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Periodontal disease may help initiate Alzheimer’s disease, according to a new study. Researchers at the University of Illinois at Chicago found that untreated periodontal disease caused inflammation and the degeneration of brain neurons in mice that’s similar to the effects of Alzheimer’s disease in humans.
“Other studies have demonstrated a close association between periodontitis and cognitive impairment, but this is the first study to show that exposure to the periodontal bacteria results in the formation of senile plaques that accelerate the development of neuropathology found in Alzheimer’s patients,” Dr. Keiko Watanabe, one of the study’s authors, told Science Daily.
The mice that were exposed to the bacteria again and again had much higher amounts of a senile plaque that’s found in the brain tissue of Alzheimer’s patients.
What this means is that the bacteria from periodontal disease is not just travelling from the mouth to the brain; it’s also significantly disrupting the brain, to a potentially fatal degree, when it’s left unchecked over a long enough period.
A new common thread
Periodontal disease has already been linked to heart disease, diabetes, and several types of cancer, though the nature of those relationships is just beginning to come into focus. Initially, the catalyst seemed to be the bacteria from periodontal disease. But now it appears that inflammation, the body’s natural response to infection (periodontal disease is an infection) plays a role, too.
Scientists don’t completely understand what causes Alzheimer’s disease in most people, either, though this new study potentially exposes one of the clearest paths yet. There’s thought to be a genetic component in some early-onset cases. Late-onset Alzheimer’s stems from a complicated series of brain changes that occur over decades, according to the National Institute on Aging.
The causes likely include a combination of genetic, environmental, and lifestyle factors. But it’s been difficult to understand how much of an influence each one of those has because their importance can vary from person to person. In other words, there’s not a straightforward cause-and-effect equation. But that may be about to change.
For a while now, there’s been a lot of interest in the factors beyond genetics, like the relationship between cognitive decline and heart disease and diabetes. With this new study, there’s suddenly a common thread: periodontal disease.
What we do know
For all the uncertainty, here’s what we do know about Alzheimer’s disease. Back in 1906, Dr. Alois Alzheimer noticed abnormal clumps (now called amyloid plaques) and tangled bundles of fiber (now called tau or tangles) in the brain tissue of a woman who died of an unusual mental illness. These plaques and tangles are still considered some of the main features of Alzheimer’s disease.
Another is the loss of connections between neurons. Neurons are the body’s broadband. They transmit messages between different parts of the brain and from the brain to muscles and organs. Imagine if all your emails started coming back as undeliverable. In a very basic sense, that’s kind of what having Alzheimer’s is like.
It gets murky from there, but researchers think it’s likely that damage to the brain begins a decade or even more before memory or other cognitive problems become apparent. All the while people feel and appear to be symptom-free. But as more neurons die, more of the brain is affected. What begins as occasional forgetfulness will eventually evolve to an inability to do even the simplest stuff.
Because the onset is still shrouded in mystery, and the rate of progression is different from person to person, Alzheimer’s disease, at this point, is irreversible.
How widespread is it? It’s hard to come up with a concrete count because it’s commonly misdiagnosed and undiagnosed, but the consensus is that about 5.5 million Americans have it. It’s ranked as the sixth-leading cause of death, though it may be closer to the third, behind heart disease and cancer, for older adults, according to the National Institute on Aging.
With our population about to become older than ever before, because of the large amount of aging Baby Boomers, there’s a heightened urgency to understand Alzheimer’s before those numbers begin rising sharply.
Too good to be true?
More positively, a nutritious diet, physical activity, social engagement, and mental stimulation have all been shown to help people stay healthy as they age, and there’s a hope among the scientific community that they may also reduce the risk of cognitive decline and Alzheimer’s. A number of clinical trials are testing those possibilities now.
But what if it turns out to be even easier than that in most cases? What if it comes down to simply preventing and treating periodontal disease? Sound too good to be true? Consider this, then: Right now, half of American adults have periodontal disease, and 70 percent of adults 65 and older have it.
Seems like a minimal investment for a potentially huge reward, right? So, let’s start here. You’ll find a rundown of some of the clearer warning signs for periodontal disease. If you think you may have it, or even if you’re unsure, contact my office and schedule an appointment. I’ll conduct a Comprehensive Periodontal Evaluation.
If you’ve read this far, what’s another hour, especially when it could mean adding years to your life?
Periodontal disease is so easy to prevent: Brush, floss, rinse, repeat a couple times a day, and visit your dentist every few months. Yet half of American adults have it, and 70 percent of adults 65 and older.
