In a recent article we discussed the connection between Alzheimer’s disease and periodontitis. For one group of patients, this link may create a significant risk of dementia in later life, and that group is people with Down syndrome. Down syndrome patients are often infected with the bacteria most responsible for periodontitis, Porphyromonas gingivalis. In addition, more than 50% of them over the age of 60 show signs of dementia. This is one more piece of evidence demonstrating the link between gum disease and Alzheimer’s type dementia. Why are Down syndrome children infected so easily, what are the consequences, and how can families help to prevent gum disease in a relative with Down syndrome?
Why Do Down Syndrome Patients Get Periodontitis?
Oral bacteria cause gum disease. Although oral hygiene plays a large part in preventing gingivitis and the more serious periodontitis, the immune system also plays a role. Unfortunately, Down syndrome patients are known to have weaker immune systems as a result of their disorder. Therefore, they typically face extreme gum disease at much younger ages than the rest of the population. By age five, for example, far greater numbers of Down syndrome children test positive for P. gingivalis than others of the same age.
Consequences of Gum Infections
For Down syndrome children, gum infections may cause the premature loss of their primary teeth, long before they are expected to fall out and be replaced by permanent teeth. They also tend to suffer from a higher incidence of cavities. And later in life, they show very high concentrations in brain tissue of the proteins that are connected with Alzheimer’s disease.
For Down syndrome adults, this symptom may be caused by two different, but related factors. First, the extra chromosome the leads to Down syndrome is the one that carries the gene for producing the protein amyloid-beta (also called beta-amyloid), giving every cell three chromosomes with directions for producing this known component of Alzheimer’s disease. Second, infection in the brain tissue with P. gingivalis is shown to increase amyloid-beta production by brain cells. Therefore, Down syndrome adults above the age of forty typically show signs of amyloid-beta in the brain tissues at levels far beyond the rest of the population. Although dentistry has no solution for the first problem, it does have solutions for the second.
Preventing Periodontitis in Down Syndrome Patients
A 2016 Brazilian review of the scientific literature on this subject found that two important factors determine the likelihood of preventing serious gum disease in a Down syndrome child or adult. The most important step to take is for a capable adult to assist them with oral hygiene by monitoring their technique. In effect, this makes certain that they receive the same quality oral care that is practiced by people free of gum disease. Next is making regular visits to the dentist. The Sacramento Dentistry Group offers to see patients quarterly or on a trimester basis for their teeth cleanings, instead of the standard semi-annual appointment schedule. Finally, it does appear that prescription mouthwashes designed to effectively kill oral bacteria assist greatly in gum disease prevention, but only if combined with the above behaviors.
For more information about how you can prevent periodontitis in your family or for your Down syndrome patients, contact the Sacramento Dentistry Group today!