Like other diseases, Alzheimer's/dementia is influenced by a person's lifestyle. We can relatively easily reduce the risk of developing Alzheimer's/dementia if we maintain good oral hygiene, and in particular, avoid gum disease.
What is gingivitis?
Gingivitis is usually caused by bacteria that accumulate in the spaces between the gums and teeth (in the gum pockets). Symptoms include red and swollen gums, bleeding when brushing or eating, bad breath, and more.
Chronic Periodontitis is defined as a condition in which bacteria accumulate in the periodontal pockets and create a persistent inflammatory condition. When the pockets are inflamed over time, the space between them and the teeth increases. Over time, the gums will begin to recede and disappear, the teeth will appear longer and there may be gaps between them, and they may even begin to move out of place, and over time it will become increasingly difficult to eat and talk.
Most cases of the disease are in adults, and there is a tendency to worsen with age, usually due to gum infections that were not treated thoroughly and caused damage to the jawbone and gums.
What influences the development of chronic gingivitis?
Factors that may influence the development of chronic meningitis include:
- Chronological age.
- Smoking.
- Aggressive and/or poor brushing.
- Old crowns with rusted metal, inaccurate fillings.
- Breathing with your mouth open / sleeping with your mouth open – will cause dry mouth and more bacteria.
- Heredity – Some families have weak gums that are more susceptible to infections.
- Saliva composition – people with more calcium in their saliva + poor brushing habits – will have more tartar and subsequently an increased risk of gingivitis.
What is the connection between gingivitis and cognitive decline and Alzheimer's/dementia?
Various studies have found a link between chronic gingivitis and various diseases, such as diabetes and heart disease. One of the common bacteria in the mouth (known as porphyromonas gingivalis) is recognized by medicine as a key factor in the development of chronic gingivitis.
Recent studies have found evidence of the presence of this bacterium in the spinal fluid and saliva of people diagnosed with Alzheimer's disease, and the bacterium is recognized as a risk factor for the development of amyloid-beta protein deposits, which are a pathological sign characteristic of Alzheimer's disease.
It has long been known that this bacteria increases the risk of chronic heart disease, and it is disturbing that the bacteria can be found in both the general bloodstream and the bloodstream in the head.
A 2019 study found that the risk of dementia was 6% greater among people with chronic gingivitis.
There are disagreements among scientists about the mechanism that causes this effect.
There are several possible explanations: release of a toxin by the bacteria, a chronic inflammatory state of the nervous system in an attempt to fight the bacteria, an incorrect response of the immune system, or the formation of deposits in the blood vessels.
As mentioned, the exact effect and direct connection between chronic gingivitis and dementia have not yet been agreed upon.
However, there is clearly a connection.
What can be done to reduce the risk of developing Alzheimer's/dementia due to chronic gingivitis?
- Good and proper oral hygiene at home, meaning proper brushing, flossing, and rinsing the mouth with an antibacterial solution (without alcohol).
- It is important to maintain an oral hygiene routine over time.
- It is recommended to maintain a routine of tartar removal treatments with a hygienist, as recommended for each person, as needed.
- Routine check-ups with a dentist, at least once a year and as needed.
- Contact a periodontist if and when there is persistent gingivitis.
Sources:
Dental Federation, Dr. Guy Volpin – School of Dentistry, Tel Aviv University
Choi, S., Kim., K., Chang, J., Kim., SM, Kim., SJ, Cho, H. & Park, SM (2019). Association of Chronic Periodontitis on Alzheimer's Disease or Vascular Dementia , 67(6), 1234-1239.
Ryder, MI (2020). Porphyromonas gingivalis and Alzheimer disease: Recent findings and potential therapies. Journal of Periodontology , 91(Suppl. 1), S45–S49.
Yang, C., Huang, P. & Fang C. (2021). Does periodontitis really play a role in dementia? Novel evidence from molecular insights . Journal of Dental Sciences , 16 , 530-531.