Periodontal Disease More Than 'Linked' to Alzheimer's Disease?

American Academy for Oral Systemic Health Holds Annual Scientific Conference
Important Links Between Mouth Health and Overall Body Health Presented
(PRWEB) October 22, 2013

    Our very own Chicago based Dental Coach Stephanie Lodding joined with more than 400 health care professionals at the third annual American Academy for Oral Systemic Health Science Meeting recently held in Las Vegas. Conference presenters spoke about the strong connection between mouth health and general health. These include links between oral health and heart disease, stroke, diabetes, Alzheimer’s, and cancer.

    Stephanie noted nearly 80 percent of the American population has gingivitis or gum disease, and 20 million people have sleep apnea. “It is time for something new. We have been telling the same story for years and too many people still have these problems. They are at an increased risk for serious diseases and increase healthcare costs. It’s simply time to change the conversation. We have new information and new ways to test for and treat these conditions.”

    Stephanie added that bleeding gums create an open doorway for harmful bacteria to enter the bloodstream and activate the immune system. “The ultimate goal is to have a healthy mouth and close this pathway. More people are becoming aware of this mouth-body connection and are asking for more complete dental care. Many physicians are insisting on it. We’re all working hard to lower risk factors and people want help doing better,” says Stephanie. “This is all a part of the new trend in dentistry and medicine where physicians and dentists are starting to work closer together to lower healthcare costs and to help manage diabetes, avoid heart disease and stroke and Alzheimer’s, prevent problems during pregnancy, and better control inflammation, among other things.”

    This year’s conference featured 27 presentations focused on the mouth-
body health connection:

  • Amy Doneen MSN ARNP, a national authority on heart disease stroke and diabetes prevention in Spokane Wash., and one of the featured speakers at the conference, stated “poor oral health and germs from the mouth are associated with heart disease, stroke, diabetes, Alzheimer’s, and rheumatoid arthritis.”
  • Dr. James Winde, a sleep physician showed that sleep apnea produces changes in body chemistry that promote inflammation. Winde states that behavior problems in children can also be closely tied to sleep apnea and snoring in children. “Dentists play an important role in developing the jaws and open airways and providing dental appliances when CPAP therapy is not successful,” says Winde.
  • Dr. Judith Miklossy, a leading Alzheimer’s researcher showed oral bacteria can directly cause Alzheimer’s disease. This is a new and exciting area of research and suggests that proper treatment to eradicate these bacteria could prevent Alzheimer’s dementia in the future.
About Stephanie Lodding:

Stephanie has been a full-time practicing hygienist for 21 years. She specializes in cosmetic hygiene and oral systemic care of her patients, with 15 years of experience working beside one of the leading cosmetic dentists in the country. Stephanie is on the Executive Board for the American Academy of Oral Systemic Health (AAOSH) and also is the Current Meeting Chair for 2012-2013. Stephanie has lectured internationally on several topics and is sought-after for her passion and expertise. She has extensive knowledge and background in periodontal therapy and is helping hygienists and doctors transform an average hygiene team into oral health specialists. As a dental coach, Stephanie is passionate about inspiring teams to achieve greater success.

The American Academy for Oral Systemic Health

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    For 100 years, certain bacteria responsible for periodontal or 'gum' disease have been linked to Alzheimer's and general dementia. Why is it still covered like breaking news every time another study comes out linking the two?  Suppose a study came out that went beyond 'Link' and showed 'cause'? Would the media be as excited or would it be ignored?

    It seems that whenever you hear about a chronic disease somehow connected to gum disease the media will refer to it as a 'link.'  'Alzheimer's Linked to Periodontal Disease, Study Finds' or 'A New Heart Disease Link with Gum Disease Found,' the headlines scream. So, what exactly are these 'links?'
    We are talking about a connection between specific oral pathogens and their presence in the affected physical location (brain, heart, arteries, kidney, pancreas, etc.).
    Identifying these pathogens is hard enough, but studies which able to do that are fairly common today. If, however, you could show 'CAUSE,' if you could rule out all other factors that could also be 'causing' the disease and that would be very significant, don't you think?

    I certainly do.

Dr. Judith Miklossy    Dr. Judith Miklossy is a Swedish researcher who completed a study in May of 2011 showing that certain pathogens commonly found to be active in periodontal disease -- certain 'spirochetes' frequently linked to major other diseases as well, are responsible, either fully or in large part, to the onset of Alzheimer's Disease (aka AD).  AD is the most common cause of dementia and a lot of reseach goes into finding a cure.  First, however, the 'cause' of the disease had to be identified, and Dr. Miklossy has done that. Once you have the cause you are on the fast-track to nailing down a cure.  If not a cure, at least a much more focused and effective treatment protocol might be devloped in the meantime.

