Remember when your dentist told you to floss?
January 24, 2019 7:26 AM Subscribe
We may finally know what causes Alzheimer’s: the bacteria that cause gingivitis getting into the brain. Amyloid plaques could well be an immune response. Mouse model tests look promising in showing a causal relationship. Some preliminary human "are you serious is this a thing" trials with a gingivitis toxin blocker do also. Best news: a gingivitis vaccine is on the horizon.
Wow, this is insane. I hope we can cure/prevent Alzheimers because it is uniquely devastating to watch.
Also, go to the dentist, everyone!
posted by OnTheLastCastle at 7:33 AM on January 24, 2019 [13 favorites]
Also, go to the dentist, everyone!
posted by OnTheLastCastle at 7:33 AM on January 24, 2019 [13 favorites]
Incredibly weak sauce. notice all the qualifiers. This is preliminary data on an immensely multi-factorial disease, and to say "gingivitis bacteria cause altzheimers, stopping them will cure it no more altzheimers" is rankest daily mail type clickbait. flagged.
posted by lalochezia at 7:36 AM on January 24, 2019 [55 favorites]
posted by lalochezia at 7:36 AM on January 24, 2019 [55 favorites]
This is a hoax planted by my dentist in response to my sassy answers* when he asks me to floss more.
*I think of it as a policy of radical honesty.
posted by Bulgaroktonos at 7:38 AM on January 24, 2019 [20 favorites]
*I think of it as a policy of radical honesty.
posted by Bulgaroktonos at 7:38 AM on January 24, 2019 [20 favorites]
If there is a connection (I leave it to actual scientists to judge the quality of this research), I would use this as more ammunition to stop the inexplicable, illogical and incredibly stupid segregation of dentistry from other medical specialties. It needs to become part of regular medical care, no different from cardiac care or urology. People don't get proper dental care because it's either not covered, covered inadequately, and in general treated as a luxury option instead of standard medical care.
But it is standard medical care. Gum infections can cause heart attacks. Maybe they increase the risk of Alzheimer's. Maybe they do all kinds of other things, but we don't know, because we don't treat dentistry like a regular part of medicine, so we're not looking.
/rant
posted by emjaybee at 7:44 AM on January 24, 2019 [276 favorites]
But it is standard medical care. Gum infections can cause heart attacks. Maybe they increase the risk of Alzheimer's. Maybe they do all kinds of other things, but we don't know, because we don't treat dentistry like a regular part of medicine, so we're not looking.
/rant
posted by emjaybee at 7:44 AM on January 24, 2019 [276 favorites]
Thanks for the rant emjaybee, as a dentist I would love to see this happen.
Also, there is a link to the scientific article at the bottom of the article, and it's pretty interesting (and also not paywalled), so before you write this post off as click-bait, have a look
posted by OHenryPacey at 7:48 AM on January 24, 2019 [17 favorites]
Also, there is a link to the scientific article at the bottom of the article, and it's pretty interesting (and also not paywalled), so before you write this post off as click-bait, have a look
posted by OHenryPacey at 7:48 AM on January 24, 2019 [17 favorites]
But it is standard medical care. Gum infections can cause heart attacks. Maybe they increase the risk of Alzheimer's. Maybe they do all kinds of other things, but we don't know, because we don't treat dentistry like a regular part of medicine, so we're not looking.
1000x this. One of my brothers ended up with a chunk of bacteria in his heart that invaded via his gums. It just hung out there, suspended in biofilm, sending sorties of bacteria to infect his blood and organs, and threatening to break off and clog an artery supplying his brain. He spent weeks in the hospital before and after the surgery required to remove it, incurring incredible medical debts. All because he felt like he needed to ration his care, and teeth were not the priority there.
posted by a snickering nuthatch at 7:55 AM on January 24, 2019 [51 favorites]
1000x this. One of my brothers ended up with a chunk of bacteria in his heart that invaded via his gums. It just hung out there, suspended in biofilm, sending sorties of bacteria to infect his blood and organs, and threatening to break off and clog an artery supplying his brain. He spent weeks in the hospital before and after the surgery required to remove it, incurring incredible medical debts. All because he felt like he needed to ration his care, and teeth were not the priority there.
