Periodontitis and its Relationship to Alzheimer’s Disease

You are in the middle of a sentence and you forget what you are talking about. You take your vitamins and medications and ten minutes later, you can’t remember if you took them. You walk into a room and forget why you went in. Your general practitioner tells you it’s normal aging, stress, you have a lot on your mind. As the months go by, the symptoms get worse. Finally, you go to a neurologist and they tell you that you have early-onset Alzheimer’s disease, dementia. The words hit you like a punch in the gut. How did this happen? What could I have done to prevent this? Amazingly recent scientific investigations have found that the plaque on your teeth, the bleeding in your gums, the occasional extraction were all contributors to plaque formation in your brain and the subsequent loss of cognitive acuity. 

What is Gum Disease?

1. Preventable with proper oral hygiene and regular dental checkups (brushing twice a day for two minutes, flossing once a day before bedtime, limiting sugar in our diet)
2. Three out of four Americans have a form of the earliest stage of gum disease (gingivitis)
3. There are four stages to gum disease. If left untreated can progress to the more serious
4. Oral condition, periodontitis, and systemic disease.

Stages of Gum Disease

1. Stage 1 – gingivitis, inflamed, red gums that bleed when brushing
2. Stage 2 – early periodontitis, slight loss of bone occurs
3. Stage 3 – moderate periodontitis, more gum, and bone are lost, teeth begin to get loose
4. Stage 4 – advanced periodontitis, symptoms become more severe, teeth become very loose, pain on chewing and biting, infection is present (pus)

In all of these stages, inflammation and infection are seen. In gingivitis the pathology is reversible. In periodontitis, the pathology requires expert dental care.

Causes of Periodontitis

1. Poor oral hygiene
2. Pre-existing conditions like diabetes

Etiology and Complications

Bacteria that exist in our mouths (all the time) combine with foods that are high in sugar. They form a gelatinous material called plaque. The bacteria secrete enzymes that act on the sugar to form acids. These acids eat away at our teeth and bone causing disease. Initially, the problem was thought to be confined to our teeth, gums, and bone. Scientific studies have proven that periodontitis is now associated with respiratory disease, rheumatoid arthritis, coronary artery disease, diabetes, and most recently Alzheimer’s Disease. In addition to acid, cytokines are produced by the cells fighting the bacteria. Cytokines are formed to fight inflammation. Too many cytokines produce plaque, pathology, and Alzheimer’s Disease.

1. Periodontitis is a common oral infection.
2. Involving gram-negative, anaerobic bacteria, 700 different types of bacteria exist in our mouth. Porphyromonas Gingivatis, Campylobacter Rectus, and Prevotella Melannogenica are key in causing inflammation and infection in the mouth. They are also found in the plaque in Alzheimer’s Disease (beta-amyloid protein). It is felt that the plaque is formed in response to inflammation. Inflammation is caused by the bacteria increasing the levels of proinflammatory cytokines. Cytokines cause the cells to produce plaque as a protective mechanism to inflammation too much results in pathology, Alzheimer’s Disease.
3. The bacteria release pro-inflammatory cytokines into the systemic circulation.
4. This increases levels of inflammation (where the cytokines land).
5. Levels of C-Reactive Protein also increase, showing that the inflammation is systemic in nature.
6. Periodontal disease is a “low-level systemic disease”.

What is Alzheimer’s Disease?

1. It is a fatal neurodegenerative disease
2. Characterized by inflammation and plaque formation in the neurons (nerve cells) found in the brain
3. Reaches 50% of the population by age 85
4. Causes dementia and loss of cognitive function, loss of memory
5. Affected by age, family history, education, high fat diet, hypertension, diabetes, trauma to the head, genetic predisposition-apolipoprotein “E”, and periodontal disease.
6. Plaques are deposits of a protein fragment called beta-amyloid. They appear in between cells of the brain disrupting the transfer of neurological signals
7. Tangles also present in Alzheimer’s Disease are twisted fibers that build up inside the nerve cells
8. People diagnosed usually live between 4-6 years 

Connection between Periodontal Disease and Alzheimer’s Disease

1. Dementia does not allow people to take proper oral care of themselves
2. Periodontal disease causes systemic inflammation that expresses itself in the brain by plaque formation, causing dementia and loss of memory.

What Can We Do?

1. Eating low fat, low sugar diet
2. Vigilant oral home care
3. Exercise
4. Annual checkup with a physician
5. Visiting 172 NYC Dental twice a year for check-ups and cleanings

Make an Appointment with 172 NYC Dental

The adage “a stitch in time saves nine” still rings true. A dental cleaning twice a year might allow us to enjoy our lives a bit more fully as we go into our golden years. Call us at 646-921-5541 to make an appointment today at our new ultra-modern facility.