From her report on the study:
    "These important results, as proposed earlier, indicate that periodontal pathogen spirochetes in an identical way to T. pallidum (cause of Syphillis. -ed.) have the ability to invade the brain, persist in the brain and cause dementia. They also indicate that co-infection by several spirochetes occurs in AD. These findings are in agreement with recent observations showing an association between periodontal diseases and AD."

    This is very good news, isn't it?

    If it is a good study it should get published in one of the professional journals, and it did.  The study was published in the 'Journal of Neuroinflammation' just a couple of years ago.  Of course, If you want to show proof that your research truly does reveal the cause of a disease then you have some hurdles to clear and the research data must satisfy Koch and Hill’s criteria for causality

    It does, and this is really big news -- yet, we don't hear about it.  Where is the media?  I know I read about two other studies this year that, again, show a link between gum disease and Alzheimer's but Dr. Miklossy's study goes further and seems a little more significant, so where is all of the buzz?  A search of any news articles gave me exactly zero results.  Zero.

    Surely the Alzheimer's non-profits would have plenty to say on the findings but a search of their sites revealed absolutely nothing, as well.  In fact, this from the Alzheimer's Foundation of America1:

"The causes of Alzheimer's disease are still unknown."

"Current research indicates that Alzheimer's disease may be triggered by a multitude of factors, including age, genetic makeup, oxidative damage to neurons from the overproduction of toxic free radicals, serious head injuries, brain inflammation, and environmental factors."

"Age is the most important known risk factor for Alzheimer's disease."

    No mention of a connection between periodontal pathogens and AD.

    A small possibility of mention may come from the Alzheimer's Association2, if you read between the lines:

"Here are some things to keep in mind about the research underlying much of our current knowledge about possible prevention:

    "Insights about potentially modifiable risk factors apply to large population groups, not to individuals. Studies can show that factor X is associated with outcome Y, but cannot guarantee that any specific person will have that outcome. As a result, you can "do everything right" and still have a serious health problem or "do everything wrong" and live to be 100."

    "Much of our current evidence comes from large epidemiological studies such as the Honolulu-Asia Aging Study, the Nurses' Health Study, the Adult Changes in Thought Study and the Kungsholmen Project. These studies explore pre-existing behaviors and use statistical methods to relate those behaviors to health outcomes. This type of study can show an "association" between a factor and an outcome but cannot "prove" cause and effect. This is why we describe evidence based on these studies with such language as "suggests," "may show," "might protect," and "is associated with." 

    Well, Dr. Miklossy DID prove cause and effect, met the criteria...yet over two years later is being ignored by the big players.  Heck, they don't even acknowledge the connection with periodontal disease-related pathogens at all, though the message has been loud and clear for years.  Oddly, the Alzheimer's Association does acknowledge an association with AD and cardiovascular disease3, but again, do not acknowledge the long-standing links between cardiovascular plaque and periodontal pathogens:

Heart–head connection

    "The risk of developing Alzheimer's or vascular dementia appears to increase as a result of many conditions that damage the heart or blood vessels. These include high blood pressure, heart disease, stroke, diabetes and high cholesterol. Some autopsy studies show that as many as 80 percent of individuals with Alzheimer's disease also have cardiovascular disease."

    "A longstanding question is why some people develop hallmark Alzheimer's plaques and tangles but do not develop the symptoms of Alzheimer's. Vascular disease may help researchers eventually find an answer. Autopsy studies suggest that plaques and tangles may be present in the brain without causing symptoms of cognitive decline unless the brain also shows evidence of vascular disease. Many experts believe that controlling cardiovascular risk factors may be the most cost-effective and helpful approach to protecting brain health."

    It is humorous, but both organizations indicate that 'age' as being the biggest risk factor in developing dementia.  Does this mean that our best shot at preventing Alzheimer's Disease is in not growing old?  Sounds good to me!  Where's the protocol?