posted by a snickering nuthatch at 7:55 AM on January 24, 2019 [51 favorites]
Noticed that the second author of the paper is an undergrad at UIC, which is pretty cool.
posted by coppermoss at 8:00 AM on January 24, 2019 [4 favorites]
posted by coppermoss at 8:00 AM on January 24, 2019 [4 favorites]
Wow. Just yesterday I read this article (Could This Radical New Approach to Alzheimer’s Lead to a Breakthrough?) that also links Alzheimer's, ALS, and Parkinsons to bacteria. Specifically cyanobacteria, and they think they may have a promising, cheap treatment.
posted by SonInLawOfSam at 8:07 AM on January 24, 2019 [7 favorites]
posted by SonInLawOfSam at 8:07 AM on January 24, 2019 [7 favorites]
Like I say to climate change deniers, let’s just pretend that this preventative strategy works, because it can’t be a bad thing in the long run.
posted by Cool Papa Bell at 8:09 AM on January 24, 2019 [19 favorites]
posted by Cool Papa Bell at 8:09 AM on January 24, 2019 [19 favorites]
OK but I feel like we should not overlook the fact that the people telling you how to manage gingivitis are also poking you in the gums with a piece of sharp metal.
posted by mhoye at 8:19 AM on January 24, 2019 [18 favorites]
posted by mhoye at 8:19 AM on January 24, 2019 [18 favorites]
Guys, I have really bad teeth and gum issues and have been freaking out for months that I’m going to have a heart attack and now I’m freaking out that I’m going to get Alzheimer’s, too.
(I have a dentist appointment for Monday, so I’m mainly freaking out all this will happen before Monday, which is statistically unlikely, I know.)
posted by greermahoney at 8:24 AM on January 24, 2019 [11 favorites]
(I have a dentist appointment for Monday, so I’m mainly freaking out all this will happen before Monday, which is statistically unlikely, I know.)
posted by greermahoney at 8:24 AM on January 24, 2019 [11 favorites]
(But this seems like a really good breakthrough and a gingivitis vaccine would be awesome!!)
posted by greermahoney at 8:25 AM on January 24, 2019
posted by greermahoney at 8:25 AM on January 24, 2019
You should clean your teeth, but flossing is ineffective or more correctly, its benefits are unproven.
Personally I prefer interdental brushes and floss only those few places that can't be reached otherwise.
posted by samastur at 8:39 AM on January 24, 2019 [4 favorites]
Personally I prefer interdental brushes and floss only those few places that can't be reached otherwise.
posted by samastur at 8:39 AM on January 24, 2019 [4 favorites]
Burhanistan: Eh, my grandmother had all of her original choppers and got gushing praise from her dentist into her 90s and still developed Alzheimers symptoms.
Well, there's all the evidence you need that this can't be true.
Conversely, more than one thing could be a factor in developing Alzheimers!
I didn't start taking proper care of my teeth (floss, then brush with Sonicare, then Listerine, twice a day) until I hit middle-age. I have had scaling and root planing twice (never, ever again). My concern is that it's already too late for me, and I'm just a walking heart attack or Alzheimer's case waiting to happen.
posted by tzikeh at 8:47 AM on January 24, 2019 [11 favorites]
Well, there's all the evidence you need that this can't be true.
Conversely, more than one thing could be a factor in developing Alzheimers!
