Is there a Dental Link to Alzheimer’s?
July 9, 2012
Alzheimer’s disease (AD) is one of those diseases you would not wish on anyone. I have it in my family. My grandfather died from it about 30 years ago.
Since its discovery more than 100 years ago, there have been many scientific breakthroughs in AD research. In the 1960s, scientists discovered a link between cognitive decline and the number of plaques and tangles in the brain. The medical community then formally recognized Alzheimer’s as a disease and not a normal part of aging. In the 1970s, scientists made great strides in understanding the human body as a whole, and AD emerged as a significant area of research interest. This increased attention led in the 1990s to important discoveries and a better understanding of complex nerve cells in the brains of AD patients. More research was done on AD susceptibility genes, and several drugs were approved to treat the cognitive symptoms of the disease.
More recently, researchers have found long-term evidence that periodontal (gum) disease may increase the risk of cognitive dysfunction in healthy individuals, as well as those who are already cognitively impaired. The evidence shows that gingival inflammation may contribute to brain inflammation, neurodegeneration, and Alzheimer’s. My own observations in practice show that as the disease progresses, home care becomes more challenging for patients, which leads to more inflammation, and may contribute to progression of the disease.
Previous research has shown that patients with AD had a significantly higher level of antibodies and inflammatory molecules associated with periodontal disease in their plasma compared to healthy people. One of the tests used to evaluate cognitive function is called the Digit Symbol Test, which is part of the standard measurement of adult IQ.
Researchers found that periodontal inflammation in tested subjects at age 70 years old was strongly associated with lower test scores. Participants with periodontal inflammation were 9 times more likely to test in the lower range in this particular test compared to participants with no periodontal inflammation. Amazingly, this strong association held true even in those subjects who had other risk factors linked to lower testing scores, including obesity, cigarette smoking, and tooth loss unrelated to gum inflammation.
Obviously, the research will continue. Another obvious fact is that I continue to read more and more connections between poor oral health and systemic issues. And, the last obvious fact is that I am trying to educate patients on a daily basis about the significance of good oral health. The mouth is the link to the rest of the body.
I had three patients this week who flat-out refused to accept the fact that they have a problem because they have no pain. They think I am trying to pull the wool over their eyes. I say it over and over; lack of pain is not a good indicator of a problem. Your teeth can be practically falling out and I would be willing to bet you have no pain. Dentists wish that gum disease did hurt. It would be easier to get patients to improve their health.
The Silent Epidemic – Part 2
September 21, 2011
Last week we discussed the role and effect that diabetes has on oral health. It is not something that should be taken lightly. If you missed this column, please visit the website at the end of this column or e-mail me directly and I will send you a copy.
After reading last week’s column, it may seem frightening that there is no way out of the partnership of horrors between diabetes and severe gum disease. There are solutions. Just as poor oral health can compound a diabetic’s plight, proper oral health can come to the rescue.
Clinical studies confirm that treatment of gum disease reduces oral inflammation, which removes the factor that triggers the body’s inflammatory response which, in turn, plays a major role in compounding the effects of diabetes.
Dental treatments that fight gum infections also help improve control of blood sugar levels in diabetics.
If you are pre-diabetic, your dentist may actually be able to help prevent diabetes. If you already have diabetes, your dentist may be able to help you keep it under control, improve your quality of life and reduce the risk of premature death.
There’s even better news. It’s never too late to improve oral health care. Even if you already have severe gum disease or other dental problems, proper treatment can help stop it in its tracks. In many cases, dentists can even reverse the damage done to your teeth and gums as well as manage the metabolic elements of diabetes. And, if you haven’t yet developed any symptoms of diabetes-related oral health problems, your dentist can start a prevention program that will help you stay in control of your diabetes, maintain better health and enjoy a preferred quality of life.
Perhaps the best news is that this is something that doesn’t require exercise, taking a pill, giving yourself a shot of insulin, or sticking to a special diet. However, some or all of these things may be necessary to also help control diabetes. From an oral health perspective all you need to do is to start seeing your dentist and talking to him or her about your particular situation.
In the dental world there are going to be varying degrees of participation from dentists, depending on their knowledge or “philosophy” of care, when it comes to partnering with you to manage the oral health issues in regards to diabetes or pre-diabetes. Different dentists just practice differently. The best team approach is between the doctor, the patient and the dentist. If one of these team members does not participate, the battle cannot be won. Often times it is the patient who is not doing the things that he or she needs to do to properly manage the problem. If the dentist does not seem too concerned about your diabetes, you have the desire to have your oral health properly managed and are willing to do your part, find a new dentist.
The point is that this is a serious issue and if you, the patient, wants to take control of it, a team effort is needed.
