Beyond Tooth Decay: The Implications of

Poor Oral Health

By Jude Fabiano

Alzheimer’sBack in 2010, researchers from NYU concluded that there’s a link between gum inflammation and Alzheimer’s disease after they reviewed 20 years of data. The researchers analyzed data from 152 subjects enrolled in the Glostrop Aging Study, which looks at psychological, medical and oral health in Danish men and women over a 20-year period that ended in 1984. Through comparing cognitive function at ages 50 and 70, the NYU researchers found that gum disease at 70 was strongly associated with low scores for cognitive function. According to researchers, study participants were nine times more likely to have a score in the lower range of the cognitive test if they had gum inflammations. Even though this study took into account such potentially confounding factors as obesity, cigarette smoking and tooth loss unrelated to gum inflammation, there remained a strong association between lower cognitive test scores and gum inflammation.!

Three years later, researchers from the University of Central Lancashire (UCLAN) built on the findings of this study by comparing brain samples from 10 living patients with Alzheimer’s with 10 brain samples from people who didn’t have the disease. Analysis revealed that a bacterium typically associated with chronic gum disease was present in the Alzheimer’s brain samples but not in other samples. The team followed this research up in 2014 with a new mouse study, the results of which were published in the Journal of Alzheimer’s Disease.

Pancreatic CancerA research team from Harvard School of Public Health in Boston were the first to report on evidence of a link between gum disease and pancreatic cancer back in 2007. The type of 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 teeth’s base. The other main type of gum disease, gingivitis, was not linked to increased cancer risk, although it can lead to periodontitis if persistent.!

After examining data on gum disease from a follow-up study involving a cohort of over 51,000 men beginning in 1986, the Harvard researchers found that men with a history of gum disease had a 64% increased risk of pancreatic cancer when compared with men who never had gum disease. The greatest risk for pancreatic cancer among this group was in men with recent tooth loss, although the study was unable to find links between other types of oral health problems, such as tooth decay and pancreatic cancer. The researchers have suggested that there may be a link between high levels of carcinogenic compounds found in the mouth of people with gum disease and pancreatic cancer risk, and that these compounds could react to the gut’s digestive chemicals in a way that creates an environment favorable to the development of pancreatic cancer. However, in a 2012 follow-up study, they couldn’t prove that periodontitis was a cause or result of pancreatic cancer, but they were able to prove that the two were linked.

Heart DiseaseThe connection between dental hygiene and heart disease is a well-known one; researchers from the University of Bristol in the UK and the Royal College of Surgeons in Dublin found that people with bleeding gums from poor dental hygiene were at an increased risk of heart disease. They saw that heart disease risk increased because bacteria from the mouth of people with bleeding gums is able to enter the bloodstream and stick to platelets, which can then form blood clots that interrupt the flow of blood to the heart and trigger a heart attack.

Researchers from Bristol University investigated how the bacteria interact with platelets by mimicking the pressure inside the blood vessels and heart, and found that these bacteria use the platelets as a defense mechanism; by clumping the platelets together, they can completely surround themselves, shielding them from attack by immune cells and making them less detectable to antibiotics.