I didn't start taking proper care of my teeth (floss, then brush with Sonicare, then Listerine, twice a day) until I hit middle-age. I have had scaling and root planing twice (never, ever again). My concern is that it's already too late for me, and I'm just a walking heart attack or Alzheimer's case waiting to happen.
posted by tzikeh at 8:47 AM on January 24, 2019 [11 favorites]
At the bottom of that that article is a link to another that says, "Read more! How lack of sleep causes Alzheimer's!"
posted by KleenexMakesaVeryGoodHat at 8:49 AM on January 24, 2019 [6 favorites]
posted by KleenexMakesaVeryGoodHat at 8:49 AM on January 24, 2019 [6 favorites]
I was just reading this article, which presents this bit plus many others. I find it compelling.
posted by Riverine at 8:50 AM on January 24, 2019
posted by Riverine at 8:50 AM on January 24, 2019
My dentist told me that I am going to have a "relationship" with the periodontist for the rest of my life
posted by thelonius at 8:57 AM on January 24, 2019 [15 favorites]
posted by thelonius at 8:57 AM on January 24, 2019 [15 favorites]
What I find interesting is the genetic predisposition aspect of this. Like it was assumed that if alzheimer's had a genetic component, it was something to do with brain chemistry or brain cell metabolism, but instead it turns out it might have more to do with weak gums or thin walls to the blood vessels supplying them, or something similar.
posted by sexyrobot at 8:57 AM on January 24, 2019
posted by sexyrobot at 8:57 AM on January 24, 2019
but instead it turns out it might have more to do with weak gums or thin walls to the blood vessels supplying them, or something similar.
well, my dad was developing Alzeimers when he died and like Burhanistan's grandma, he had pretty much perfect teeth (and gums). So I'm thinking that whatever's going on, genetic predisposition shall remain a factor.
posted by philip-random at 9:02 AM on January 24, 2019
well, my dad was developing Alzeimers when he died and like Burhanistan's grandma, he had pretty much perfect teeth (and gums). So I'm thinking that whatever's going on, genetic predisposition shall remain a factor.
posted by philip-random at 9:02 AM on January 24, 2019
No flossing = horrible bad breath. Flossing = good breath.
posted by Melismata at 9:13 AM on January 24, 2019 [5 favorites]
posted by Melismata at 9:13 AM on January 24, 2019 [5 favorites]
The article I s an argument against flossing, right? Flossing injures the gums creating possible infection sites.
posted by rodlymight at 9:15 AM on January 24, 2019 [3 favorites]
posted by rodlymight at 9:15 AM on January 24, 2019 [3 favorites]
Well and I wonder if fluoride plays a role? My mom and dad grew up without it in their water, and had terrible tooth and gum problems their whole lives. I've had some cavities, but nothing like what they went through. But I grew up in a larger town with a fluoridated water system.
That's one reason I ultimately pulled the plug on living in a housing development that was on a private non-fluoridated system; I was not going to risk my kid's teeth that way, I wanted us on a municipal system that had fluoride. His teeth are doing pretty well so far.
This is an exciting area for research, I hope it gets pursued and leads to some important discoveries, even if we don't discover the One True Cure for Alzheimer's right off. As with gut bacteria, I feel like there's a lot we are missing.
posted by emjaybee at 9:21 AM on January 24, 2019 [7 favorites]
That's one reason I ultimately pulled the plug on living in a housing development that was on a private non-fluoridated system; I was not going to risk my kid's teeth that way, I wanted us on a municipal system that had fluoride. His teeth are doing pretty well so far.
This is an exciting area for research, I hope it gets pursued and leads to some important discoveries, even if we don't discover the One True Cure for Alzheimer's right off. As with gut bacteria, I feel like there's a lot we are missing.
posted by emjaybee at 9:21 AM on January 24, 2019 [7 favorites]
Floss schmoss.
Get yourself a waterpik. It's a tiny powerhose for your mouth. $50. Feels amazing.
posted by Damienmce at 9:24 AM on January 24, 2019 [9 favorites]
Get yourself a waterpik. It's a tiny powerhose for your mouth. $50. Feels amazing.
posted by Damienmce at 9:24 AM on January 24, 2019 [9 favorites]
You should clean your teeth, but flossing is ineffective or more correctly, its benefits are unproven.
For tooth decay. They are well proven to help gum disease.
posted by Celsius1414 at 9:29 AM on January 24, 2019 [17 favorites]
For tooth decay. They are well proven to help gum disease.
posted by Celsius1414 at 9:29 AM on January 24, 2019 [17 favorites]
Flossing injures the gums creating possible infection sites.
