Can Periodontal Disease Affect The Brain?

Periodontal disease – is the inflammation and infection of the gum tissues and other supporting tissues of the teeth caused by oral bacteria.

While gum disease is considered a localized infection that affects the teeth, gums, and surrounding oral tissues, it can also have dramatic adverse effects on a person’s systemic health. Recent research studies show a direct connection between gum disease and the eventual development of Alzheimer’s disease.

Periodontal inflammation has shown an association with inflammation in the brain. This inflammation increases the risk for cognitive dysfunctions linked to Alzheimer’s disease. Alzheimer’s disease is the #1 type of dementia and the 6th leading cause of death in the United States. About five million Americans have been diagnosed with this progressive condition that involves loss of cognitive function and short-term memory.

Alzheimer’s disease appears to be increasing in the United States, with more and more patients each year receiving a diagnosis. 

What Is Gum Disease?

Periodontal disease is a slow-developing, progressive disease that can destroy your oral and systemic health. Many of the signs and symptoms of periodontal disease sneak up on patients and are often ignored initially. It is essential not to ignore these signs and symptoms as periodontal disease is the #1 cause of tooth loss. Periodontal disease comes in many different forms. These forms include aggressive, chronic, necrotizing periodontitis and periodontitis associated with systemic diseases. 

Each of these different types of gum disease has distinct characteristics and symptoms. All kinds of gum disease will require prompt treatment by a dentist to help halt subsequent bone and gum tissue loss. The risk of gum disease increases with age. Dental caries is a more significant risk for tooth loss for younger people, while gum disease is more critical for older people.

Risk Factors Of Periodontal Disease

• Age. Research has shown that over 70% of Americans aged 65 and older have some form of gum disease.
• Tobacco Use (including smoking). Research has shown that tobacco use also increases a person’s risk for gum disease.
• Family History (Genetics). Genetics allows for some patients to be more susceptible to the development of gum disease.
• Stress. Research has shown that increased stress can make it more difficult for the body to fight off infection. This includes gum disease.
• Prescription Drugs (Medications). Some medications, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect the health of oral tissues. Notify your dentist of any changes in medications and dosages.
• Bruxism (Teeth Grinding). Bruxism can place excess force on the supporting tissues of the teeth and could increase the rate at which the oral tissues are destroyed.
• Presence Of Systemic Disease. Many of these diseases can interfere with the inflammatory process. These diseases of chronic and systemic inflammation include cardiovascular disease, diabetes, and rheumatoid arthritis.
• Poor Diet/ Nutrition. A diet low in essential nutrients can compromise the body’s immune system and make it harder to fight off infection. Because gum disease begins as an infection, a poor diet can worsen the condition of your gum tissues.

Gum Disease Signs And Symptoms

• Bleeding Upon Brushing or Flossing. This is probably the most common sign that gum disease is active. It is often overlooked. Gum disease is an inflammatory disease. As the bacteria and toxins irritate the oral tissues, the body responds by activating the inflammatory process. This will cause the gingival tissues to become puffy and red. Important to note that bleeding gums can also signify something more sinister like leukemia and blood platelet disorders.
• Unexplained Pain Or Swelling. Periodontal infections are present in this manner. When an oral infection occurs, you must get to a dentist as soon as possible for evaluation and treatment. If the condition is left unchecked, it will cause damage to the gum tissues and the bone supporting your teeth. Your blood can also carry it to other parts of the body through the bloodstream affecting your overall health.
• Persistent Halitosis (Bad Breath). This change in breath odor can occur from many things, but persistent bad breath can be due to progressive gum disease. As the disease destroys the gum tissues, the areas where the oral bacteria can flourish will increase, causing a foul odor in the mouth. There are other causes of chronic halitosis that your dentist should also rule out before treatment.
• Change In Your Smile Or Loose Teeth. As gum disease progresses, your teeth will loosen and move out of position. 
• Teeth Become Longer In Appearance. As gum disease advances, it will lead to the destruction of the bone and gum tissues. This loss of gingival tissues will show up as gum recession. Once the gingival tissues pull back, more of your teeth will show, making them appear longer.
• Pus Drainage. An active periodontal infection will create pus which can ooze out from between the teeth and gums. This drainage will cause a bad taste and bad breath.

Common risk factors of Alzheimer’s disease include: 

Old age

Heredity

Family history

Curiously, most of the patients diagnosed with Alzheimer’s disease also had progressive gum disease. 

Periodontal Inflammation Equals Increased Risk For Alzheimer’s Disease?

Gum disease increases the risk of developing cognitive dysfunction. Recent studies have shown there is a causal relationship between these two conditions. Patients with periodontal inflammation face an increased risk of having lower cognitive functions versus those without periodontal inflammation.

