The Connection Between Oral Health And Alzheimer’s

Dr. Christopher Li Etobicoke - Li Family Dental

By Dr. Christopher Li

October 27, 2023

dental care, oral health, oral health and alzheimer's, plaque, preventative care

Many people are unaware there is a connection between oral health and almost every other system in the body. In fact, recent research has confirmed this connection includes the brain, showing that plaque in the mouth can cause amyloid plaque in the brain of Alzheimer’s patients. Here, we look at this recent revelation connecting oral health and Alzheimer’s, and how you can help reduce the risk of developing Alzheimer’s with proper oral care. 

How Does Plaque Contribute To The Connection Between Oral Health And Alzheimer’s?

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Researchers discovered that a bacterium known as Porphyromonas gingivalis (P. gingivalis) can move from the mouth to the brain. These bacteria release enzymes called gingipains, which attack nerve cells in the brain, leading to memory loss and, in some cases, Alzheimer’s Disease. Gingipains were found in the brains of almost all 53 diseased Alzheimer’s patients involved in the study. So, what does plaque have to do with this process? P. gingivalis is found in 85.75% of plaque samples taken from patients with chronic periodontitis. Also, abnormal proteins called amyloid plaques form in the spaces between nerve cells, first developing in the areas of the brain responsible for memory and cognitive functions. 

Dental Plaque Vs. Amyloid Plaque In Alzheimer’s Development

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Amyloid plaques form in the spaces between nerve cells in the brain, while dental plaque is a film made of bacteria, leftover food, and saliva that forms on teeth. When dental plaque is not removed, the risk of P. gingivalis increases, allowing it to travel to the brain and produce damaging gingipains. Alzheimer’s Disease is not the only risk related to this form of cell damage, which is also connected with diabetes and insulin resistance, cardiovascular disease, respiratory infections, and gastrointestinal/colorectal cancers. 

Exactly What Causes Amyloid Plaque Buildup?

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Plaque buildup is caused by protein pieces “clumping” together. The protein beta-amyloid is found in larger proteins in the fatty membrane surrounding nerve cells. It is “sticky,” allowing it to build into plaques, with the most damaging beta-amyloid creating groups of a few pieces. These small clumps might block signals between cells, activating immune system cells and triggering inflammation. Alzheimer’s amyloid plaques also collect between neurons and disrupt cell function, leading to memory and cognitive function issues. 

Does Oral Health Affect The Progression Of Alzheimer’s Disease?

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The researchers noted the amount of gingipains rose over time, suggesting a possible tipping point that triggers or worsens dementia symptoms. Plaques also spread through the cortex in a predictable pattern. However, the rate of progression varies. Although the average Alzheimer’s patient lives from four to eight years, some survive as long as 20, as other health conditions and age influence the course of the disease as well. 

Does Oral Health Impact Alzheimer’s Patients?

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Once a patient is diagnosed with Alzheimer’s, their oral health impacts their illness differently. Throughout the stages of the disease, it becomes more and more challenging to manage oral health independently. In fact, dentists are sometimes the first to raise concerns about potential Alzheimer’s or dementia when patients who have always taken good care of their teeth and gums display signs of a deteriorating oral health regime.

In the early stages, dental check-ups and oral hygiene help reduce the risk of decay and gum disease requiring complex dental treatments. As the disease worsens, patients are less able to undergo dental procedures as they can feel overwhelmed and frightened and even become aggressive and resistant to treatment. In the middle to later stages, patients require the assistance of a caregiver to maintain their oral health. This can be more stressful for the caregiver than the patient, requiring compassion and an effective strategy to help patients follow a good oral health regime. 

How To Help Loved Ones With Alzheimer’s Maintain Oral Health

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When your loved one is struggling with daily self-care, it is vital to provide assistance to help them stick to an oral health regime. This is made easier if you take the time each day to offer helpful instructions, handing them their toothbrush, helping them apply toothpaste, and getting them started on brushing their teeth. As they work, you can offer tips or help guide their hand to ensure they are cleaning each tooth.

It can be helpful to show them how you brush your teeth and have them follow along. Keep in mind it is not uncommon for patients to experience frustration and become aggravated by these types of situations. It is best to avoid forcing them to brush their teeth and instead move on to a new activity and then try revisiting teeth brushing when they seem calmer later in the day.

For some patients, it is necessary to brush their teeth for them. In this case, being gentle is key to helping keep your loved one comfortable. You don’t want them to associate brushing their teeth with something unpleasant.

Be sure they brush in the morning and before bed. If they take liquid medications, have them take their medicine before brushing. You can also book their regular dental checkups, prepare them for the appointment, and come along to discuss changes and concerns about their teeth and gums with their dentist.  

Tips For Oral Health And Alzheimer’s Disease Prevention

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To reduce the risk of Alzheimer’s disease, nothing is more important than focusing on reducing plaque and the presence of P. gingivalis. These tips will help:

  • Avoid skipping brushing and flossing to ensure you don’t go to bed with debris in your mouth that can lead to plaque buildup
  • Follow your hygienist or dentist’s instructions when they provide advice on how to brush and floss to ensure you are brushing properly
  • If you find flossing too difficult, ask your dentist to recommend another tool to get the same results
  • Use fluoride toothpaste
  • Keep your mouth moist by drinking plenty of water to reduce acids and the presence of bacteria
  • Consider using mouthwash to help remove debris that contributes to plaque
  • Eat healthier snacks, especially raw fruits and vegetables, that help remove food debris and bacteria
  • Reduce sugar in your diet
  • Quit smoking to reduce bacteria and acids in your mouth and improve saliva production and health
  • See your dentist twice a year for a checkup and professional cleaning to remove plaque

Knowing there is a connection between oral health and Alzheimer’s is an incentive to improve your oral health regime. For more information, give us a call at 416-232-2033 or request an appointment by clicking here.

Dr. Christopher Li

About the author

Dr. Christopher Li; Dr. Chris, as he is affectionately known, is a licensed dentist with over 20 years of experience. His caring personality makes even the most tentative person at ease. Patients are constantly commenting about how Dr. Chris is incredible at delivering pain-free freezing, and how he has an amazing chair-side manner.

Dr. Chris and his team have built an exceptional dental clinic serving The Queensway, Etobicoke, Toronto and surrounding areas.

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