2023-05-12 13:23:31
Eight out of 10 adults over the age of 35 have some form of periodontal disease. Periodontal disease or periodontitis is a chronic inflammatory condition caused by bacteria that coat the surface of the roots of the teeth. If left untreated it can lead to bone loss around the teeth, infection, and tooth loss. Treatment consists of cleaning teeth above and below the gum line and some more serious cases surgery is required. In addition to its relationship with cardiovascular diseases, already demonstrated, it has been discovered that it is also associated with diseases such as Alzheimer’s or stroke.
He has just been warned Spanish Society of Periodontics and Osseointegration (SEPA) and the Spanish Society of Neurology (SEN) in a consensus report stating that periodontitis not only increases the risk of ischemic stroke and Alzheimer’s dementia, but it is also considered that different oral health interventions can reduce the risk of suffering from these neurological disorders.
The report, says the vice president of SEPAPaula Matesanz, “shows that periodontitis increases the risk of ischemic stroke and Alzheimer’s dementia.”
In this sense, José Miguel Láinez, president of the Spanish Society of Neurology (SEN)“risk markers such as periodontitis are of great help in trying to avoid, reduce or minimize the impact of these neurological disorders”.
Of all the neurological diseases, this report has analyzed the two for which there is the greatest scientific evidence of their relationship with periodontitis: cerebrovascular disease and dementia. The report reports the evidence from three clearly defined points: the epidemiological association between periodontitis and these two neurological diseases, the biological mechanisms that may explain these associations, and intervention studies on the effect of periodontal treatment as a primary or secondary preventive measure for stroke. and dementia.
Based on the epidemiological data extracted from studies evaluated in this report, “it is estimated that people with periodontitis have a 1.7 times greater risk of suffering from Alzheimer’s dementia and a 2.8 times greater risk of suffering an ischemic stroke than periodontally healthy people.” », highlights Yago Leira, periodontist and coordinator of the working group SEPA-SEN.
Now, says Anne Frank, head of the Neurology Department of the La Paz University Hospital (Madrid) and member of the group SEPA-SEN “It would be very important to have epidemiological studies that confirm this relationship and, above all, studies that help us to know in detail the mechanisms involved.”
In this sense, the suspicions revolve, fundamentally, on the inflammatory hypothesis; Specifically, as this expert explains, “it is speculated that this link may be due to the inflammatory effect produced by periodontitis, a chronic, low-grade but persistent inflammation in the body that triggers an inflammatory cascade, which ends up not only causing negative consequences at a neurological level but also in other target organs, which would also explain its incidence in cardiovascular health or diabetes”.
It is estimated that people with periodontitis have a 1.7 times greater risk of suffering from Alzheimer’s dementia and a 2.8 times greater risk of suffering an ischemic stroke.
Specifically, in ischemic cerebrovascular disease, there is experimental evidence on how the chronic immunoinflammatory response of periodontitis triggers a prothrombotic state of hypercoagulability and vascular endothelial dysfunction that can increase the risk of cerebral embolism/thrombosis.
In the case of Alzheimer’s disease, according to Leira, “studio crowds in animals have shown that bacteremia and endotoxemia that occur in periodontitis, together with a state of chronic low-grade inflammation, contribute significantly to the development of neurodegenerative processes involved in cognitive dysfunction, such as neuroinflammation and neuronal death. , the formation of senile plaques due to deposits of amyloid beta peptides as well as the appearance of neurofibrillary tangles due to hyperphosphorylation of the Tau protein».
Currently, there are no randomized clinical trials that study the impact of periodontal treatment in reducing the risk of stroke and dementia, and there are no intervention studies on secondary prevention of these pathologies. However, as clarified in the SEPA-SEN report, there are various publications observational studies in which it is suggested that different oral health interventions can reduce the risk of suffering stroke or dementia.
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