Preventing the Progression of Alzheimer's Disease with… Toothpaste and Floss?

New research reinforces the many ways oral health is linked to overall systemic health. When the body is fighting inflammatory diseases (like periodontal disease), it's harder for the immune system to effectively fight off infection and handle other health conditions. Not only that, but some types of bacteria are able to cross the blood/brain barrier and create further (and more complex) health problems, with numerous links being found between oral health and conditions like cardiovascular disease, diabetes, and Alzheimer's disease.

Periodontal disease is a low-grade but chronic inflammatory disease where pathogenic bacteria creates oral health problems that can lead to inflammation of the gums, gingivitis, bone loss, degradation of tooth attachment, and eventually tooth loss. While regular dental checkups and cleanings can help to diagnose and treat the condition from the early stages, many adults skip regular dental visits until they experience pain, discomfort, or other urgent dental issues.

New research is emerging all the time, with several studies over the past few years each building upon the previous to help increase understanding of how this bacteria impacts the development and progression of Alzheimer's disease.

For example, research from the University of Central Lancashire (UCLan) in the UK, published in the Journal of Alzheimer's Disease in 2013, found via post-mortem tissue analysis that brains affected by Alzheimer's also showed the presence of Porphyromonas gingivalis, a strain of bacteria associated with gum disease and commonly found in oral cavities.

Following that, in 2018 a team of researchers at the University of Illinois at Chicago illustrated that long-term exposure to periodontal disease bacteria is directly tied to inflammation and degeneration of brain neurons in mice, an impact similar to Alzheimer's disease in humans. Their research took previous findings a step further by showing that exposure to periodontal bacteria leads to the formation of the signature amyloid-beta plaques that accelerate the development of Alzheimer's disease in humans. This study illustrated that mice exposed to chronic periodontal disease bacteria had more brain inflammation and more neuron degeneration than the control group, and amyloid beta protein analysis and RNA analysis showed greater expression of the genes associated with negative outcomes like inflammation and degeneration. Furthermore, the periodontal bacteria itself was again directly found in the brain tissue of the mice in the study group, and a related bacterial protein observed within neurons.

Now, researchers from the University of Bergen in Norway have taken it a step further and found a clear connection between periodontal disease and Alzheimer's disease. The team discovered DNA-based proof that this bacteria that causes gingivitis, a common gum disease, can cross the blood/brain barrier. When that happens, the bacteria produces a protein that destroys the brain's nerve cells, leading to memory loss and eventually Alzheimer's disease. The bacteria won't cause Alzheimer's in and of itself, but its presence not only increases the risk of developing Alzheimer's disease but can also drive more rapid progression of the disease.

With the University of Bergen's research pointing to a specific enzyme that works to destroy nerve cells in the brain, the research team has a new therapeutic target for slowing the progression of Alzheimer's disease, resulting in new drug development. This new drug is aimed at blocking the harmful enzymes the bacteria produce, and testing is expected to begin later in 2019.

Overall, these continued findings mean that there are simple measures that can disrupt the progression of Alzheimer's. Regular brushing and flossing have long been recommended as a measure of maintaining good health in general, but now there's more reason than ever to keep up with good dental habits. Also, where there is a genetic history of Alzheimer's disease, regular dental visits can help to keep the mouth healthy and to find and treat periodontal disease in its earliest stages, before the bacteria have time to cause further harm.

Looks like toothpaste and floss are good for more than just a happy smile! 

Further Reading & References: 

Brush your teeth -- postpone Alzheimer's. ScienceDaily, 3 June 2019. www.sciencedaily.com/releases/2019/06/190603102549.htm

Determining the presence of periodontopathic virulence factors in short-term postmortem Alzheimer's disease brain tissue. Journal of Alzheimers Disease, 2013. doi: 10.3233/JAD-121918.

Chronic oral application of a periodontal pathogen results in brain inflammation, neurodegeneration and amyloid beta production in wild type mice. PLOS ONE, 2018. doi: 10.1371/journal.pone.0204941

Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Science Advances, 2019. doi: 10.1126/sciadv.aau3333

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