So, in a modest attempt to put a meaningful dent in this epidemic, we launched a four-part blog series with our last post that’s aimed at sharing everything you need to know about periodontal disease, from symptoms to treatments. Here, we’ll get into what it can do to you if left unchecked. The ramifications could run far deeper than your gums. Check back here next month, when we’ll highlight some factors that may be putting you at greater risk.
More and more, studies are confirming what periodontists have suspected for a while: There’s a direct link between periodontal disease and several potentially fatal diseases. Though, the reason for that link is changing. Originally, the blame fell on the bacteria, but the latest research seems to be indicating that it may come down to inflammation, the body’s natural response to infection.
Either way, this much, at least, is clear: The longer periodontal disease goes unchecked, the greater the risk of developing heart disease and experiencing complications from diabetes.
You’re probably thinking, We were talking about my mouth. How did we get to heart disease? In truth, the exact nature of the cause-and-effect relationship isn’t clear yet. Inflammation, as we mentioned, appears to be culprit, but how? That’s what we’re looking into now.
Researchers from a study last year began to suspect that bacteria from periodontal disease is making its way well beyond the mouth, travelling throughout the body—and triggering inflammation everywhere it goes, including the heart, where it may spur the formation of arterial plaque. It’s not a reach. Oral bacteria’s already been discovered in the fatty deposits of people with atherosclerosis, a disease in which plaque builds up in the arteries. In time, those deposits narrow arteries or break loose and clog them entirely, causing a heart attack or stroke.
For the time being, the bacteria link remains speculation. But, what the study did prove is that those with periodontal disease are twice as likely to have heart disease, and that risk is even greater for those with high cholesterol. That affects a lot of people. More than 85 million Americans have some form of heart disease, and 200 million are in some stage of periodontal disease.
Whether periodontal disease is directly or indirectly causing heart disease, consider this: Heart disease is the leading cause of death for both men and women in this country. It’s responsible for one in four deaths each year, according to the Centers for Disease Control and Prevention. Doesn’t scheduling a checkup with your dentist seem like a fairly low-maintenance way to help your cause?
If you have diabetes, you’re more likely to get periodontal disease, and that’s just because you’re more susceptible to contracting infections. Your risk is even higher if your diabetes isn’t under control. Lots of bacteria thrive on glucose. When diabetes isn’t controlled, high glucose levels in mouth fluids may help the bacteria thrive, creating the sort of environment that’s right for periodontal disease.
Thickening blood vessels, a complication of diabetes, may increase your risk for gum disease, too. The vessels deliver oxygen and nourishment to body tissues, including the mouth, and remove their waste. When they thicken, it reduces their efficiency, which weakens gum and jawbone tissue and makes it harder for them to fight off infection.
Should you let your periodontal disease go unchecked, you’re increasing your chances of developing any number of diabetic complications, including nerve and kidney damage and even heart disease. Severe periodontal disease can increase blood sugar, which fuels the stretches when the body functions with high blood sugar. It’s like throwing gas on a fire, basically.
Just having periodontal disease is going to make it more difficult to control your blood sugar. But the upside is, according to one landmark study, treating your periodontal disease should make it easier to manage your diabetes.
A study published last November in the British Journal of Cancer showed that the bacteria that causes periodontal disease may also be responsible for some types of cancer, including pancreatic cancer. Up to that point, the reason was uncertain, but the connection was clear: Men with periodontal disease are 54 percent more likely to develop pancreatic cancer than women, 49 percent more likely to develop kidney cancer, and 30 percent more likely to develop blood cancers. Overall, men with a history of periodontal disease are 14 percent more likely to be diagnosed with some form of cancer than men with healthy gums.
That same group of researchers, in January, published a supplemental study in which they found a strong association between a gum disease diagnosis and death caused by pancreatic cancer. The inflammation that’s caused by periodontal disease, they concluded, may make it easier for harmful bacteria to travel to other parts of the body and act as a sort of “booster” for cancer cells.
The link between periodontal disease and osteoporosis is also just beginning to come into focus.
In a study of more than 1,200 post-menopausal women, the women who had the bacteria that causes periodontal disease were more likely to have bone loss in their oral cavities, a precursor for tooth loss if left untreated. Another study, this one spanning more than a decade, found that post-menopausal women could significantly reduce their risk of tooth loss by simply treating their periodontal disease.
Cutting-edge research is finally tracking down the answers that have eluded periodontists and physicians for years. But, what has always been clear is this: Much of this can be easily prevented.