Dentist explains the connection between Alzheimer's and oral health

This week is Dementia Action Week, an event across the UK that aims to get the public to take action to help improve the lives of those living with dementia.

There are said to be 34.5 million people who know someone currently living with dementia across the UK, and one in three of those born in the UK will go on to develop dementia in their lifetime. But did you know that a routine dental check-up can indicate the onset of the disease in some patients?

To coincide with Dementia Action Week, Dr Smita Mehra, BDS MFGDPRCS and Principal Dentist at The Neem Tree Dental Practice explains the connection between Alzheimer's and oral health, and how family and friends can help care for the oral health of those suffering with the degenerative disease:

What is the connection between oral health and Alzheimer's?

“Alzheimer's is a degenerative disease that most commonly affects those aged 60 and over, and its connection with oral health is focused on the long-term impact of caring for teeth and gums in patients, as the disease progresses.

"The earlier a patient is diagnosed, the sooner they can be educated on how to effectively clean and care for their oral health through simple, digestible instructions, almost like muscle memory.” 

How can your oral health indicate signs of Alzheimer’s?

“Some initial signs of an Alzheimer’s patient will be a mouth that is poorly taken care of. Usually - but not always - this will be an elderly patient who is seemingly neglecting their oral care. 

“There will be large deposits of plaque and calculus, and swollen or bleeding gums with cavities. These will be either visible to us as dentists, or evident from the patient complaining of pain upon touching or blowing air onto teeth. 

“A dry mouth due to ageing or complex medicine combinations can also lead to dental cavities, as well as difficulty swallowing or sometimes even speaking. With Alzheimer’s, the overall presentation of the patient is key. Simply put, these are the signs of neglect.

“As dentists, we wouldn’t be isolating and identifying bacteria, e.g. Porphyromonas gingivalis, which have been linked with this disease. We would leave that to the scientists.”

What does current research say about this connection?

“One of the biggest links between periodontal disease and Alzheimer's patients is the evidence of a particular type of bacteria found in oral cavities - Porphyromonas gingivalis. Some studies indicate that this specific type of bacteria is linked to patients who suffer from Alzheimer’s, as well as rheumatoid arthritis. 

“There are also some purely observational theories that mercury - a known neurotoxin found in amalgam fillings - could potentially be linked to patients suffering from Alzheimer’s, as well as MS and Chronic Fatigue Syndrome. 

“Many UK dental practices don’t typically rely on amalgam fillings anymore, and instead use mercury-free alternatives, such as ceramics or composite fillings. What’s more, some European countries, such as France, Sweden, Norway, and Denmark, have either banned or restricted the use of mercury fillings over the past two decades.” 

What should people do to best protect themselves from the potential health impacts of this connection?

“Prevention is key when it comes to reducing the chance of the Porphyromonas gingivalis bacteria growing within oral cavities. Patients should regularly see their dentists for check-ups and hygiene visits, to stay on top of treatments and to avoid any worsening of the condition by reducing the bacterial count. 

“For Alzheimer’s patients in more developed stages of the disease, a chaperone or family member should be present in the room during any dental appointments or check-ups, in order to understand how to help with oral care maintenance at home. As well as this, they could communicate any dental issues or symptoms they may have witnessed the patient suffering from. 

“They should also make sure that they are scheduling regular future appointments for the patient with their dentist, and ask to receive reminders via email or text message so that none are forgotten.”