Periodontitis – A Potential Risk Factor for Alzheimer’s Disease

Periodontitis – A Potential Risk Factor for Alzheimer’s Disease

Periodontitis and Alzheimer's Disease

A recent study published in Neurology looks at the intricate association between periodontitis and Alzheimer’s disease, a form of dementia that impairs memory and cognitive function. This connection could hold key implications for preventing Alzheimer’s. 

Key Takeaways: 

  • Gingivitis presents as red, swollen gums that may bleed during brushing or flossing. It can typically be reversed with diligent oral hygiene and professional dental care.
  • Periodontitis is a severe form of gum disease that results from untreated gingivitis and can cause significant damage to oral tissues, teeth-supporting ligaments and bones. 
  • Once established, periodontitis requires continuous dental management to prevent further damage.
  • Preventing periodontitis involves regular dental checkups, proper oral care, a healthy lifestyle, and stress management.
  • Current research suggests a possible link between periodontitis and Alzheimer’s disease. Continuous research investigates the relationship between oral health and brain health, focusing on Alzheimer’s disease.

With new research emerging on the possible link between gum health and Alzheimer’s disease, your dental health may hold the key to a healthier brain. As periodontitis is a progressive disease resulting from untreated gingivitis, prevention and good oral health through regular dental checkups are imperative. 

If you want to dive deeper into the study, potential risk factors, and preventive measures for periodontitis, the article below is a must-read. 


Understanding Periodontal Disease (Gum Disease) and its Progression to Periodontitis

Periodontal disease, or gum disease, is an umbrella term encompassing various conditions affecting the teeth’ surrounding tissues. It is a broad term, and it’s crucial to recognise two primary stages of periodontal disease.

Gingivitis – Initial Stage of Periodontal Disease

  • Definition: Gingivitis is the initial stage of periodontal disease, characterised by:
    • Red, swollen gums
    • Gums that may bleed during brushing or flossing
  • Cause: Accumulation of plaque, a sticky film of bacteria, on teeth and gums.
  • Treatment: Gingivitis is generally mild and reversible with:
    • Regular brushing and flossing
    • Professional dental cleanings

Periodontitis – Advanced Stage of Periodontal Disease

  • Progression: Periodontitis develops when gingivitis is left untreated.
  • Impact: Inflammation extends deeper, affecting:
    • Ligaments and bones supporting the teeth
  • Symptoms:
    • Gum recession
    • Pocket formation between teeth and gums
    • Loss of tooth-supporting bone
    • Tooth mobility
    • Tooth loss in severe cases
  • Management: Periodontitis is a chronic condition requiring ongoing dental care and possible referral to a periodontal specialist.

Key Differences between Gingivitis and Periodontitis

  1. Severity:
    • Gingivitis: Milder, reversible form
    • Periodontitis: More advanced, can range from mild to severe condition
  2. Reversibility:
    • Gingivitis: Can be reversed with proper oral care
    • Periodontitis: Generally not reversible; requires ongoing management
  3. Tissue Involvement:
    • Gingivitis: Affects only the gum tissue
    • Periodontitis: Extends to ligaments and bones supporting the teeth
  4. Symptoms:
    • Gingivitis: Red, swollen gums that may bleed
    • Periodontitis: Includes gum recession, pocket formation, and bone loss

Risk Factors for Periodontitis

Understanding who is at risk of periodontitis is crucial for prevention. Several risk factors contribute to the development of this condition:

  • Poor Oral Hygiene: Failing to brush and floss regularly allows plaque to build up on the teeth and gums, increasing the risk of gum disease.
  • Tobacco Use: Smoking and tobacco use are strongly linked to periodontitis.
  • Genetics: Some individuals may be genetically predisposed to gum disease.
  • Chronic Illness: Conditions like diabetes and certain medications can increase the risk of gum disease.
  • Stress: Chronic stress can weaken the immune system, making it harder for the body to fight off infections, including gum disease.
Periodontitis and Alzheimer's Disease

Preventive Care is important for Oral and Brain Health

The Importance of Preventive Care in Oral and Brain Health

Holistic dentistry emphasises the interconnectivity of oral health and overall wellbeing. This study demonstrates a link between gum disease, tooth loss, and the shrinkage of the hippocampus in the brain. Therefore, adopting a preventive approach to oral care is crucial. Here are our guidelines and recommendations to help you maintain a healthy mouth, positively impacting your brain health.

Maintain a Holistic Oral Hygiene Routine:

  • Brush your teeth at least twice a day using a toothbrush with soft bristles. Make sure to clean all tooth surfaces and the gumline.
  • Complement your brushing with daily flossing or interdental brushes to remove plaque and food particles trapped between teeth and gums.

Regular Toothbrush Replacement:

  • Change your toothbrush every 3-4 months or sooner if the bristles are frayed. A worn-out toothbrush is less effective in maintaining oral cleanliness.

Focus on Healthy Nutrition Choices:

  • A well-rounded nutrient, nutrient-dense diet is essential for oral health. Include leafy greens and good fats. 
  • Minimise the intake of sugary snacks and drinks, which can promote bacterial growth, leading to gum disease.

