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Monday, September 28, 2020

Alzheimer’s and dementia: A new study offers another good reason to maintain good oral hygiene

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Researchers studying the cause of Alzheimer’s have identified amyloid and tau proteins that actually accumulate in the brain.

But Dr. Diana Kerwin, a specialist in geriatric medicine at Texas Health Presbyterian Hospital, said she is still unable to determine what triggers that cascade and begins buildup in brain tissue.

“And so looking at something like an infectious etiology is actually something that has been going on for about 10 years, but actually in the background,” Kerwin said. “And it wasn’t until the last two or three years that a certain protein called gingipain associated with periodontal disease was actually identified. And it has a link with the amyloid protein that builds up in the brain. “

Highlights of the interview

Study information

  • This started in Down syndrome patients. They noted that patients with periodontal poor health had an increased risk of Alzheimer’s and there is an increased risk with Down’s syndrome. So someone started looking at it a little closer.
  • So periodontal health has been examined in multiple observational studies involving geriatric patients or older patients because they are at increased risk for Alzheimer’s. They began to notice that when looking at patients with periodontal disease or problems with periodontal disease, there was also an increased risk of Alzheimer’s.

Did gum disease occur before or after dementia?

This is important because periodontal disease does not manifest itself after the patient has developed memory loss and dementia, and perhaps he is not doing a good job or is unable to keep up with personal care, such as personal hygiene, due to memory loss or dementia. This is happening before. So we think it is more part of the cause rather than the effect of the disease itself.

Are gum disease common among the elderly?

  • Gum disease is common in several age groups. It becomes more difficult for older patients depending on whether they have had access to good dental care and whether they have been able to keep up with the maintenance of their teeth.
  • Additionally, many elderly patients take medications that cause dry mouth which can worsen the health of the gums and mouth tissues.
  • But I think this is something that is probably happening in patients while they still have the ability to maintain their oral hygiene. We just haven’t been able to tell people how important this is.

Need for further studies?

  • There is some early evidence that there appears to be a direct cause between periodontal disease and Alzheimer’s, but it is early and is being examined.
  • I think we can definitely, at this point, say that poor gum health or periodontal disease will increase the risk of developing Alzheimer’s over time, especially if it’s not addressed with good teeth cleaning and healthy gums.
  • It is definitely a risk factor. When you look at how I keep my brain healthy, some of it probably also maintains good overall health. And part of that is your gums and also your oral hygiene.

RESOURCES

Large study links gum disease to dementia

NIH: periodontal disease in the elderly

Harvard Health: Aging of the mouth and how to keep it younger

The highlights of the interview have been illuminated edited for clarity.

Do you have a suggestion? Email Sam Baker at sbaker@kera.org. You can follow Sam on Twitter @srbkera.

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