New research links dental health and Alzheimer’s. In this post you’ll get 10 action items you can use to protect your brain during covid-19, and when things are back to “normal.”
Let’s get a little background, and then think strategically about what to do with this information. Taking action is where the rubber meets the road, otherwise you’re just finding out one more depressing fact.
Brain health, particularly Alzheimer’s and other forms of dementia, is almost always the biggest fear people have about their long term health and quality of life. Meanwhile, during the covid-19 pandemic, many people are reducing “routine” dentist visits. In fact, the World Health Organization currently recommends “routine” dental care be delayed until covid-19 transmission rates are reduced.
New research strongly links dental health to brain health, and the clearance of Amyloid beta which is crucially involved in Alzheimer’s disease as the main component of the amyloid plaques found in the brains of people with Alzheimer’s disease.
The World Health Organization’s August 2020 guidance on oral care still recommends that non-essential oral health check ups, dental cleanings and preventive care be delayed until there has been “sufficient reduction in (COVID-19) transmission rates.” If you need to go to a dentist during the pandemic, I would recommend reviewing this August 2020 document “Considerations for the provision of essential oral health services in the context of COVID-19” While the short document linked here is intended for oral care and public health professionals, it contains information that may help you assess your risks and help you determine questions that you may want to ask your provider in advance of a procedure.
Pathogens that may act as a trigger or co-factor for Alzheimers include p gingivalis, the key pathogen in chronic periodontitis. A 2010 survey in the USA concluded that 47.2% of adults aged 30 years and older had periodontitis. P gingivalis is adept at evading the immune system. Once it has crossed the blood brain barrier it can cause neuroinflammation.
At this point, while the association with p gingivalis and alzheimers is strong, we can’t say whether p gingivalis is found in alzheimer’s brains because Alzheimer’s patients are prone to microbial infections, or because the microbial infection is a cause of Alzheimer’s disease. However, this study (in mice) study strongly suggests that low grade chronic periodontal pathogen infection can result in the development of neuropathology that is consistent with that of AD. And here, demonstration of a known chronic oral-pathogen-related virulence factor reaching the human brains suggests an inflammatory role in the existing AD pathology.OK, I can keep throwing research at you, but I think you get the point.
It’s notable that underlying inflammation can affect the cardiovascular system as well brain health.
10 Action items to reduce these risk factors and support the health of your mouth, and brain, especially during the covid-19 pandemic:
- Brush thoroughly. Sounds obvious but think about how much time you actually spend brushing your teeth. If you are rushing, you are probably not paying attention to all areas of your mouth, particularly hard to reach areas. It is important to concentrate on the hard to reach areas, which may involve moving your jaw a bit to one side to make space in the far back area of your mouth. I recommend a very soft toothbrush.
- Brush often. If you are able to work from home more, it’s a good excuse to get into the habit of brushing after meals. You visit the bathroom anyway, and your toothbrush is right there! You might be surprised how good it feels.
- Brush your tongue. Your tongue harbors bacteria. You may find your breath smells better, too.
- Get a new toothbrush right now. Change your toothbrush every 30 days unless you have a UV sterilizer or you sterilize it another way. To sterilize your toothbrush on a regular basis. You can submerge your toothbrush in 8 oz water with 1 teaspoon of clorox or other bleach. Rinse your toothbrush well before you use it after sterilizing it in this way.
- Floss. I know, you might hate flossing. The problem is, your toothbrush doesn’t get between your teeth as well as floss does. Keep in mind you’re mainly flossing between the teeth, not forcing the floss under your gums, which can cause damage. If your gums bleed when you floss, this is telling you something. You may already have a problem a dentist needs to address. Don’t let that stop you from flossing and thus compounding the problem. You may find that once your gums get accustomed to flossing, there is less bleeding.
