Medical Connection: Oral Health and Alzheimer’s Disease

Researchers have found a possible link between oral health and Alzheimer’s disease. With this new knowledge, it’s more important than ever to maintain good oral hygiene, especially flossing. This may help you prevent Alzheimer’s disease, along with other health issues like diabetes and heart disease. oral health and dementia

To get you up to date on the most recent information and what you can do to protect yourself, we’ll look at:

  • Is there a link between oral health and Alzheimer’s disease?
  • What is periodontitis?
  • How to prevent gum disease
  • Our favorite flossing tools
  • Other ways gum disease impacts your overall health

The actual cause of Alzheimer’s disease is unknown and there are many possible factors that may play a part in developing it. By understanding the possible connection between it and oral health, you’ll find the motivation, habits, and tools you need to prevent your oral health from becoming a factor from being one of them.

Is there a link between oral health and Alzheimer’s disease?

Yes. A 2019 study confirmed that there is a link between oral health and Alzheimer’s disease. Researchers found a connection in Porphyromonas gingivalis, a form of bacteria associated with gum disease. Known as P. gingivalis for short, this form of bacteria secretes a toxic enzyme known as gingipains, which is known to:

  • Help P. gingivalis take root and survive
  • Prevent the body from defending itself from infection
  • Use up iron and other nutrients in the body
  • Destroy body tissue

The 2019 study was performed on both living and deceased Alzheimer’s patients by analyzing their saliva, spinal tissue, and brain fluid. The most important observations came from analyzing the brain fluid. According to the study, 96% of test subjects with symptoms of Alzheimer’s disease had much higher concentrations of gingipains than those without symptoms.

This gives us evidence that bacteria associated with gum disease is able to travel from the mouth to the brain, possibly resulting in Alzheimer’s symptoms. Dr. Richard Kao is the president of the American Academy of Periodontology, an organization of over 8,000 periodontists. He says that:

Periodontists have long known that a healthy mouth contributes to a healthy body, and research has suggested an association between periodontal disease and dementia conditions, such as Alzheimer’s. These recent findings present strong evidence on how periodontal disease can impact the pathogenesis of Alzheimer’s disease and should highlight how crucial it is to manage periodontal disease, especially in older adults or individuals who have increased risk for dementia

For Dr. Kao and his colleagues, this study serves to reinforce the importance of maintaining healthy gums.

What is Alzheimer’s disease?

Alzheimer’s disease is a form of dementia, an umbrella term for impaired cognitive abilities. People with dementia may have trouble:

  • Memory
  • Language
  • Motor skills
  • Decision making
  • Mood/behavior fluctuations
  • Disorientation

While associated with older people, it’s not a normal part of the aging process. 

Alzheimer’s disease is the most common form of dementia. It’s a progressive disease, meaning that it will only become more severe as time goes on. Alzheimer’s disease may first appear as minor memory loss. It will eventually progress to where sufferers can no longer care for themselves. 

We don’t currently know the actual cause of Alzheimer’s. While recent discoveries give us insight into certain aspects of the disease, they don’t account for all the different factors. We do know that:

  • Age is the biggest risk factor for Alzheimer’s disease
  • Family history plays an important role
  • It can take years for symptoms to appear
  • Markers for stroke and heart disease may increase your vulnerability

There is mounting evidence that exercise, diet, and sleep can help reduce your risk of developing Alzheimer’s. With new research also linking it to oral health, we expect to see basic oral hygiene eventually playing a role, as well. gum disease and alzheimer's

What is periodontitis?

Do everything you can to take care of your gums. Alzheimer’s has been linked to periodontitis, which is a severe form of gum disease that attacks the bone and soft tissue of the mouth. 

Gum disease begins as gingivitis, an infection where the gums become red and swollen. Gingivitis is easily treated and even reversible. However, it will develop into periodontitis (periodontal disease) if not treated immediately.

One of the common signs of periodontitis is when the gums begin to pull away from the teeth, also known as receding gums. At this point, the infection has worked its way deeper into the soft tissue and bone that supports your teeth. You run the risk of losing teeth if the infection isn’t treated immediately or effectively.

Despite its severity, periodontitis is a surprisingly common problem. The National Laboratory of Medicine (NLM) estimates that around 47% of American adults over the age of 30 have it in some form. The risk of developing periodontitis only grows as you age. The NLM also estimates that around 70% of Americans over the age of 65 have some type of periodontal disease.

