June is Alzheimer’s and Brain Awareness Month—providing an opportunity to take steps to reduce your risk for dementia, often referred to as the scariest disease on the planet.
Did you know that the health of your gums is directly related to your risk for memory loss? In this blog, I’ll share how caring for your gums can reduce your risk for Alzheimer’s and heart disease.
Dementia is the most expensive disease in the western world today, and Alzheimer’s disease is the most common form of advanced memory loss. Over 6 million people have Alzheimer’s disease in the USA and globally, by 2050, the numbers of afflicted persons will triple to 115 million.
Dementia doesn’t usually happen overnight. In fact, its stages progress slowly over about 20 years. The first stage typically has no symptoms and features a gradual cognitive decline over the first five years. The 2nd stage lasts about 10 years as a person becomes more forgetful to the point that the afflicted person and family become aware of the loss in cognitive function without being gross impaired. The 3rd stage lasts about 5 years and is technically called Mild Cognitive Impairment, when a person is more impaired, might lose their job, but can sometimes still live on their own. This third stage terminology of “Mild Cognitive Impairment” is somewhat misleading, as the loss in abilities is clearly more than mild. The 4th stage is dementia, when is a person is now mentally disabled and no longer able to care for themselves; a state we would all hope to avoid at this point, we become a burden on the people we love.
There are multiple factors that contribute to this gradual decline, and we are beginning to realize that if we act early, we should be able to prevent 60-80% of cases of dementia.
The most common cause for memory loss in people is insulin resistance and elevated blood sugar levels. The latest research has shown that just bringing blood sugar levels to normal and restoring proper insulin sensitivity would help avoid 60% of cases of Alzheimer’s disease. This is a dramatic finding! For details on this insulin resistance and cognitive decline connection, read The Better Brain Solution.
We have also discovered that nutrient deficiencies, such as vitamin B12, mixed folates, magnesium, vitamin D, and omega-3 fats, also contribute to memory loss. As does our exposure to common toxins in our environment such as mercury, lead, inorganic copper, and nitrosamines.
Another reversible cause of memory loss is inflammation. The largest source of inflammation in our body is our gut, especially when it leaks (leaky gut syndrome) or is loaded with the wrong microbes (dysbiosis of the gut microbiome).
Many of us do not realize that the second leading cause of inflammation in the body is the lining of your gums, called gingivitis. Imagine if one of your arms was covered in a bright red rash—that would get your attention, right? And do you know that the surface area of your gums inside your mouth is about the same size as the surface area of your arm?
While examining patients in my clinic, I have been astounded by the widespread gum inflammation I see and yet they often do not think it is a serious matter.
Over the last decade, the medical world has come to realize that gum (periodontal) health is a major risk factor for inflammation. Studies have shown that the more gum inflammation (gingivitis) you have, the higher your levels of hs-CRP become (a simple and inexpensive blood test and an excellent systemic marker for inflammation). Elevated hs-CRP levels are not only related to systemic inflammation, but they also increase your risk for heart disease and growth of arterial plaque. So, yes—taking better care of your gums will help prevent heart attacks and strokes.
More recently, studies have shown that gingivitis directly contributes to brain inflammation as well. Over the past 10 years, studies have shown that chronic periodontal disease increases the risk for Alzheimer’s disease by 70%, similar to the risk for using tobacco or being obese.
Not only is the inflammation a problem, but inflamed gums promote the growth of bad bacteria, such as Porphyromonas gingivalis (P gingivalis), which is associated with the growth of beta-amyloid brain plaques.
What can you do to reduce your risk for gingivitis, inflammation, heart disease, and cognitive decline?
An easy approach would be to take better care of your gums, specifically:
- Brush your teeth at least twice per day
- Floss daily
- Use a water pick daily
- See your local dental hygienist 2-4 times per year for a cleaning (frequency varies with the health of your gums)
Eating the right foods is another important step to protect our heart and your brain.
Here is my Better Brain Solution list of a dozen foods to eat more often:
- Green leafy vegetables
- Other colorful vegetables
- Omega-3 rich seafood
- Olive oil and other healthy cooking oils
- Organic berries and cherries
- Cocoa and dark chocolate
- Tea and coffee in moderation
- Red wine in moderation
- Spices and herbs
- Beans (they have a low glycemic load)
- Probiotic sources
Combining the right foods with better periodontal health is a smart and important step to prevent cognitive decline.
Dr. Masley’s Six Steps to a Better Brain:
- Eat the right foods (plant-based, smart fats, with a low glycemic load), and avoid sugar.
- Meet essential nutrient needs (in particular magnesium, vitamin D, a good quality multivitamin, adequate fish oil, and a source of fiber and probiotics).
- Add activity, both aerobic & fitness strength training, and mentally challenging activities.
- Proactively manage stress.
- Avoid brain toxins (mercury, lead, inorganic copper, pesticides, and nitrosamines).
- Optimize the health of your gums.
In my clinic, this combination of interventions has been shown to increase brain processing speed by 25%, making you mentally sharper.
It also has the potential to prevent up to 80% of memory loss and Alzheimer’s disease, and lead to a lifetime of vitality.
I wish you the best of health,
Steven Masley, MD, FAHA, FACN, CNS
There is a strong association between periodontal health and cytokine levels. After the gut, the mouth is the second most common cause for inflammation. Those with periodontal disease have higher hs-CRP levels, and those with more gingivitis have higher carotid IMT scores (arterial plaque). Franek E et al. Intima-media thickness in patients with type 2 diabetes & periodontal disease. Source Dept of Internal Diseases, Central Clinical Hospital Warsaw Poland, 2012
Cognitive testing in middle aged adults in the Atherosclerosis Risk in Communities study (ARIC) has also shown that those with infrequent tooth brushing and increased gingival plaque over six years had lower cognitive scores for digital symbol substitution and word fluency. Naorungroj et al. Cognitive Decline and Oral Health. J Dent Res 2013 Sep; 92(9): 795-801.
In a five-year study of men and women averaging 80 years of age, severe periodontal disease and periodontal inflammation are both associated with an increased risk for cognitive decline. This Alzheimer’s disease risk is similar to the risk associated from tobacco use (50-70% ↑ risk) or for obesity (70-100% ↑ risk). Kimura Y, Ogawa H, Yamaga, T, et al. Periodontitis, periodontal inflammation, and mild cognitive impairment: A 5-year cohort study. J Periodontal Res. 2019 Jun;54(3):233-240.
Similar to how abnormal microbes within the gut microbiome have been identified as a risk factor for cognitive decline, specific periodontal microbes are similarly linked. Especially, Porphyromonas gingivalis (P. gingivalis), a type of periodontitis-related bacteria, was frequently detected in autopsy brain tissues of patients with AD. In contrast, the bacteria were not detected in normal human brain tissue. Matsushita K, et al. Periodontal Disease and Periodontal Disease-Related Bacteria Involved in the Pathogenesis of Alzheimer’s Disease. J Inflamm Res 2020; 13: 275–283.
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