Reducing oral bacteria in those with mild dementia
Research type
Research Study
Full title
Feasibility study to reduce oral bacteria and improve periodontal health in those living with mild dementia
IRAS ID
174981
Contact name
Shelley J Allen-Birt
Contact email
Sponsor organisation
University of Bristol
ISRCTN Number
ISRCTN74980794
Clinicaltrials.gov Identifier
297965, Sponsors Registered Charity Number
Duration of Study in the UK
3 years, 11 months, 31 days
Research summary
There is a strong association between periodontitis (gum disease) and increased risk for Alzheimer's Disease (AD), a common cause of dementia. The immune system is implicated in the initiation and progression of AD. With ageing, the nonspecific (innate) immune system plays an increasing role in infection control. Aβ (in amyloid plaques) may be triggered by the presence of bacteria as part of an innate immune response and amyloid plaques are at higher density in AD brains. One source of chronic bacterial infection is the mouth, an area generating systemic immune tolerance. Many of the bacteria we (and others) have found at higher levels in AD brain samples come from the mouth. We propose that deep seated anaerobic bacteria in gum margins may ultimately pose a threat to cognitive function. These anaerobes trigger the release of inflammatory cytokines from human innate cells which may increase the permeability of the blood-brain-barrier to bacteria and their toxins. Once in the brain, bacteria activate microglia and other cells which release toxic levels of Aβ, exacerbating neuronal damage. We hypothesise that reducing oral bacteria will slow dementia trajectory. Short-term reduction of bacteria able to access the brain, by cleaning the mouth and gum margins, may reduce inflammation resulting in a temporary improvement. Long-term reduction of bacteria by effective dental hygiene may help sustain this and prevent further neuronal degeneration. We wish to conduct a feasibility study including up to 20 mild dementia patients with periodontitis, to determine the effect of periodontal stabilisation therapy. This will allow assessment of compliance, how well patients cope with treatment and whether improving periodontal health is possible for these patients. This will enable an application for funding for a larger trial to assess whether this approach can slow dementia symptom progression.
REC name
South West - Frenchay Research Ethics Committee
REC reference
15/SW/0343
Date of REC Opinion
22 Jan 2016
REC opinion
Further Information Favourable Opinion