How Periodontitis Develops

Periodontitis is caused by the buildup of plaque and tartar on your teeth and below the gumline. Plaque forms when the starches and sugars in food combine with the bacteria in your mouth. Plaque eventually turns into tartar if left untreated. Unlike plaque, tartar is solid and must be removed by a registered dental hygienist since regular dental hygiene won’t remove it.

Tartar is called calculus once it’s below the gumline. There, calculus keeps collecting bacteria, which is what irritates your gums. Over time, pockets begin to deepen around your teeth where even more plaque, tartar, and bacteria are collected. The final result is bone, tissue, and even tooth loss due to infection deep within your gums.

Preventing Periodontal Disease

Fortunately, preventing periodontal disease is easier than you may think. The best thing any person can do to protect their oral and overall health is to practice good oral hygiene. This means:

  • Brushing your teeth twice a day for two minutes
  • Flossing between your teeth at least once a day after eating
  • Going to your regular dental appointments

Following these three steps are essential for maintaining good oral health. Not only will they help you prevent possible tooth loss, but they may also help in protecting yourself from Alzheimer’s disease.

How to Prevent Gum Disease

Brushing and regular dental appointments are critical for good dental hygiene. However, flossing regularly may be the most important step in protecting you from health issues like Alzheimer’s. While brushing removes plaque from the surfaces of your teeth, flossing removes bacteria from between your teeth where most oral diseases start. Not even mouthwash can do that.

Failure to floss greatly increases your risk of:

  • Tooth decay
  • Gum disease
  • Bacterial infections
  • Bad breath

Flossing still isn’t a substitute for brushing, though. You’ll still need to brush your teeth regularly to keep your teeth in tip-top shape. When combined with brushing, interdental cleaners such as floss work together to act as the first line of defense in protecting your teeth.

Making Flossing a Daily Habit

How many times have lied to your dentist about flossing? If you winced at that question, you’re not alone. Developing any habit is hard enough. Developing the habit of flossing regularly can be even more difficult. 

When it comes to flossing regularly, remember how important it is for your:

  • Oral health
  • Overall health
  • Self-confidence

Forgetting to floss occasionally isn’t the end of the world and gingivitis is curable. Periodontal disease, on the other hand, can result in receding gums and even tooth loss if not prevented or treated. What’s more, treatments are much more expensive and invasive.

You’ll want to develop a flossing habit as soon as possible to save yourself the time and money it requires to treat periodontitis. To kickstart your habit, you’ll need to:

  1. Choose a trigger
  2. Set up a visual cue
  3. Floss a single tooth
  4. Keep track of changes
  5. Keep track of your progress

To choose a trigger, choose something that you already do regularly and add flossing to it, like brushing your teeth at night. Set up a visual cue by placing your floss or another interdental cleaner next to your toothbrush as a reminder. Start by flossing a single tooth and gradually flossing more over time.

It can help to keep track of changes so you can recognize improvement in your oral health. This could be better breath or teeth that feel cleaner than before. Keep track of your progress on a calendar to see how far you’ve come since you started your flossing habit.periodontitis and dementia

Our Favorite Flossing Tools

One of the hardest things about flossing is the floss itself. We’re big fans of traditional waxed dental floss. However, there are some other options for cleaning between your teeth that don’t require traditional floss. 

WaterPik Water Flosser

This has been one of our favorites for years. The WaterPik Water Flosser is able to comfortably remove bacteria and food particles from between your teeth using a powerful stream of water. Water flossers perform their best when used correctly, so talk to one of our hygienists about proper technique.

BURST Water Flosser

This option from BURST is one of the newest on the market and we absolutely love it. It provides you with three spraying modes to remove debris and plaque from between your teeth and at the gumline. It’s sleek, compact, and comes with a USB charger and travel bag making it perfect for flossing on the go. It also has options for people with braces or periodontal issues.

Flossing Picks

Do you want a more traditional flossing experience without the hassle of regular floss? If you said “yes” then floss picks are your best choice. These small pieces of plastic have a string of floss attached to provide you with more control and faster flossing time. They also double as a toothpick if you have a leftover piece of food that’s been nagging at you.

Flossing with Braces

Flossing can be particularly frustrating if you have braces. Fortunately, dental health companies have recognized this problem and are making products to make it easier to keep your teeth clean as you’re straightening them. Water flossers like the WaterPik and BURST water flossers are also great options, but more affordable options are available.

Do you have a favorite flavor or brand of waxed floss that you love but can no longer use due to braces? Floss threaders may be the option for you if so. These tools allow you to continue using regular floss with metal braces by threading the floss around the metal wires and between your teeth. This way, both your braces and teeth get cleaned!

