Good oral health can help keep dementia at bay

The good news is that keeping your mouth healthy can prevent illness or even improve your general health.

So said Professor Alpdogan Kantarci of the Harvard University Dental School, speaking on a ZOE Science and Nutrition podcast.

Conversely, he said, taking good care of your mouth, and visiting the dentist regularly, can play an important role in preventing these diseases from arising.

Since the 1990s research has been focusing on the links between oral diseases, especially periodontal (gum) disease, and systemic disease.

There’s now no doubt that there is a connection between poor oral health and cardiovascular disease, diabetes, and lung conditions such as pneumonia, and the list is growing. According to Professor Kantarci, worldwide data shows that over 50 conditions are connected to oral diseases. And it works both ways. People with poorly controlled diabetes often have higher levels of periodontal disease, and frail elderly people with a range of complaints, including dementia or Alzheimer’s disease, frequently have poor oral health and gum disease.

The mouth is a reservoir of bacteria and microbes of all kinds, and when periodontal disease occurs, including bleeding gums, bacteria from the mouth are able to enter the bloodstream and travel around the body, where they can interrupt the normal activity of the organs and the immune system. If the periodontal disease is chronic and below the gumline, this continues over time, over-activating the immune system constantly and escalating the problem.

Research in this area from around the world is at a fairly early stage, but it is now showing that periodontal disease can increase the risk of dementia and Alzheimer’s disease by one-and-a-half to twofold.

In other words, it doubles your chances of developing dementia. Conversely, Alzheimer’s can up to double your chances of developing gum disease. Further studies are underway but it is thought that the bacteria from the mouth can stimulate inflammation in the brain and also disrupt the way the immune system can fight them. They don’t directly cause Alzheimer’s but they can contribute to worsening brain pathologies, explained Professor Kantarci.

This was one of the earliest connections made between oral and general health. Diabetes frequently causes bleeding gums and periodontal disease, while at the same time gum disease can make diabetes symptoms worse. However, if you treat gum disease in patients with diabetes, this reduces the bacterial load and the inflammatory burden on the body, improving their blood sugar control.

A periodontal cleaning can reduce your HBA1C level by 0.4%, which is hugely significant.

People with gum disease are almost twice as likely to have heart disease as those who do not. It is understood that when mouth bacteria get into the bloodstream, they produce proteins that cause platelets in the blood to stick together, forming clots that can trigger heart attacks. People who suffer strokes are also more likely to have gum disease.

Having gum disease in pregnancy can triple your chance of having a premature baby, which therefore has a low birth weight. According to the Oral Health Foundation, there is a one in four chance that a pregnant woman with gum disease will give birth before 35 weeks, all of which puts the baby at a disadvantage. Getting gum disease treated during pregnancy can reduce the risk of a premature birth. Pregnant women are entitled to free dental care under the NHS, so it’s really worth taking that up.

Chest infections and pneumonia can be caused or worsened when patients breathe in droplets from the mouth or throat. People with high levels of oral bacteria due to periodontal disease are at greater risk of this, especially frail, elderly people. A systematic review concluded that one in 10 pneumonia-related deaths in the elderly could be prevented by improving oral hygiene, so good oral care is particularly essential for this group.

Saliva is essential for a healthy mouth. People with dry mouth, due either to medications or conditions such as Sjogren’s syndrome, are at greater risk of developing oral problems and also other systemic disease.

The Covid-19 pandemic threw the link between poor oral health and general health into sharp focus, as certain groups of people were seen to be more severely affected. London dentist Dr Victoria Sampson became increasingly aware that patients with conditions such as diabetes, hypertension and cardiovascular disease were at higher risk of complications from Covid-19 - and also had altered oral biofilms and periodontal disease.

She explained: 

Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections? | British Dental Journal (nature.com).

Since Covid, Victoria has continued her research into the oral microbiome and the relationship between the mouth and the rest of the body. ‘I am obsessed with gums and gum disease, and their impact on systemic disease – in diabetes, heart disease, Alzheimer’s, infertility and chronic inflammatory conditions like rheumatoid arthritis (RA),’ she said. Her new London practice, The Health Society, is a multidisciplinary practice, with the aim of taking a more holistic approach to health. It focuses on oral health but also involves the services of a nutritionist, blood tests, salivary diagnostics, and oral microbiome testing.

The good news is that improving your oral health can also improve your general health. Consistent twice-daily brushing with a good protective toothpaste like BioMin^® F*, flossing and using an interdental brush, together with regular dental checkups, mean not only that decay (caries) can be prevented, but also periodontal disease can be seen and treated at an early stage. Oral cancers, too, can be detected.

Getting periodontal disease identified and treated means that blood sugar levels in diabetes can be brought under control and, especially in the cases of frail elderly people, the risk of developing heart disease and lung diseases like pneumonia and even Covid can be minimised. ‘We can help our medical colleagues treat their patients better if they are treated by us too,’ concluded Professor Ketarci.

Healthy mouth, healthy body is not just a slogan, it’s potentially a lifesaver.
 
*BioMin^® F toothpaste is designed to stick to the tooth surface where it gradually dissolves over 12 hours, slowly releasing calcium, phosphate and fluoride ions, which work with the saliva to neutralise the acids in the mouth and protect it around the clock.

• Inflammation of the gums (redness, swelling)
• Bleeding gums
• Bad breath
• Bad taste in the mouth
• Loose teeth