Dr. Vikrant Kundu

BDS (Hons)
MDS ( Orthodontics )
CAIC ( Implantology Korea )
ADIC ( Implantology Israel )
CHIEF MENTOR, Mirell International

The Alzheimer’s and Oral Health Connection

Alzheimer's disease (AD) is a lethal neurodegenerative disease which causes someone’s nerves to be damaged with increasing age. However, the onset of AD can be either early or late. It is typically featured by the salient inflammatory characteristics, increased levels of pro inflammatory cytokines, and microglia activation which are responsible to the inflammatory condition of the central nervous system. Whereas, periodontal diseases comes into existence when oral bacteria prowl under your gum line, spreads rapidly, infecting the spaces between gums and teeth.

A specifically hardly known reason behind gum diseases being terribly dangerous is of how it causes your body to react: with local inflammation in the mouth which isn’t good for your health. As with any infection, your body transports white blood cells to fight off the bacteria, and with them comes along inflammation.

Inflammation of the gum tissue continues, and generally gets worse which further contributes to increasing risk of heart attack, cardiac arrest and/or stroke and progression of Alzheimer’s disease( as discovered from recent studies).

Inflammation is known to play a vital role in both the disease process serving as a connection between periodontitis and Alzheimer’s. Our present review throws a light on possible enigmatic and systemic link between AD and periodontitis and AD and “inflammation”, and “proinflammatory cytokines”.

Oral health infections induces a systemic link associated with memory loss of AD
Let’s look into the Alzheimer’s-Oral health infections links

Gum Disease and Alzheimer’s Grow Together

A recent research of Alzheimer’s patients discovered that those suffering from gum disease had notably plummeted over a period of the year than those with healthy mouths. The inference at this extremity is that it is a relationship of reciprocation: not only does gum disease exasperate Alzheimer’s, but Alzheimer’s causes hard time to the patient in managing their oral health and hygiene.

Inflammation has continually been considered to be a part of Alzheimer’s, but with this new information we now know that gum disease is directly serving to the spread of and impact of inflammatory markers. It is appalling to know that periodontal health can have such a teriffyin effect on the progress of Alzheimer’s – for many it strikes really close to home!

Oral Bacteria

In the oral cavity, an overabundance of bacteria and microorganisms are found in the sticky plaque biofilm that layers upon the many surfaces in the mouth. Furthermore, in depth periodontal pockets can be created and nurture a large number of pathogenic bacteria. Oral bacteria linked with oral disease and implicated in AD include P. gingivalis, P. intermedia, F. nucleatum, T. forsythia, T. denticola, and spirochetes which have also been found in Alzheimer’s brains. An evident attribute about spirochetes in aspect to their link to AD include being neurotropic in nature, meaning they particularly target and damage nerve tissue, contribute and promote inflammation, and build neurofibrillary tangles and amyloid plaques, the trademark signal of AD.

As per a recent research conducted, over the age of 60, with mild to moderate AD exhibited a six times increase in degree of cognitive dwindling after 6 months. Additionally, this study exhibited an increase in periodontal-linked pro-inflammatory cytokines after 6 months.

What’s more to manifest a strong interrelation or concurrence between periodontal disease and AD, it is signifying that periodontal disease remained before the start of AD.

Mode of Moving of Microbes to the Brain

The most common passage by which microbes reach the brain is via the bloodstream. During food grinding, flossing, and periodontal treatment, oral bacteria are released into the bloodstream and can stay there for up to 180 minutes. In a young healthy individual, a bacterium is held by the immune system. However, in older people with a compromised immune system, bacteria can be seated in periodontal pockets and persisted to be released.

Another way microbes make way to the brain is by sailing through the blood-brain blockade. With age, the existence of plethora of bacteria, viruses and microbes compromises the uprightness of the blood-brain blockade, making it flexible for microbes to trespass and burst on the nerve tissue. The increased invasion of the blood-brain blockade with age leads to encouragement of Alzheimer’s.

Poor Sleep Adds to Alzheimer's Associated Brain Proteins

Bouts of bad sleep can substantially ameliorate the amount of amyloid beta and tau in the brain, which are connected to a higher risk of Alzheimer's disease. Medical researchers also produced findings supporting the theory that chronic bad sleep or sleeping pattern in midlife could elevate the risk of developing Alzheimer's disease later on in life.

A study of middle-aged and fit adults has found that bad sleep can lead to proliferation of levels of 2 specific proteins linked with Alzheimer's disease: amyloid beta and tau. A single night of disturbed sleep, slow wave sleep increased levels of amyloid beta, while a week of bad-quality sleep heightened levels of tau.

The protein levels as likely as not return to normal later.

So! The biggest concern is those who have chronic sleep problems may lead to chronically elevated amyloid levels, which further results to higher risk of amyloid plaques and Alzheimer's.

HSV-1 and Oral Candidiasis

Besides periodontal disease, other common oral infections in adults age 65 and above are the oral herpes simplex virus (HSV-1) and oral candidiasis. An estimated 70% of adults older than 50 years contain the HSV-1 virus. It is usually dormant in the peripheral nervous system and can be prompted by high levels of illness, obesity or stress. Research indicated that once prompted, the virus declines the body’s capability to fight off infection, hence increasing the possibility of developing periodontal infections. In addition, it forms pro-inflammatory elements, supplemetin to extra challenges to an already compromised system. These severe effects of the virus leads to production of raised levels of HSV-1 proteins found in the amyloid plaques linked with AD, establishing a strong interdependence between HSV-1 and Alzheimer’s.

It has been shown that oral yeasts and fungal infection can be present in ulcerated periodontal pockets in teeth treated by root canal therapy, and also on the mucosa beneath dentures and partials. Because dentures ordinarily foster high amounts of oral denture stomatitis, a systemic fungal infection or inflammatory status of the mucosa, candidiasis can appear, thereby creating an additional link between oral disease and Alzheimer’s.

The Older Adults and Improper Oral Health

Health problems such as high blood pressure, heart diseases, arthritis, poor vision, limited mobility diabetes, and depression come with age. While xerostomia occurring from medications taken to tackle these health issues can cause poor oral health. Poor dexterity amongst elderly makes it difficult to keep oral health. With a compromised dentition, the inability to consume and chew essential diet may result in nutritional deficiencies, which adds another risk factor to AD.

Ironically No 100% cure for Alzheimer’s, but current advanced medical science fortunately point how and where we can cure the gum disease that’s contributing to Alzheimer’s.

And here comes the Dental professional’s main role, who is to take the initiative to educate AD patients and their caregivers to try to prevent oral disease as much as possible. For all you know now, the key to decelerate the progression of Alzheimer’s is practicing preventive dentistry and oral hygiene.

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