Is there a Dental Link to Alzheimer’s?

Alzheimer’s disease (AD) is one of those diseases you would not wish on anyone. I have it in my family. My grandfather died from it about 30 years ago.
Since its discovery more than 100 years ago, there have been many scientific breakthroughs in AD research. In the 1960s, scientists discovered a link between cognitive decline and the number of plaques and tangles in the brain. The medical community then formally recognized Alzheimer’s as a disease and not a normal part of aging. In the 1970s, scientists made great strides in understanding the human body as a whole, and AD emerged as a significant area of research interest. This increased attention led in the 1990s to important discoveries and a better understanding of complex nerve cells in the brains of AD patients. More research was done on AD susceptibility genes, and several drugs were approved to treat the cognitive symptoms of the disease.
More recently, researchers have found long-term evidence that periodontal (gum) disease may increase the risk of cognitive dysfunction in healthy individuals, as well as those who are already cognitively impaired. The evidence shows that gingival inflammation may contribute to brain inflammation, neurodegeneration, and Alzheimer’s. My own observations in practice show that as the disease progresses, home care becomes more challenging for patients, which leads to more inflammation, and may contribute to progression of the disease.
Previous research has shown that patients with AD had a significantly higher level of antibodies and inflammatory molecules associated with periodontal disease in their plasma compared to healthy people. One of the tests used to evaluate cognitive function is called the Digit Symbol Test, which is part of the standard measurement of adult IQ.
Researchers found that periodontal inflammation in tested subjects at age 70 years old was strongly associated with lower test scores. Participants with periodontal inflammation were 9 times more likely to test in the lower range in this particular test compared to participants with no periodontal inflammation. Amazingly, this strong association held true even in those subjects who had other risk factors linked to lower testing scores, including obesity, cigarette smoking, and tooth loss unrelated to gum inflammation.
Obviously, the research will continue. Another obvious fact is that I continue to read more and more connections between poor oral health and systemic issues. And, the last obvious fact is that I am trying to educate patients on a daily basis about the significance of good oral health. The mouth is the link to the rest of the body.
I had three patients this week who flat-out refused to accept the fact that they have a problem because they have no pain. They think I am trying to pull the wool over their eyes. I say it over and over; lack of pain is not a good indicator of a problem. Your teeth can be practically falling out and I would be willing to bet you have no pain. Dentists wish that gum disease did hurt. It would be easier to get patients to improve their health.