Demetia and periodontal disease-Which came first the chicken or the egg?


Its been documented that there is a real correlation between gum disease and dementia but so far there is no definitive proof of a cause and effect, ie does poor oral hygiene put someone at greater risk for dementia ? Possibly since studies have shown that some people with dementia have been found to have the bacteria P Gingivalis in their brains. So which came first Dementia or poor oral hygiene?

No one really knows and no one to my knowledge has designed a study that has been able to prove cause and effect. Actually My own Grandmother had a rip roaring case of periodontal disease in her forties and had all her teeth removed and only developed Alzheimers disease when she was in her eighties after having worn a full denture for forty years so its safe to say that plaque had nothing to do with her mental decline.

I will confirm that in my own practice I have followed most of my elderly  patients for years and see them regularly. I have noticed that their dental hygiene seems to worsen as their mental accuity worsens. When I see them on their recall visit they often have a bumper crop of dental plaque and also  seem to have a diminished mental acuity as well. Which came first? I believe their dementia may be the cause of their poor plaque control but that's just my hunch.

How designing a  study that will clear up the relationship between dementia and periodontal disease. Here's my idea for a study.  Assign  two group of patients,  both of which have been diagnosed with dementia. One group will get their teeth brushed and cleaned by a trained aide daily and the other group should stick to what ever they normally do.  This seems to be a doable study since most people suffering from significant dementia do have aides or family to assist them and having a caregiver brush and clean their teeth intra proximally will only take about 5 minutes a day.
 six months both groups should receive cognitive testing to see if their is a difference with both groups. If needed this study could be extended longer and should provide an answer to our question.

from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/04/demetia-and-periodontal-disease-which.html - http://lspindelnycdds.blogspot.com/

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