Can gum disease contribute to Alzheimer's disease

We know good heart health can help protect against dementia, now a recent study looks at  whether there is a link between Alzheimer’s and gum disease.

The research, published in medical journal PLOS ONE, suggests inflammation in the gums may increase the rate of cognitive decline in those already living with Alzheimer’s, and adds weight to the argument that inflammation in the body and the brain may cause Alzheimer’s. 
The small study, by the University of Southampton and King's College London, observed 59 people with mild to moderate dementia for six months. It looked at the participant’s cognitive state, oral health and markers found in their blood showing inflammation.
It found those with gum disease (periodontitis) experienced a sixfold increase in their rate of cognitive deterioration.
Bupa Dentist Dr Mark Psillakis says while more studies need to be done, there is enough anecdotal evidence out there to advocate keeping our mouths and gums healthy.
“It will probably help you maintain your cognitive capacity and it may help you somewhat against dementia and Alzheimer’s,” says Dr Psillakis. “And what if it’s proven in 10 years time that’s not the case, so what have we done? We’ve encouraged people to keep their mouth clean and healthy.”
Dr Psillakis says those living with gum disease are pumping bacteria into their blood stream every time they chew.
Older ladies caring for each other
“Those bacteria will bring about an inflammatory load, it stimulates the immune system and it starts producing all those inflammatory mediators, and that inflammation will damage the tissue at the site it occurs,” says Dr Psillakis.

Margaret Ryan, Head of Dementia Services at Bupa Australia, says while more evidence is needed it’s worthwhile investing in anything that could minimise our risk of developing Alzheimer’s.

“It would be wonderful if it was as simple as that, I suspect it’s a combination of all kinds of things, but certainly there’s nothing to be lost and everything to be gained from looking after your oral health,” says Ryan. “If further research shows there is a definite link in terms of minimising risk it’s something that needs to be done and can be done now to prevent problems in the future.”

Oral hygiene in older people

Dr Psillakis says dental hygiene can be challenging for some older people.
“They may reach an age where the arthritis has set in and they’re struggling to grip their toothbrush, in that case we talk about using an electric toothbrush.”
It can also be difficult for those living with advanced dementia to look after their teeth.

Ryan says oral hygiene is a big focus in Bupa Aged Care homes, as many residents have dentures and need some extra help taking care of their teeth and gums. 

“We have to support our residents a lot, and monitor their oral hygiene very carefully,” she says. “It’s one of the key things we look at as it puts people’s wellbeing at risk because of nutrition, quality of life and pain management.”

Tips to avoid gum disease

-  Try an electric toothbrush.
-  Floss at least once a day.
-  Add a fluoride mouthwash.
-  Always take your dentures out at night.
-  Limit high-sugar foods and drinks.
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