Mother Always Said, “Brush Your Teeth”

Leaving the dentist’s office last week, I was presented with a goody bag. A toothbrush, toothpaste and dental floss. Regrettably, there was no dark chocolate Snickers bar. There was, however, a one page article.  As the title did little to explain the content, I decided to at least read the first paragraph. I then read the entire article.

The general purpose of the column was to share current dental research findings. This particular study was focused on periodontal disease and its relationship to Alzheimer’s disease.  Teeth and gums that are neglected lead to bacterial build up which in turn leads to inflammation aka periodontitis…inflammation around the teeth.  There have been postmortem studies which indicate that periodontal bacteria travels to the brains of patients with AD during their lifetimes.  While not conclusive, the growing body of evidence suggests that while periodontal disease does not cause Alzheimer’s disease, there could be a contributory factor.

Dr. Richard Nagelberg, DDS, the author, goes on to say that the evidence linking periodontal disease to vascular dementia is “bulletproof.” It is the inflammation, which again is the culprit.  He also goes on to describe the association between periodontal disease and diabetes.  Periodontal disease negatively influences glycemic control by increasing insulin resistance. Here he refers to inflammatory cytokines (a protein that impacts on cell behavior) released in response to periodontal disease.

The message is clear. The mouth, like any other part of the body, requires maintenance and attention. Despite this, over the years this geriatric care manager can count the number of clients who have gone to the dentist in their later years. And here in Westchester County, New York, we even have dentists who make home visits.

So why is the dentist not part of the plan of care?  The senior feels he is old so why worry about old teeth. Another older adult feels her teeth are not bothering her, so why make a fuss. And a visit to the dentist cost money and Medicare does not pay (true!) Whatever the reason, as caregivers and care managers, we have a responsibility. As Dr. Nagelberg pointed out, we must recognize the mouth/body connection.