A study published in the Journal of Dental Research found that older adults with periodontal disease or gingivitis were twice as likely to develop mild cognitive impairment or dementia than those without these conditions. This was based on a review of over 100 studies involving nearly 1 million participants. Gum disease can cause inflammation in your mouth and brain, which may lead to cognitive decline.

2. Another study published in the journal Neurology found that people with periodontal disease were twice as likely to develop dementia than those without the condition. Periodontal disease occurs when bacteria from plaque build-up around teeth, causing them to become loose and fall out. Researchers believe that bacteria and toxins that enter the bloodstream through the mouth could lead to inflammation in the brain. Bacteria present in periodontal disease, particularly certain spirochetes, can travel along the trigeminal nerve that connects the mucous membranes of the mouth to the brain, potentially causing brain damage. This inflammation may contribute to the onset of dementia. However, the researchers also suggest that the connection could be more indirect, with the inflammation of gum disease leading to cardiovascular disease or diabetes, which are known risk factors for dementia.

Prevention is vital when caring for the oral health of a patient with Alzheimer’s disease. Dementia affects much of daily living, including personal hygiene. So many of the beneficial practices that are known to improve oral health, such as exercise, a healthful diet, regular brushing of teeth, and dental checkups, can be difficult or impossible for someone whose memory is failing them. A person in cognitive decline might find it difficult to remember to care for their oral health with the same vigilance that they used to. Routines and patterns are helpful tools to assist with memory; deviation from the established schedule can subvert the expectations of someone who relies on it to help with their decision-making process. Alarms and written planners might be helpful in reminding someone finding themselves unable to remember to care for their oral health with the same vigilance as before. It’s also important to check in on members of our communities that may have needs different from our own.

Andrew Slavin, DMD, FACS

Andrew Slavin, DMD, FACS

Hello there, great choice moving towards the personal dental health care you desire!

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