34 replies to this topic

[Turnbuckle]

A retrospective cohort study from a month ago shows an effect, but a rather small one for chronic periodontitis -- around 5% additional risk--

 

Association of Chronic Periodontitis on Alzheimer's Disease or Vascular Dementia

 

Compared with healthy participants, [Chronic Periodontitis] patients had a higher risk for overall dementia (aHR = 1.06; 95% CI = 1.01‐1.11; P = .015) and AD (aHR = 1.05; 95% CI = 1.00‐1.11; P = .042).

https://onlinelibrar....1111/jgs.15828

 

 

Compare this 1.05 increase in relative risk versus a 2-3 increased risk for one APOE4 gene and a 12 fold increase for two. Not in the same ballpark.

 

One gene has 20-40 times the effect of periodontitis (which is further along than gingivitis), and two genes 220 times the effect.

 

The APOE4 allele, present in approximately 10-15% of people, increases the risk for Alzheimer's and lowers the age of onset. Having one copy of E4 (E3/E4) can increase your risk by 2 to 3 times while two copies (E4/E4) can increase the risk by 12 times

https://www.alzdisco...for-your-health

 

 

Edited by Turnbuckle, 14 April 2019 - 07:14 PM.

[xEva]

A retrospective cohort study from a month ago shows an effect, but a rather small one for chronic periodontitis -- around 5% additional risk--

 

 

Compare this 1.05 increase in relative risk versus a 2-3 increased risk for one APOE4 gene and a 12 fold increase for two. Not in the same ballpark.

 

One gene has 20-40 times the effect of periodontitis (which is further along than gingivitis), and two genes 220 times the effect.

 

 

The original study, Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors, 2019, addresses this question. They say, APOE is involved in innate immune function, and that APOE4 variant may be more susceptible to P.gingivalis toxins:

 

Studies in mice deficient in APOE proteins demonstrated an impaired innate immune response to the bacterial pathogen Listeria monocytogenes, implicating APOE in normal innate immune function in vivo. It was recently reported that human APOE is a target of gingipain proteolysis, and the authors suggested that this mechanism could generate neurotoxic APOE fragments in the AD brain. We propose that APOE4 may be more susceptible to gingipain cleavage than APOE3 or APOE2 due to the presence of more arginine residues, resulting in decreased innate immune function and the generation of neurotoxic fragments.

 

 

It could be that gingivitis + APOE4 is really bad news (and not everyone with APOE4 develops AD -- maybe because they did not have this nasty bug?). By the same token, gingivitis + APOE3/2 may result in milder or later onset disease, because of a more effective innate immune response -?

[Turnbuckle]

 

 

It could be that gingivitis + APOE4 is really bad news (and not everyone with APOE4 develops AD -- maybe because they did not have this nasty bug?). By the same token, gingivitis + APOE3/2 may result in milder or later onset disease, because of a more effective innate immune response -?

 

 

What is the biggest cause of gingivitis? Not brushing your teeth. People who don't take care of their teeth can be expected to be less health conscious in general, so to pick one thing where there are likely many things going on is not particularly scientific, especially as it is a tiny effect that is dwarfed by APOE4 genetics.

[xEva]

Not really. Some people rarely brush teeth and yet never develop gingivitis. A relative of mine, born and raised in a village in Russia in the beginning of the last last century, never brushed teeth, and yet, by the age of 47, had no gingivits and only 1 cavity. I think genetics plays a major role here (some people's saliva has a more winning composition than others). But maybe that was an exception. 

 

I believe that, for an average individual with average oral hygiene, the luck of the draw ends with this bacterium. It has very nasty virulence factors, which flair up when the person is stressed and/or undernourished and, not to forget, which also affect the virulence of other bacteria. That's what makes it an exceptionally nasty bug among the rest run of the mill pathogens.

[Turnbuckle]

Not really. Some people rarely brush teeth and yet never develop gingivitis. A relative of mine....

 

 

Anecdotal reports don't stand up to the statistics--

 

Therapeutic mouthwash (MW) is an adjunctive tool along with a regular oral hygiene routine of daily tooth brushing and daily flossing. Previous systematic reviews have demonstrated that it is effective against dental biofilm and gingival inflammation...

https://www.ncbi.nlm...pubmed/30733843