You're doing it wrong.
Get yourself a waterpik.
Yes, if you can, sure! That's just flossing with water pressure instead of solid floss, so absolutely.
posted by tzikeh at 9:33 AM on January 24, 2019 [1 favorite]
You're doing it wrong.
Get yourself a waterpik.
Yes, if you can, sure! That's just flossing with water pressure instead of solid floss, so absolutely.
posted by tzikeh at 9:33 AM on January 24, 2019 [1 favorite]
Also, there is a link to the scientific article at the bottom of the article, and it's pretty interesting (and also not paywalled), so before you write this post off as click-bait, have a look
People in the pharma industry have spent many years and many billions of dollars and done large scale human trials pursuing a hypothesis that had way more evidence than this backing it up. It accomplished nothing other than invalidating the hypothesis.
The click-baity part is not that one decent research article doesn't exist, but the leap from a suggestive study that joins a pile of suggestive ones to "looks like we may have this figured out" and "cures and treatments now in sight." We figure out cancer about once a year based on this standard.
posted by mark k at 9:44 AM on January 24, 2019 [8 favorites]
People in the pharma industry have spent many years and many billions of dollars and done large scale human trials pursuing a hypothesis that had way more evidence than this backing it up. It accomplished nothing other than invalidating the hypothesis.
The click-baity part is not that one decent research article doesn't exist, but the leap from a suggestive study that joins a pile of suggestive ones to "looks like we may have this figured out" and "cures and treatments now in sight." We figure out cancer about once a year based on this standard.
posted by mark k at 9:44 AM on January 24, 2019 [8 favorites]
KleenexMakesaVeryGoodHat: At the bottom of that that article is a link to another that says, "Read more! How lack of sleep causes Alzheimer's!"
What if I stay up late to brush my teeth?
posted by clawsoon at 9:49 AM on January 24, 2019 [11 favorites]
What if I stay up late to brush my teeth?
posted by clawsoon at 9:49 AM on January 24, 2019 [11 favorites]
I listened with excitement to a "Radio Lab" piece describing how at MIT 40hz light seemed to 'clean out' the amyloids in alzheimer's mouse brains. The researcher went on to mention that there was something like a 99% non correlation between effective alzheimer's treatments in mice vs humans.
That said, where do I get whatever they are selling?
posted by Pembquist at 9:50 AM on January 24, 2019 [1 favorite]
That said, where do I get whatever they are selling?
posted by Pembquist at 9:50 AM on January 24, 2019 [1 favorite]
If you have mental health stuff that makes dental care and dentists' visits difficult, tell your dentist, and then switch dentists if they aren't understanding about it. If you have severe anxiety about going to the dentist, talk to your doctor about it. It was world-changing when I both got anxiety medication and a dentist who knew and was chill about all of this. This was also the first dentist who explained that the epinephrine they do before the lidocaine actually causes something that may feel like a panic attack. I know Uber and Lyft have problematic elements, but if you're not taking anxiety meds before dental appointments because you have to drive there, seriously, consider it.
Given how important this sort of thing is starting to seem to a lot of areas of health, learning how to advocate for better care in this area is looking more and more important. Even if this isn't a 1-to-1 link, the implication that this could be a worse problem for people who have other issues that lead to trouble maintaining oral hygiene is rough.
posted by Sequence at 9:51 AM on January 24, 2019 [26 favorites]
Given how important this sort of thing is starting to seem to a lot of areas of health, learning how to advocate for better care in this area is looking more and more important. Even if this isn't a 1-to-1 link, the implication that this could be a worse problem for people who have other issues that lead to trouble maintaining oral hygiene is rough.
posted by Sequence at 9:51 AM on January 24, 2019 [26 favorites]
I'm not worried, I floss on occasion.
