Floss to Prevent Alzheimer's?

Many of us are guilty of scheduling an appointment with a dentist and as the date gets closer, (or day before) we decide to try to floss (for the first time) or brush away the plaque that has been building up on our teeth for the past six months. Yes, I brush twice a day but flossing? That just seems so time consuming to do every single day. However, I was recently told that flossing can prevent Alzheimer’s disease, so I decided to do some digging.

Alzheimer’s disease is one of the main causes of dementia and affects approximately 4.5 million patients in the United States currently (Kamer et al., 2008). One of the hypotheses to explain the causation of Azheimer’s disease is perpetuating inflammation in the brain that causes the neurodegeneration to occur (Kamer et al., 2008). This inflammation is likely caused by the amyloid plaques and neurofibrillary tangles associated with Alzheimer’s disease (Kamer et al., 2008).  These neurological changes stimulate glial cells to produce C-reactive protein (CRP) (an inflammation reactive protein) and tumor necrosis factor (TNF) that in turn cause glial cells to keep making more (Kamer et al., 2008). This positive reinforcement perpetuates the inflammation in the brain and leads to neurodegeneration.

Periodontal disease is a polymicrobial inflammatory disease that affects the tissues that support the teeth including the connective tissue and epithelium (Singhrao et al., 2014). This can be caused by a build up of plaque causing gingivitis that is common in children and young adults but is reversible (Singhrao et al., 2014). Gingivitis, if left untreated can persist and become chronic/irreversible leading to tooth decay and extend into the connective tissue and bone (Singhrao et al., 2014). It is approximated that 35% of the people between 30 and 90 in the United States with teeth have this disease and it increases in prevalence with age (Singhrao et al., 2014). Due to the increase in systemic inflammation because of periodontitis and its close proximity to the trigeminal nerve endings, it is hypothesized it could be a risk factor in the incidence and progression of Alzheimer’s disease (Singhrao et al., 2014).

To prevent periodontitis participating in good oral hygiene practices is imperative including brushing and flossing regularly. Maybe taking that extra time to floss every day can do more than just appeasing your dentist.

Citations

Kamer, A. R., Craig, R. G., Dasanayake, A. P., Brys, M., Glodzik-Sobanska, L., & de Leon, M. J. (2008). Inflammation and Alzheimer's disease: possible role of periodontal diseases. Alzheimer's & Dementia, 4(4), 242-250.

Singhrao, S. K., Harding, A., Simmons, T., Robinson, S., Kesavalu, L., & Crean, S. (2014). Oral inflammation, tooth loss, risk factors, and association with progression of Alzheimer's disease. Journal of Alzheimer's Disease, 42(3), 723-737.