Whole Body Health - Alzheimer's Disease

Alzheimer’s Disease and dementia affects over 35.6 million individuals worldwide, with the number predicted to double every 20 years to reach over 115 million people by 2050.¹ Due to its high prevelence, it is highly likely that many know someone with the disease and are familiar with some of the common signs: forgetfulness, memory loss and confusion. However, what you may be surprised to learn is that there is an association between periodontitis and cognitive brain loss associated with Alzheimer’s disease?²

Let’s take a look at how and why the two are linked:

These amyloid plaques are hard, insoluble accumulations of beta amyloid proteins that clump together between the nerve cells (neurons) and infect the brains of Alzheimer’s patients.

Toxic amyloid plaques within the brain are a central feature of Alzheimer’s disease.³ Over time this amyloid plaque build up leads to loss of cognitive function (dementia). When plaque bacteria builds-up and the plaque becomes thick and dense, it then becomes more toxic and can lead to inflammation of the gums called gingivitis.

A healthy mouth has minimal plaque build-up. Without plaque build-up in the mouth, bad bacteria cannot multiply, cause cavities, gum inflammation, or periodontal disease. If gingivitis is left untreated it can progress to periodontal disease.

Research has shown that periodontal pathogens have demonstrated the ability to cross the brain-blood barrier4 with, enzymes related to periodontal disease found in OVER 90% of brain tissue biopsies from Alzheimer‘s patients.

Did you know?

Patients with Alzheimer’s Disease and cognitive function loss are at a higher risk for developing poor oral hygiene and periodontal disease?⁶

A clinical study which looked at the oral health status of 180 patients with dementia and 229 without dementia, found that patients with dementia had significantly worse oral hygiene⁷ .

The same clinical study found that patients with dementia had significantly worse periodontal disease, measured by tooth attachment loss⁷ . This may be due to Alzheimer’s patients forgetting to regularly brush their teeth or day-to-day routines sliding when relying on others to help.

What are the warning signs of periodontal disease which individuals with Alzheimer’s should look out for?8

Gingivitis

• Red, swollen or tender gums

• Bleeding gums

• Persistent bad breath

Periodontitis

• Receding gums

• Loose teeth

• Sensitive teeth

• Pain when chewing

This means that individuals with Alzheimer’s Disease and those involved in their care should be extra mindful of maintaining stringent oral health habits to help keep periodontal disease at bay.

References

1. Prince M, Jackson J. World Alzheimer Report. London: Alzheimer’s Disease International; 2009: 14-18

2. Chen CK, Wu YT, Chang YC. Association between chronic periodontitis and the risk of Alzheimer’s disease: A retrospective, population-based, matched-cohort study. Alzheimer’s Research & Therapy 2017; 9:56

3. Murphy MP, LeVine H 3rd. Alzheimer’s disease and the amyloid-beta peptide. J Alzheimers Dis. 2010;19(1):311-323. doi:10.3233/ JAD-2010-1221

4. Poole S, Singhrao SK, Chukkapalli S, Rivera M, Velsko L, Kesavalu L, et al. Active invasion of Porphyromonas gingivalis and infection-induced complement activation in ApoE(-/-) mice brains. J Alzheimers Dis 2015; 43:67-80.

5. Poole S, Singhrao SK, Kesavalu L, Curtis MA, Crean S. Determining the presence of periodontopathic virulence factors in short-term postmortem Alzheimer’s disease brain tissue. J Alzheimers Dis 2013; 36:665-677.

6. Foley NC, Affoo RH, Siqueira WL, Martin RE. A systematic review examining the oral health status of persons with dementia. JDR Clinical & Translational Research 2017; 2:330342

7. Gill-Montoya JA, Sanchez-Lara I, Canero-Pardo C, Fornieles F, Montes J, Vilchez R, Burgos JS, Gonzalez-Moles MA, Barrios R, Bravo M. Is periodontitis a risk factor for cognitive impairment and dementia? A case control study. J Periodontal 2015; 86:244- 253.

8. NHS UK. Available at: https://www.nhs.uk/conditions/gum-disease/symptoms/ [Last accessed: 07 December 2020