- Water flossing is another option. Water flossers and string floss can sometimes reach different gaps or types of trapped items. I do both, depending on what I ate and how my mouth feels. Remember to use only the gentle settings on the flosser, and do not point the water jet under your gums. Another good thing about water flossing is that the water can clean acids from your teeth. Brushing your teeth with an acidic mouth helps wear away tooth enamel, so if you don’t water floss, at least swish water around your mouth before brushing, particularly after eating or drinking acidic foods. If you really want to go all-in on the reducing acidity front, put a pinch of baking soda in your water flosser water.
- Xylitol Gum: Xylitol seems to target the anaerobic bacteria in your mouth. Anecdotally, some credible people claim it helps repair cavities, but this is not something I have found much research on at this time. You want a piece of gum to have close to a gram of xylitol. I have found I like “Spry” which is available online and at many major stores. If I can’t brush after a meal, I pop a piece of xylitol gum to at least move saliva around my mouth and clear away some of the very small food particles you can’t feel that may be left behind.
- Stay hydrated. You want lots of saliva. Really. Spit is your friend. Also, when you are dehydrated, your saliva is thicker, and is less effective at moving particles off your teeth.
- Breathe through your nose. Mouth breathing dries out your dental tissues. Some people use and quite like mouth tape for sleeping. You can also try to train yourself to breathe through your nose. It helps to gently suction your tongue to the ridge behind your front teeth, and try to breathe in a relaxed manner. This will get you used to breathing through your nose more, and may help you breathe through your nose during sleep. If you have serious trouble breathing through your nose, that is an issue worthy of medical attention. You could have upper airway resistance syndrome, sleep apnea or other serious issues a medical practitioner can help identify and treat.
- Take anti infective action. Having periodontal disease and getting Covid-19 has been called a “pathway to pneumonia”. You want to shift the biofilm to a more healthy balance. An option here is to use hydrogen peroxide (peroxly an oral hydrogen peroxide 3% solution is good if you can get it) mix with baking soda. You can make a little slurry or put the baking soda on your teeth and put a capful of the peroxyl in your mouth and swish it around. You can use a soft pick to squish it in between your teeth. Do not swallow this! If you see blood when you spit it out, you may have an infection. If your mouth is less than very healthy, you should be under the care of a dentist. Another, easier option is to use 1 teaspoon Clorox or other bleach 8 oz water in your water pic. Very safe, effective, inexpensive anti microbial. Don’t ever swallow this! Spit conscientiously and rinse with clean water afterwards just in case.This can also be used to sterilize your toothbrush, see above.
What if you need to have a tooth cleaning or other dental procedure?
Keep in mind tooth cleaning will aerosolize virus, which can be in room air for several hours. Take precautions. Can you be the first person of the day in that room? Is the dentist or hygienist using an n-95 mask without a valve? Inquire about ventilation and air purification used in the office, but be prepared if they don’t have great answers. Office buildings tend to be built for energy efficiency more than air exchange and hepa filtration. Review the WHO guidance linked above for more thoughts.
I hope you found this helpful. The 10 action items above are good for your long-term brain health, pandemic or not. As usual, if you have questions, you can hit me up on Instagram or Twitter.
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Neither Deb Stewart nor any employee of Custom Healthspan LLC is a physician, psychologist, registered or licensed dietitian, certified nutritionist, physical therapist, or other healthcare professional and the scope of his or her consultation services does not include diagnosis, treatment, or cure of any psychological or physical condition, nor do the services replace the necessary services of licensed healthcare providers. None of the content presented constitutes medical or psychiatric advice, nor is it a substitute for treatment. The content on this website is for educational and informational purposes only. Clients should use their own judgement before applying any information herein to their own personal situation. Custom Healthspan LLC disclaims all liability as stated in the Terms and Conditions of Use and Service of this website. Visitors are encouraged to consult a physician before engaging in any Custom Healthspan LLC program or any constituent activity, especially if you suffer or believe you may suffer from a serious psychological or physiological condition or illness.
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