The Alzheimer’s risk increases as the level of periodontal inflammation increases. Researchers believe that periodontal inflammation also causes an increased decline in people already experiencing declining cognitive functions.

In a 2005 study, studies noted an increased presence of antibodies and inflammatory chemicals linked to gum disease in patients with Alzheimer’s disease compared to healthy individuals. Patients with Alzheimer’s disease also showed higher levels of periodontal bacteria in brain tissues.

Researchers believe that when the periodontal bacteria is present in elevated levels, they enter the bloodstream and eventually make their way to the brain tissue, where they can cause infections and damage.

Researchers believe there are three ways that gum disease can lead to Alzheimer’s Disease:

1. Periodontal bacteria cause infections and can damage brain tissue.

2. Periodontal bacteria triggers inflammation in the brain. This chronic and systemic inflammation is directly involved in Alzheimer’s disease.

3. Oral bacteria responsible for gum disease can also cause vascular changes. These changes can promote Alzheimer’s disease.

Recent Research

Increases in “harmful” bacteria and decreased beneficial bacteria in gums associated with amyloid-beta

Older adults with more harmful than healthy bacteria in their gums are more likely to have evidence for amyloid-beta in their cerebro spinal fluid. This amyloid-beta is a crucial biomarker for Alzheimer’s disease. This information is from a recent study from NYU College of Dentistry and Weill Cornell Medicine. However, this bacterial imbalance in oral bacteria was not associated with another Alzheimer’s disease biomarker called tau.  

Two hallmark proteins characterize Alzheimer’s disease in the brain:

amyloid beta

Clumps together to form plaques (brain amyloid accumulate). Amyloid-beta is believed to be the first protein deposited in the brain as Alzheimer’s disease begins to develop.

Tau

Builds up in nerve cells and forms tangles in brain tissues.  

The process by which brain amyloid levels accumulate and are associated with Alzheimer’s disease pathology is complex and not fully understood. The current study supports the understanding that inflammatory diseases (like gum disease) disrupt the clearance of amyloid from the brain. Amyloid changes are typically noted decades before tau pathology, or the symptoms of Alzheimer’s disease are detected.

The results of recent research showed that individuals with decreased beneficial bacteria versus bad bacteria. With a ratio favoring harmful to healthy bacteria, they were more likely to have the Alzheimer’s disease signature of reduced amyloid levels in Cerebro Spinal Fluid. Findings suggest that because high levels of healthy bacteria help maintain bacterial balance and decrease inflammation, they may protect against Alzheimer’s.  

Relationship Between Periodontal Disease and Alzheimer’s Disease

Researchers used the Digital Symbol Test (DST) for cognitive function for patients aged 70. Researchers noted those with periodontal inflammation have lower DST scores compared to those with minor inflammation or none at all. Other risk factors for low DST scores, such as obesity and other forms of tooth loss unrelated to gum disease, were ruled out.

Early Periodontal Health and Alzheimer’s Disease

Findings suggest that any Inflammation present as a child increases the risk of developing Alzheimer’s disease as an adult. Developing gum disease or losing teeth before age 35 increases the risk of having Alzheimer’s disease as we age. This makes it so important to maintain a good dental hygiene regimen throughout life.

Common Shared Risk Factors

Common risk factors for both periodontal and Alzheimer’s disease include:

Genetics

Use of cigarettes

These risk factors could explain the connection between these two diseases. Periodontal inflammation and tooth loss are risk factors for Alzheimer’s disease. It is also believed that gum disease can cause cerebrovascular injury to the brain. Stroke is also a significant risk factor for Alzheimer’s disease, and gum disease increases the risk of stroke development. Typically, any chronic inflammatory disease will have an adverse effect.

Alzheimer’s Disease As a Risk Factor for Periodontal Disease

Patients with Alzheimer’s disease cannot always practice the required dental hygiene to maintain good oral health. This poor dental hygiene puts them at an increased risk of developing gum disease. While there is no conclusive evidence that gum disease causes Alzheimer’s disease or that taking proper care of teeth can reduce the risk of this form of dementia, numerous studies conclude that preventing gum disease is an effective way of avoiding or delaying Alzheimer’s disease. A healthy lifestyle, including regular exercise and a nutritious diet, regular visits to the dentist, and practicing proper dental hygiene by brushing teeth and flossing are effective ways of preventing both periodontal and Alzheimer’s disease.

Contact Marielaina Perrone DDS at (702) 458-2929 to schedule a no-cost cosmetic consultation appointment if you are ready for a smile makeover. We cannot wait to help you with your smile makeover to create the smile of your dreams.