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Poor dental health may lead to Alzheimer’s (2013-10-07)

People with poor oral hygiene or gum disease may be at a greater risk of developing Alzheimer’s disease, a new study suggests.

According to new evidence from an international team of researchers (led by The University of Central Lancashire - UCLan - School of Medicine and Dentistry, including The Blizzard Institute in the United Kingdom and Dr. Lakshmyya Kesavalu at the University of Florida College of Dentistry, an associate professor in the College of Dentistry department of periodontology), oral bacteria from poor dental hygiene have been linked to brain tissue degeneration.


Alzheimer’s disease dental study

Gingivitis is seen in 97 percent of the population, Kesavalu said. It is one of the most common diseases to affect humans, more common than the common cold.
According to the Centers for Disease Control and Prevention, about 64 percent of seniors age 65 and over have moderate or severe periodontal disease. Alzheimer’s disease, according to the Alzheimer’s Association, is the sixth leading cause of death in the United States — affecting more than 5 million Americans.

The research,led by Professor Stjohn Crean and Dr Sim Singhrao from UCLan, examined brain samples donated by ten patients without dementia and ten patients suffering from dementia. The research demonstrated the presence of products from Porphyromonas gingivalis in brains from patients suffering from dementia.

Lipopolysaccharide, a component of Porphyromonas gingivalis, an oral bacterium, was found in four out of 10 Alzheimer’s disease brain samples. It was not found in any samples from the brains of people who did not have Alzheimer’s disease.

“This clearly shows that there is an association between oral bacteria and Alzheimer’s disease, but not causal association,” Kesavalu said.

This bacterium is commonly associated with chronic periodontal (gum) disease. These bacteria enter the bloodstream through daily activities such as eating, chewing, tooth brushing but especially following invasive dental treatment, and from there, potentially enter the brain on a regular basis.
The researchers propose that every time they reach the brain, the bacteria may trigger immune system responses by already primed brains cells, causing them to release more chemicals that kill neurons.
This could be one mechanism that leads to changes in the brain, which is typical of Alzheimer’s disease, and could be responsible for causing symptoms such as confusion and deteriorating memory.

Finding P. gingivalis in the brains from dementia sufferers compared to those without dementia is significant as its presence in Alzheimer’s diseased brains has not been documented previously and at the same time adds to a growing body of evidence that suggests an association between poor oral health and dementia.

Professor Stjohn Crean, Dean, School of Medicine & Dentistry said:

“Whereas previous studies have indicated a link between dementia and other bacteria and viruses such as the Herpes simplex virus type I, this new research indicates a possible association between gum disease and individuals who may be susceptible to developing Alzheimer’s disease, if exposed to the appropriate trigger! Research currently underway at UCLan is playing an active role in exploring this link, but it remains to be proven whether poor dental hygiene can lead to dementia in healthy people, which obviously could have significant implications for the population as a whole. It is also likely that these bacteria could make the existing disease condition worse.”

Dr. Sim K. Singhrao, Senior Research Fellow at UCLan said: “We are working on the theory that when the brain is repeatedly exposed to bacteria and/or their debris from our gums, subsequent immune responses may lead to nerve cell death and possibly memory loss. Thus, continued visits to dental hygiene professionals throughout one’s life may be more important than currently envisaged with inferences for health outside of the mouth only.
The future of the research aims to discover if P. gingivalis can be used as a marker, via a simple blood test, to predict the development of Alzhiemer’s disease in at risk patients.”

The paper was published in July in the Journal of Alzheimer’s Disease.

For more information
The University of Central Lancashire (UCLan)

University of Florida, Gainesville

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