Prevention Alzheimer - International Foundation    You just have to wonder why these organizations ignore this good research.  Being that this is the time of year that many well-off Americans make their charitable contributions to these and other huge non-profits, personally, I would skip these two and steer my assistance to Prevention Alzheimer - International Foundation4:

Mission Statement Opening

"Our mission adheres to the view of Henry Wisniewsky (1978) and Zaven Khachaturian (1985), two internationally recognized outstanding scientists, that a slow acting infectious agent, acquired at an early age and requiring decades to cause dementia, can play a role in Alzheimer disease. It also adheres to the view expressed by Barry Bloom, previous Dean of the Harvard School of Public Health: "If an infectious agent is responsible for even a portion of these diseases, that could change the outlook for treatment and prevention dramatically."

    Taking a look at our little perio pathogen friends and the decades of links between them and heart disease, you might suspect that the American Heart Association (AHA) would be on board and seriously supporting research into this area.  Let's see...

Peter B. Lockhart, DDS    In a statement issued by the American Heart Association early in 2013, lead author, Peter B. Lockhart, D.D.S. emphatically denied any proof whatsoever that periodontal disease caused heart diseases.  He stated that the data was very confusing, even after his group reviewed over 500 studies, they found nothing that showed a causative relationship between the two.

    The media went on a frenzy due to misinterpreting Dr. Lockhart's statement and their reports implied that the AHA denied any connection whatsoever.  The AHA issued a statement a month later clarifying their position after the scientific community demanded they do so.

From WebMD5:

    Kenneth S. Kornman, DDS, PhD, editor of the Journal of Periodontology, said the review found that there is an independent association between heart disease and gum disease. That means that people who have one are also more likely to have the other. That's true even if they don't smoke or have diabetes, two things that are known to drive up the risk for heart and gum disease. It's not yet known why the two frequently occur together.

    He said it's also true that there's no evidence to show that gum disease causes heart disease, but that's because studies that could prove that have not been done.

    "We have to be careful," Kornman says. "We don't want to say to the public, [gum disease] doesn't cause heart disease. The fact is that we don't know."

    Still, Lockhart says people deserve to understand that the benefits of treating gum disease may be more limited than they had believed.

    "We have to tell patients what we know and not what we think," he says.

    Right, and I believe that Dr. Kornman is correct, "The fact is that we don't know."  But we do know that there is a connection, it is just that no research has shown 'causation' as yet.

So just what is the dental profession telling patients?

    In a survey of 484 readers, we asked,

"Has your dentist or hygienist ever discussed with you the connection between dental diseases and other systemic illnesses, such heart disease, Alzheimer's or diabetes?"

70%    No, never.     
17%    Yes, I think it was mentioned. 
  5%    Yes, and they really harp on me about it. 
  3%    Yes, and they have me on a specific home-treatment protocol. 
  5%    No, I had to tell them about it. 

    The ADA is at least acknowledging the connections between oral health and systemic health and a search of the ADA website will bring up several articles either referencing or focusing on them.

    One article in particular introduces us to Dr. Hema Patel, a dentist from Freemont, CA.  Dr. Patel put together a program for Stanford University medical faculty, residents and medical students in an effort to bridge the gap between medicine and dentistry.

Dr. Hema Patel
    “My goal was to collaborate on an oral health curriculum in medical schools,” said Dr. Patel. “Residents and students should have more oral health education than is usually offered at medical schools. Everything that happens in the oral cavity reaches the rest of the body, and patients are living longer with more chronic illnesses. All health professionals can better serve their patients if they have a sound knowledge of oral health.”6

    While this is encouraging, the ADA remain adamant about keeping the medical and dental professions separate.  Fortunately, there are a few out there who see a need and are attempting to address it -- and we should benefit.  Until then we are on our own.

    As for me, I have always felt that with all of these links to oral health, diseases such as Alzheimer's, heart and circulatory diseases, Diabetes, E.D., Prostate and pancreatic cancers and more being recognized on a regular basis, might be prevented by understanding and taking better care of my oral health.  If I'm wrong, at the very least, I hope to avoid a mouthful of loose teeth, nasty, oozing gums and/or a mouthful of expensive implants.  Thanks to Dr. Judith Miklossy, I may just be able to add Alzheimer's Disease to that list, if I do a good job!

1.  http://www.alzfdn.org/AboutAlzheimers/research.html
2.  http://www.alz.org/research/science/alzheimers_prevention_and_risk.asp
3.  http://www.alz.org/research/science/alzheimers_prevention_and_risk.asp
4.  http://www.preventionalzheimer.org/main.html?src=%2F#2,0
5.  http://www.webmd.com/oral-health/news/20120418/no-proof-gum-disease-causes-heart-disease-aha?page=2
6.  http://www.ada.org/news/7136.aspx

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