Treating gum disease early may slow the progression of Alzheimer’s disease

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New research suggests that a bacteria known to cause gum disease may worsen symptoms of Alzheimer’s disease. Westend61/Getty Images
  • Research has linked Alzheimer’s disease to a type of bacteria known to cause gum disease.
  • Alzheimer’s disease is a type of dementia that causes loss of the ability to think and remember.
  • Scientists believe that this bacterium may worsen Alzheimer’s symptoms by increasing inflammation.
  • Treating and preventing gum disease may help slow the progression of Alzheimer’s disease.
  • Good oral hygiene can also help prevent several other diseases linked to this bacteria.

Nucleated Fusobacteria (F.nucleatum) is a common bacterium associated with oral conditions such as gum disease, bad breath, dental abscesses and oral cancer. Additionally, it has been linked to a variety of diseases elsewhere in the body, including cancers, infections, and inflammatory conditions.

More recently, a study published in Frontiers of the neurosciences of aging discovered that it may also be linked to Alzheimer’s disease.

The Alzheimer’s Association describes Alzheimer’s disease as the most common cause of dementia, accounting for approximately 60-80% of all cases. It is a progressive disease with no cure.

People with Alzheimer’s disease experience progressive loss of memory and cognition, which eventually becomes severe enough to interfere with their daily functioning. It is thought to be caused by a buildup of beta-amyloid and tau proteins in the brain that damage and kill nerve cells.

Lead author Jake Jinkun Chen, DMD, MDS and PhD, professor of periodontology and director of the division of oral biology at Tufts University School of Dentistry, said the work of his team, which was carried out using mice, showed that F.nucleatum could aggravate Alzheimer’s disease, either by creating inflammation or by settling in the brain and secreting pathological molecules.

“Our studies show that F.nucleatum can reduce memory and thinking abilities in mice through certain signaling pathways,” Chen said. “This is a warning sign for researchers and clinicians.”

While it might seem odd that bacteria in the mouth could have such strong effects, Chen said, “Your mouth is really the gateway to your body.”

Chen further explained that F.nucleatum causes abnormal growth of microglial cells. Microglial cells are immune cells in the brain that normally eliminate damaged nerve cells and infections. This excessive growth of microglial cells creates an increased inflammatory response.

“Chronic inflammation or infection is thought to be a key determinant of cognitive decline that occurs as Alzheimer’s disease progresses,” Chen said.

Chen noted that while his research doesn’t prove that periodontal disease can cause Alzheimer’s disease, it does suggest that if you don’t treat gum disease properly, you could make Alzheimer’s symptoms worse.

Additionally, treating gum disease in the early stages of Alzheimer’s disease could potentially slow its progression.

Chen thinks testing for bacterial load and degree of symptoms could one day become a way to measure the effects of F.nucleatum and monitor disease progression.

He believes this work is important because most adults suffer from periodontal disease and many will develop Alzheimer’s disease in later life. Understanding how this type of bacteria affects Alzheimer’s disease would help dentists and neurologists better understand the interplay between these two conditions.

He adds that the next step in his research will be to use a particular microRNA to target the main causes of Alzheimer’s disease, including amyloid plaque formation, tau deposition and brain inflammation.

He said his goal was to find “a robust and effective ‘one-shot’ approach leading to the discovery of effective, safe and effective treatment strategies for Alzheimer’s disease.”

Chen noted that gum disease affects 47% of Americans over the age of 30, while Alzheimer’s disease currently affects about 6.5 million people.

“Given the growing body of work – including this study – examining the links between the two, we hope people will take seriously the importance of maintaining good oral hygiene in maintaining cognitive and overall health.”

Ana Karina Mascarenhas, BDS, MPH, DrPH, FDS RCPS (Glasg), professor and associate dean of research and community health at Woody L. Hunt School of Dental Medicine, Texas Tech University Health Sciences Center El Paso, said that it is essential to have a “structured and diligent” oral hygiene routine, including the following elements:

  • Brush your teeth twice a day, preferably after meals. “That would mean after breakfast and the last thing before going to bed. Brushing your teeth after lunch would also help,” she said.
  • Use fluoridated toothpaste. This helps prevent cavities, according to the American Dental Association (ADA).
  • Avoid tobacco products and vaping. These can increase the risk of inflammation and gum disease, Mascarenhas explained.
  • See a dentist at least once a year for a checkup. The ADA says regular exams help catch problems early when they’re easier and cheaper to treat.
  • Follow your dentist’s advice carefully. This includes using mouthwash or other recommended oral hygiene aids, Mascarenhas said.
  • Get cleaned regularly by a dental hygienist. Your dentist can recommend how often to do this, based on your personal needs, she said.

Mascaren further indicated that even if you don’t have Alzheimer’s disease, there are many other compelling reasons to take care of your gums and teeth.

In addition to F.nucleatumemerging link to Alzheimer’s disease, gum disease has been linked to several other diseases, and this list continues to grow.

Certain cancers, premature births, strokes, cardiovascular disease and diabetes have been linked to poor oral hygiene, she said.

With diabetes, in particular, she said there is good evidence that people with untreated gum disease are more likely to be unable to control the disease. “The consequences of uncontrolled diabetes are debilitating, including the loss of limbs,” she said.


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