Elana Amir

There is a direct correlation between chronic systemic conditions and the condition of your mouth. Periodontal inflammatory disease may increase your risk of many health complications. The inflammatory response caused by severe gum infection can have a negative impact on your health and is associated with various diseases such as diabetes, cardiovascular disease, and Alzheimer’s, among others. However, treating this inflammation will help to manage the periodontal diseases while simultaneously keeping other chronic inflammatory conditions in check.

Alzheimer’s disease and related disorders (ADRD) are among the age-associated chronic conditions that are most challenging to health care systems around the globe. AD is a chronic neurodegenerative disease that leads to gradual loss of function in motor skills and cognitive function. It is the most common cause of dementia where symptoms become so severe that they interfere with daily tasks. In 2050, the total number of people with AD is projected to rise to 13.8 million.

Poor oral health status can have a negative impact on both systemic health and the well-being of patients with Alzheimer’s disease. Consequently poor oral health is common among people with ADRD. Dental care focuses on prevention for patients in the early stages of AD, including regular cleanings and good hygiene at home; however, oral health becomes more challenging during the middle and late stages. Memory loss, confusion, and impairment of other mental functions cause a person with dementia to be less tolerant of oral health care. Periodontitis could trigger and exacerbate an inflammatory condition in elderly, leading to memory impairments, and the accelerated progression of neurodegenerative diseases such as AD.

Not only is oral health care negatively impacted by cognitive decline, but also there are studies that show an association between AD and oral health. There is a causal link between chronic periodontitis and AD. Extrinsic inflammation is linked as a secondary cause of AD. A possible explanation is that compromised oral hygiene leads to a pathogen infecting the host and injuring soft tissues. Brushing and chewing on teeth in this condition leads to bacteria and a persistent systemic inflammatory response. This inflammatory response developed to the pathogens leads to the initiation and progression of multiple diseases or conditions. From longitudinal monitoring of patients, it is shown that chronic periodontitis contributes to declining cognition.

Several studies support links between lifestyle choices, including a good oral hygiene routine, and AD development. Poor oral health is very important when considering infections of the brain. Periodontal disease contributes to systemic markers of inflammation. Research has shown that these markers mediate the development of AD. The oral microbiome contains a range of bacteria; in vulnerable individuals, this excites and perpetuates a range of inflammatory conditions to spread through organs and tissues including the brain. By controlling the microbiome, doctors may be able to treat and prevent a range of chronic inflammatory diseases orally. 


There is a current failure at providing adequate health care for this population. There seems to be a cycle: bad oral health care is linked  to AD, which causes a further decline in oral hygiene. Establishing oral hygiene routines and providing dental treatment that is customized to the patients’ individual needs and disease stage are important to achieve better health outcomes and prevent quality of life decline. Oral health care should be included in the patients treatment before the disease progresses to the late stages. As the number of those with AD continues to dramatically increase, it is necessary to focus on identifying risk factors and delaying the progression of chronic inflammatory diseases.

This article has been reviewed by the Scientific writing team lead of Esurgi : Ishtiak Ahmed Chowdhury

References:

  1. Alzheimer’s Disease and Dementia. 2021. Dental Care. [online] Available at:
    <https://www.alz.org/help-support/caregiving/daily-care/dental-care> [Accessed 15 August
    2021].


2. Alzheimer’s Disease and Dementia. 2021. What is Alzheimer’s?. [online] Available at:
<https://www.alz.org/alzheimers-dementia/what-is-alzheimers> [Accessed 15 August 2021].
Cariodontal.com. 2021. The Mouth-Body Connection – Cariodontal | Great Neck, NY. [online]
Available at: <https://www.cariodontal.com/the-mouth-body-connection> [Accessed 15 August
2021].


3. Harding A, Gonder U, Robinson SJ, Crean S and Singhrao SK (2017) Exploring the Association
between Alzheimer’s Disease, Oral Health, Microbial Endocrinology and Nutrition. Front. Aging
Neurosci. 9:398. doi: 10.3389/fnagi.2017.00398


4. Hebert, L. E., Weuve, J., Scherr, P. A., & Evans, D. A. (2013). Alzheimer disease in the United
States (2010-2050) estimated using the 2010 census. Neurology, 80(19), 1778–1783.
https://doi.org/10.1212/WNL.0b013e31828726f5


5. Marchini, L,  Ettinger, R,  Caprio, T,  Jucan, A.  Oral health care for patients with Alzheimer’s
disease: An update. Spec Care Dentist.  2019; 39: 262– 273. https://doi.org/10.1111/scd.12375
Pritchard AB, Crean S, Olsen I and Singhrao SK (2017) Periodontitis, Microbiomes and their
Role in Alzheimer’s Disease. Front. Aging Neurosci. 9:336. doi: 10.3389/fnagi.2017.00336


6. Teixeira FB, Saito MT, Matheus FC, Prediger RD, Yamada ES, Maia CSF and Lima RR (2017)
Periodontitis and Alzheimer’s Disease: A Possible Comorbidity between Oral Chronic
Inflammatory Condition and Neuroinflammation. Front. Aging Neurosci. 9:327. doi:
10.3389/fnagi.2017.00327