Poor Dental Hygiene Can Go Beyond Tooth Decay

Poor Dental Hygiene Can Go Beyond Tooth Decay

USA- Poor dental hygiene can lead to tooth decay, gum disease and bad breath which most people are aware of, but not brushing your teeth could lead to more serious health issues. 

In 2010 researchers from New York University (NYU) discovered that there is a link between gum inflammation and Alzheimer's disease, after reviewing 20 years of data. 

The number of participants in the NYU study were fairly small. The researchers analyzed data from 152 participants that were enrolled in the Glostrop Aging Study. It looked at psychological, medical and oral health in Danish men and women. The study was done over a 20 year period and ended in 1984, when the participants were all over the age of 70. 

The NYU researchers found that gum disease was strongly associated with low scores for cognitive function. They did this by comparing the cognitive function at ages 50 and 70. The participants were nine times more likely to have a lower score for the cognitive test called the "digit symbol test"(DST) if they had inflammation of the gums. 

Even though this study took into account potentially confounding factors like obesity, cigarette smoking and tooth loss unreleated to gum inflammation, there was still a strong connection between low DST score and gum inflammation.

In 2013, UK-based researchers at the University of Central Lancashire (UCLan) built on the findings of the study done at NYU, by comparing brain samples from 10 living patients with Alzheimer's and 10 brain samples from people who did not have the disease.

This showed that a bacterium, Porphyromanas gingivalis, was present in the Alzheimer's brain samples but not in the samples from the brains of people who did not have Alzheimer's. P. gingivalis is usually assoicated with chronic gum disease.

In 2014, the team followed up with this research with a new mouse study. Dr. Sim K. Singhrao was the co-author of this study that was published in the Journal of Alzheimer's Disease and he said that there is sufficient scientific evidence to show that two of the three gum-disease causing bacteria are capable of motion or motile and have been consistently found in brain tissue.

He said that these motile bacteria can leave the mouth and enter the brain through two main routes. They can use their movement capability to directly enter the brain. One of the paths taken is to crawl up the nerves that connect the brain and the roots of teeth. The other one is indirect entry into the brain via the blood circulation system.

Dr. Singharo says that a patient who has bleeding gums that the gum disease causing bacteria will enter the blood stream every time they clean their mouth and even when they eat food.

He says that P. gingivalis is interesting because it has found ways to catch a ride from red blood cells when in the blood stream instead of getting 'off the-red blood cell bus' in the spleen, they choose to get off in the brain at an area where there are no immune checkpoints. From there, they can spread to the brain at their will. In older people, the blood vessels tend to enlarge and become leaky. The research confirmed that P. gingivalis placed in the mouths of mice finds its way to the brain once gum disease becomes established.

Their hypothesis is strengthened by the recent results in demonstrating that the chemicals released by the brain's immune system in respone to P. gingivalis reaching the brain inadvertently damage functional neurons in the area of the brain related to memory, he said.

Another disease that could be a concern is pancreatic cancer. A research team from Harvard School of Public Health in Boston, MA, reported strong evidnece linking gum disease and pancreatic cancer, back in 2007.

The gum inflammation associated with pancreatic cancer in the study was periodontitis, which affects the tissue that support the teeth and can cause loss of bone around the base of the teeth.

Gingivitis, which is the main type of gum disease where the tissue around the teeth becomes inflamed was not linked to increased cancer risk, but, gingivitis can lead to periodontitis if perisistent. It can happen when the bacteria in the plaque around the base of the teeth build up due to bad dental hygiene.

The Harvard researchers examined data on gum disease from the Health Professionals Follow-up Study, which involved more than 51,000 men and began collecting data in 1986. They found taht men with a history of gum disease had a 64% increased risk of pancreatic cancer compared to men who had never had gum disease.

The biggest risk for pancreatic cancer among the group of men was with recent tooth loss. But, the study was unable to find links between other types of oral health problems such as tooth decay and pancreatic cancer.

The researchers say that there may be a link between high levels of carcinogenic compounds found in the mouths of people with gum disease and pancreatic cancer risk. They argue  that these compounds which are called nitrosamines may react to the digestive chemicals in the gut in a way that creates an environment favorable to the development of pancreatic cancer.

A follow up study from a team in 2012 was unable to prove whether the periodontitis bacteria are a cause or result of pancreatic cancer it could only prove that the two were linked.

A more established association is between dental hygiene and heart disease.

In 2008, research from joint teams at the University of Bristol in the UK and the Royal College of Surgeons in Dublin, Ireland found that people with bleeding gums from poor dental hygiene could be increasing their risk of heart disease.

They found that heart disease risk increased in people who have bleeding gums because bacteria from the mouth is able to enter the bloodstream and stick to platelets, which can then form blood clots, interrupting the flow of blood to the heart and triggering a heart attack.

Dr. Steve Kerrigan from the Royal College of Surgeons, says, that the mouth is probably the dirtiest place in the human body. He explains that there are up to 700 different types of bacteria co-existing in our mouths.

Professor Howard Jenkison, from the University of Bristol said that caridovascular disease is currently the biggest killer in the western world. Oral bacteria such as Streptocuccus gordonii and Streptococcus sanguinis are common infecting agents and they now recognize that bacterial infections are an independent risk factor for heart diseases.

The Bristol University researchers investigated how the bacteria interact with platelets by mimicking the pressure inside the blood vessels and the heart. Professor Jenkinson's team found that the bacteria use the platelets as a defense mechanism.

By putting the platelets together, the bacteria are able to completely surround themselves and form an armor shield. This protects the bacteria from any attack by the immune system and makes them less detectable to antibioitics.

Good dental hygiene remains important for lowering risk of a variety of conditions. The American Dental Hygienists' Association (ADHA) recommend that we should brush our teeth for 2 minutes twice a day. They also say it is important to floss and rinse with mouthwash daily.


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