Oral health as a modifiable risk factor for neurodegeneration: Prudent optimism and interdisciplinary action

 Your competent? doctor has had oral health protocols for 7 years already, right? NO? So, you DON'T have a functioning stroke doctor, do you?

oral health (5 posts to March 2018)

Oral health as a modifiable risk factor for neurodegeneration: Prudent optimism and interdisciplinary action

Author links open overlay panel, , 

https://doi.org/10.1016/j.jocn.2025.111354Get rights and content

Highlights

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  Periodontitis is potentially linked to neurodegeneration via different pathways.
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  Tooth loss and impaired chewing may accelerate cognitive decline.
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  Salivary biomarkers offer a possible tool for early neurodegeneration detection.
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  Interdisciplinary collaboration between dentists and neurologists is crucial.

Abstract

Neurodegenerative diseases, including Alzheimer’s disease (AD) and Parkinson’s disease (PD), represent a growing public health burden, necessitating exploration of modifiable risk factors. Emerging evidence suggests a link between poor oral health, particularly chronic periodontitis, and neurodegeneration, mediated by systemic inflammation, direct bacterial invasion, and disruptions in the microbiota-gut-brain axis. Periodontal pathogens, such as Porphyromonas gingivalis, have been suggested to contribute to neuroinflammation, blood–brain barrier dysfunction, and amyloid-beta aggregation, all of which are implicated in AD pathology. Additionally, tooth loss and masticatory dysfunction could further exacerbate cognitive decline through reduced cerebral stimulation and impaired nutrient absorption. While the association between periodontitis and neurodegeneration is compelling, causality remains uncertain, warranting further longitudinal and interventional studies. Interdisciplinary collaboration between neurologists and dental professionals is essential to establish oral health as a potential preventive strategy for neurodegenerative diseases. Routine periodontal screenings, improved oral hygiene awareness, and early intervention could help mitigate cognitive decline. Moreover, salivary biomarkers show promise as non-invasive tools for early detection of neurodegeneration. Addressing socioeconomic and healthcare disparities in access to both dental and neurological care is crucial in minimizing disease burden. Future research should focus on mechanistic studies and randomized trials to determine whether and how periodontal interventions can influence neurodegenerative disease progression.

gingipains, periodontitis and alzheimer's

 Just maybe you want your doctor to be up-to-date on gingipains. Up to you if you want to enforce competency and get your gum disease treated while in the hospital.

Gingipains are trypsin-like cysteine proteinases produced by Porphyromonas gingivalis, a major causative bacterium of adult periodontitis.

Porphyromonas gingivalis in Alzheimer's disease brains: Evidence for disease causation and treatment with small-molecule inhibitors January 2019

Determining the presence of periodontopathic virulence factors in short-term postmortem Alzheimer's disease brain tissue April 2013

Porphyromonas gingivalis periodontal infection and its putative links with Alzheimer's disease April 2015

Alzheimer's disease-like neurodegeneration in Porphyromonas gingivalis infected neurons with persistent expression of active gingipains June 2020

Microglial Cathepsin B and Porphyromonas gingivalis Gingipains as Potential Therapeutic Targets for Sporadic Alzheimer's Disease September 2020

Porphyromonas gingivalis infection may contribute to systemic and intracerebral amyloid-beta: implications for Alzheimer's disease onset July 2020

Porphyromonas gingivalis and Alzheimer disease: Recent findings and potential therapies 

  June 2020

Interaction between genetic factors, Porphyromonas gingivalis and microglia to promote Alzheimer's disease September 2020

Linking mechanisms of periodontitis to Alzheimer's disease

April 2020

Is periodontitis a risk factor for ischaemic stroke, coronary artery disease and subclinical atherosclerosis? A Mendelian randomisation study

 Periodontitis (per-e-o-don-TIE-tis), also called gum disease, is a serious gum infection that damages the soft tissue and, without treatment, can destroy the bone that supports your teeth. Periodontitis can cause teeth to loosen or lead to tooth loss.

Maybe you want to take care of your gum disease for this reason?

Are your gums saying something about your dementia risk?

 

The latest here:

Is periodontitis a risk factor for ischaemic stroke, coronary artery disease and subclinical atherosclerosis? A Mendelian randomisation study

Bell S, Gibson JT, Harshfield EL, et al.

Atherosclerosis|October 5, 2020

Given that periodontitis and cardiovascular disease are linked in observational studies, researchers assessed if periodontitis is causally related to stroke, coronary artery disease, or subclinical atherosclerosis via Mendelian randomization. A two-sample Mendelian randomization analysis was performed using five single nucleotide polymorphisms previously linked with periodontitis in genome-wide association studies. Summary data have been collected from MEGASTROKE and combined with de novo analyses of UK Biobank for stroke and its major subtypes (up to 44,221 cases, 739,957 controls) and CARDIoGRAMplusC4D and UK Biobank for coronary artery disease (122,733 cases, 424,528 controls). According to results, there was no connection between periodontitis and any stroke, ischemic stroke or any major subtypes, or coronary artery disease. Similarly, no link was identified between periodontitis and subclinical atherosclerosis. This indicates that associations identified in observational studies may represent confounding.

Read the full article on Atherosclerosis.