Is There Really a Solid Correlation Between Periodontitis and Risk of Neurogenerative Disease?

A number of papers in recent years have suggested there to be a link between gum disease (periodontitis) and neurodegeneration. Similarly to the correlation with heart disease, it is thought that the underlying mechanism is raised chronic inflammation deriving from toxins released into the bloodstream by the bacteria that cause gum disease. Some epidemiological data suggests that the effect size is modest at best, however - a 6% increase in risk in one cohort, for example. So is there in fact a meaningful link between inflammatory gum disease and forms of neurodegeneration that are thought to be driven in large part by the chronic inflammation of aging? The hypothesis seems reasonable, but as today's open access paper notes, the evidence to date is just not that great.

This is often the way of things in research into the contributing mechanisms of age-related diseases. Having gingival bacteria release immune-provoking compounds into the bloodstream sounds like something to be avoided, and one can find plenty of evidence for this mechanism to exist. The bacteria are definitely there in the mouth, the immune response to their presence established in various ways. But is it causing enough harm in comparison to all of the other damage and dysfunction of an aged metabolism to be influential outside the local issue of gum disease?

Perhaps, perhaps not; the epidemiological data as it stands isn't enough for a concrete conclusion when taken collectively. This may be a case of where there is smoke there is fire, and better and larger studies would produce conclusive outcomes, but it is hard to say in advance. Nonetheless, it is near universally agreed that maintaining as low a level of chronic inflammation as possible with advancing age is a good idea.

Is There Any Association Between Neurodegenerative Diseases and Periodontitis? A Systematic Review

Some inflammatory diseases, such as periodontitis, might represent a factor that can contribute to central nervous system (CNS) damage. Periodontitis is a multifactorial chronic inflammatory disease that affects the supporting tissues around the teeth, triggered by dysbiotic biofilms that can lead to systemic inflammation. Periodontal disease is one of the most frequent causes of tooth loss, and is highly prevalent in adults affecting about 20-50% of the global population. It can lead to a systemic inflammatory state through mechanisms that include the spread of pro-inflammatory cytokines and/or bacteria located in the oral cavity. Persistent systemic inflammation/infection can cause neuroinflammation in the brain. Considering this possible interaction, the present study aims to systematically review the evidence supporting the association between the presence of some neurodegenerative disease and periodontitis.

From 534 articles found in this systemic review, 12 were included, of which eight were case-control, three were cross-sectional, and one was a cohort, giving a total of 3,460 participants. All studies presented a low risk of bias and reported an association between neurodegenerative disease and periodontitis. The articles showed that the groups with the two concomitant diseases had higher inflammatory markers levels, IgG levels of periodontal bacteria, and/or clinical parameters of periodontitis compared with the isolated conditions. However, the heterogeneity of the studies taken together hindered the accuracy of the evidence and also made impossible the merging of data. Also, it should be highlighted that no cohort study was retrieved regarding the association between periodontal disease and neurodegenerative diseases; therefore, causality cannot be claimed.

Although all the included studies in this review reported an association between neurodegenerative diseases and periodontitis, the level of evidence was classified to be very low, which suggests a cautious interpretation of the results.

Comments

It's probably as solid as all the conclusions based on rodent studies on neurogenerative diseases.

Differences in human, mouse brain cells have important implications for disease research
https://www.sciencedaily.com/releases/2021/06/210625173158.htm

'A UCLA-led study comparing brain cells known as astrocytes in humans and mice found that mouse astrocytes are more resilient to oxidative stress, a damaging imbalance that is a mechanism behind many neurological disorders. A lack of oxygen triggers molecular repair mechanisms in these mouse astrocytes but not in human astrocytes. In contrast, inflammation activates immune-response genes in human astrocytes but not mouse astrocytes.'

It's probably a good idea to sell all those biotech stocks whose business ideas are based on neurogenerative disease studies done on rodents.

Posted by: Jones at June 27th, 2021 11:31 AM

Humans are not 100-200lbs mice. Murine brains become senile before humans have grown to 70% off there brain size. The mice can live all their lives without any long-term repair activity and see no appreciable difference. Pet dogs and cats would be a better model since they love till old age, are exposed to abundant food and usually luck enough exercise. The experiments, of course, should exclude intentional damage ...

Posted by: Cuberat at June 27th, 2021 9:32 PM

I'm finally nearing the end of my battle with periodontal disease. Stupid me thought I could self probe my gums with a perio-probe bought online in front of the mirror and that flossing/brushing would surely reveal the disease early on. But turns out instinctive pain avoidance made me miss it completely.
Now I had 4 sessions of subgingival cleaning with ultrasonic scalers, use every interdental brush between 0.4mm to 1.3mm even for incisors. Two incisors lost 50% of the skeleton surrounding them. The bone loss started in the approximal spaces where the floss was not enough to clear out subgingival grooves but when the bone loss started it fanned out and surrounded the tooth on the buccal and lingual sides. The pain from using the brushes was tremendous early on, even now it's a disgusting procedure. All those natural cures promoted on facebook like rinsing coconut oil, colloidal silver, ginger, curcumin etc do nothing next to scaling and interdental brushes.

I want a Perio-Vaxx so bad

Posted by: Arren Brandt at June 30th, 2021 2:14 AM
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