Floss threaders can be a bit time-consuming. On the other hand, they’re an affordable solution for keeping your teeth and braces clean. There are plenty of trustworthy brands out there to choose from. Check out Dentek, Plackers, GUM, and Crest to get started.

Want to step up your flossing game from threaders and traditional floss? Look no further than Oral-B Super Floss! This floss is made specifically with braces in mind. One end has a stiff piece of plastic the same width as traditional floss. This rigid end makes it possible for floss to be easily inserted so that you can clean your teeth and braces.

Oral-B Super Floss has the added benefit of a section of “spongy” floss in the middle. It gives you the ability to clean more deeply below the gumline and around braces to get rid of even more food debris and bacteria.

Other Ways Gum Disease Impacts Your Overall Health

Alzheimer’s isn’t the only health condition related to gum disease. While it may be the latest addition to the list, there are many other serious health conditions that have been connected to oral health. Gum disease, and your oral health in general, are both important factors in maintaining your overall health.

Lewy Body Dementia and Gum Disease

There are 700 kinds of bacteria in the mouth and they can eventually make their way into your bloodstream. Once there, they can move to the brain and contribute to the development of dementia. This could eventually cause the development of Alzheimer’s, but Alzheimer’s isn’t the only form of dementia that may be connected to oral health. 

After Alzheimer’s disease, Lewy body dementia is the second most common form of dementia. While it can affect cognitive function like Alzheimer’s, it can also lead to:

  • Trouble regulating your nervous system
  • Mobility problems similar to Parkinson’s disease
  • Visual hallucinations
  • Depression

Lewy body dementia and Alzheimer’s disease both involve the growth of plaques and tangles in the brain. Plaques are irregular fragments of protein that form between nerve cells in the brain. Tangles prevent resources from moving between cells by damaging the protein transport system, causing cells to die. 

Diabetes and Gum Disease

People with diabetes have difficulty maintaining their blood sugar. Your body turns food into sugar to be used as energy, but sometimes it isn’t able to absorb the sugar (glucose) correctly. There are two main kinds of diabetes — type 1 and type 2. They affect your response to insulin, which is the hormone that transports glucose to the cells for energy.

People with type 1 diabetes are unable to produce enough insulin on their own. People with type 2 diabetes have become completely unresponsive to insulin.  

Both types of diabetes result in above-average blood sugar levels. It can have a severe impact on your eyes, kidneys, nerves, and heart, as well as your oral health. For instance, diabetes can lead to:

  • Inflamed gums
  • Bleeding gums
  • Dry mouth
  • High risk of oral infection
  • Wounds that take longer to heal
  • High risk of cavities

Diabetics have a much greater risk of developing gum disease than non-diabetics, which means they may also be at a higher risk of developing dementia. Gum disease is a common problem for diabetics and it becomes more prevalent as you get older.

High Blood Pressure and Gum Disease

According to the American Heart Association, a review of previous research has shown that high blood pressure is easier to control if you have good oral health, including better responses to medication.

For instance, those with untreated high blood pressure saw significant improvements when they focused on good oral hygiene. On the other hand, those with gum disease were unable to achieve the same results than those without good oral hygiene, even with medication.

While more research needs to be done, these results have led experts to suspect that gum disease may actually make blood pressure treatment less effective. This suggests that oral health is much more closely tied to overall health than many people realize. Dr. Davide Pietrapaoli, the lead researcher of the review, stresses this by saying:

Physicians should pay close attention to patients’ oral health, particularly those receiving treatment for hypertension, and urge those with signs of periodontal disease to seek dental care… Likewise, dental health professionals should be aware that oral health is indispensable to overall physiological health, including cardiovascular status.

There is mounting evidence that blood pressure and Alzheimer’s are also linked. According to Johns Hopkins Medicine, older patients with high blood pressure are likely to have signs of Alzheimer’s in their spinal fluid similar to those with gum disease. The risk of dementia increased if patients experienced blood variation over an eight-year span.

With the mounting research not just for Alzheimer’s but also diabetes and hypertension providing more and more data on the links to one’s oral health, it is important to maintain good habits and regular check-ups. Catching gum disease like periodontitis early and creating flossing habits for the whole family is a proactive way to secure your future health. When you make an appointment to check the status of your oral health we can even double check your flossing techniques are up to par.

Are you concerned about your risk of developing gum disease? Schedule an appointment today and get your oral health back on track!

My Family Dentistry is open Monday through Thursday and every other Friday. Give us a call at (865) 947-6453 or you can schedule an appointment online.

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