Conscious Snacking:

  • Limit snacking between meals to reduce the exposure of your teeth to acids and sugars. If you must snack, opt for healthier whole foods instead of processed packaged foods.

Regular Dental Check-ups:

  • Consistent dental and oral hygiene visits are key for early detection and treatment of gum issues. Dental visits also can remove tartar and plaque that home care can’t handle.

Tobacco-Free and Vaping-Free Lifestyle:

  • Smoking, tobacco use and vaping are major contributors to gum disease. Quitting these habits can significantly enhance your oral and overall health.

Take Care of Your Overall Health:

  • Gum disease can indicate other systemic issues like diabetes, anemia, or heart conditions. Regular check-ups with your healthcare providers can help in early diagnosis and management. (You may also need a referral to a periodontal specialist.)

Stress Management:

  • Find effective ways to manage stress, which can impact your immune system.

Integrating these preventive steps into daily life ensures optimal oral health and improves overall wellbeing.

Recent studies have suggested a potential association between periodontitis and Alzheimer’s disease. The hypothesis is that chronic inflammation, a hallmark of periodontitis, may contribute to the inflammation seen in Alzheimer’s disease. Chronic inflammation can release inflammatory molecules that might affect the brain and contribute to cognitive decline.

The Association Between Periodontitis and Brain Health

The Study’s Objective

The primary objective of this study was to investigate the longitudinal association between the number of teeth and hippocampal atrophy while considering the severity of periodontitis. The study focused on a cohort of adults aged 55 and older who lived in the community and exhibited no signs of cognitive decline. Brain scans were conducted using magnetic resonance imaging (MRI) to provide detailed images of the participants’ brains.

Methodology and Findings

The research team collected oral health and overall health information from the participants twice, with a four-year gap between each measurement. Advanced computer analysis was employed to measure the size of a specific brain area, the hippocampus, which is vital for memory.

Key Findings:

  • Significant Interaction: The data collected from 172 participants revealed a substantial interaction between the number of teeth and the severity of gum disease concerning changes in the left hippocampus over time.
  • The Author’s Insight: Study author Dr Satoshi Yamaguchi from Tohoku University in Sendai, Japan, emphasised the significance of controlling gum disease through regular dental visits. He also highlighted that teeth with severe gum disease might need extraction and replacement with appropriate prosthetic devices.
  • Atrophy Linked to Periodontitis: In a late middle-aged and older cohort, the study showed that fewer teeth were associated with a faster rate of left hippocampal atrophy in individuals with mild periodontitis. Conversely, more teeth were linked to a faster rate of atrophy in those with severe periodontitis, underscoring the importance of maintaining good oral health.

Implications for Brain Health

While this study does not conclusively establish a causal relationship, it contributes to the growing body of evidence hinting at a potential link between oral health and brain health. The findings imply that caring for teeth and addressing gum disease could have broader implications for cognitive well-being, especially among ageing populations.

Dr Yamaguchi summed it up succinctly: “Tooth loss and gum disease, which is inflammation of the tissue around the teeth that can cause shrinkage of the gums and loosening of the teeth, are very common, so evaluating a potential link with dementia is significant. Our study found that these conditions may play a role in the health of the brain area that controls thinking and memory, giving people another reason to take better care of their teeth.”

The Connection Between Gum Disease, Tooth Loss, and Brain Health

Intriguing and promising, this study suggests a connection between gum disease, tooth loss, and brain health. While further research is needed to solidify causality, it’s a compelling reason to prioritise your dental health for your radiant smile and the wellbeing of your cognitive abilities. Maintaining good oral health through regular dental visits can contribute to a healthier brain, especially in later stages of life. 

References and Further Reading: 

For further reading and to delve deeper into this topic, here are some recommended references:

  1. Neurology Journal Study: This primary source referenced in the article highlights the connection between oral health and brain health. Reading the full study to understand the methodology and findings in detail could be beneficial. Link to the study
  2. Association between Gum Disease, Tooth Loss, and Hippocampal Brain Shrinkage: This source provides additional insights into the potential link between gum disease, tooth loss, and brain health. It could offer a different perspective or additional data on the topic. Read more here
  3. Holistic Dentistry and Oral Health Maintenance: To understand the broader perspective of holistic dentistry and its emphasis on the interconnectedness of oral health and overall wellbeing, this SHDC article provides information on dental hygiene and therapy from a holistic viewpoint. Explore more
  4. Children’s Dentistry: Since gum diseases can start at an early age, understanding the SHDC approach to children’s dentistry and its importance can provide insights into early prevention and care. Learn more
  5. Dentistry for Anxious Patients: Dental anxiety can prevent individuals from seeking timely dental care, leading to advanced gum diseases. This link provides information from our SHDC team on how dentistry is adapted for anxious patients. Discover more

It’s worthwhile to stay updated with the latest research findings in this field and regularly consult your dental and medical professionals for guidance.