That occasion is the night before I have a dentist appointment.
posted by VTX at 9:59 AM on January 24, 2019 [10 favorites]
That occasion is the night before I have a dentist appointment.
posted by VTX at 9:59 AM on January 24, 2019 [10 favorites]
The dentist knows if you flossed the night before.
You can, however, fool them if you start flossing about 2 weeks before. By then your gums have stopped bleeding and look vigorous.
posted by clawsoon at 10:02 AM on January 24, 2019 [5 favorites]
You can, however, fool them if you start flossing about 2 weeks before. By then your gums have stopped bleeding and look vigorous.
posted by clawsoon at 10:02 AM on January 24, 2019 [5 favorites]
You're doing it wrong.
Hm, every dentist I’ve ever talked to told me if I’m not bleeding, I’m doing it wrong.
But there is no evidence flossing has any impact on gum disease, previously.
posted by rodlymight at 10:11 AM on January 24, 2019
Hm, every dentist I’ve ever talked to told me if I’m not bleeding, I’m doing it wrong.
But there is no evidence flossing has any impact on gum disease, previously.
posted by rodlymight at 10:11 AM on January 24, 2019
I floss constantly. For some reason, food constantly gets stuck in one specific spot in my teeth and it bugs the hell out of me. And then I figure, well, I'm already in here, so...
posted by Cool Papa Bell at 10:13 AM on January 24, 2019 [6 favorites]
posted by Cool Papa Bell at 10:13 AM on January 24, 2019 [6 favorites]
This is not my joke (I saw it on Twitter a while ago) but it is too good not to share:
Dentist: so when's the last time you flossed?
Me: dude, you were there.
posted by coppermoss at 10:20 AM on January 24, 2019 [47 favorites]
Dentist: so when's the last time you flossed?
Me: dude, you were there.
posted by coppermoss at 10:20 AM on January 24, 2019 [47 favorites]
Ha! This is funny because Pfizer tried to push a Porphyromonas vaccine to veterinarians about a decade ago but ultimately pulled it because of lack of proof of efficacy (lay article here). I recall some patients having local vaccine reactions and a few nasty systemic ones. Maybe they will reanimate it for humans!
posted by SinAesthetic at 10:22 AM on January 24, 2019 [3 favorites]
posted by SinAesthetic at 10:22 AM on January 24, 2019 [3 favorites]
This is where I recommend the only thing that's ever gotten me to floss regularly: the Access flosser. I have very tight teeth, a small mouth, and hands that cramp up almost instantly when I try to floss. This thing makes it easy and quick and a total non-issue. I live in fear they'll stop making the refills -- they actually did a few years ago, but they were brought back under the Listerine name. I recommend this SO highly.
posted by fiercecupcake at 10:27 AM on January 24, 2019 [6 favorites]
posted by fiercecupcake at 10:27 AM on January 24, 2019 [6 favorites]
So, I tend to use Listerine pretty superstitiously for a lot of maladies. Whenever I'm getting a soar throat or a cough or even an ear ache. My SO prefers less harsh mouth-washes: your Scopes, your Tom's of Maines, etc. But I new better all along. I've clearly been protecting my this whole time.
posted by es_de_bah at 10:45 AM on January 24, 2019 [1 favorite]
posted by es_de_bah at 10:45 AM on January 24, 2019 [1 favorite]
Protecting your what? :)
I floss once, usually twice a day. The one thing I haven't been great about historically has been dental checkups, but by great good fortune, my dental habits have kept me largely problem-free except for several cavities over the course of my life. When I finally went to the dentist for the first time in about a decade, I decided it was time I stopped fucking around, and bought a Sonicare Diamondclean. My dentist has had nothing but nice things to say since then. (Except "When are you going to get those wisdom teeth out?")
posted by Autumnheart at 11:02 AM on January 24, 2019 [1 favorite]
I floss once, usually twice a day. The one thing I haven't been great about historically has been dental checkups, but by great good fortune, my dental habits have kept me largely problem-free except for several cavities over the course of my life. When I finally went to the dentist for the first time in about a decade, I decided it was time I stopped fucking around, and bought a Sonicare Diamondclean. My dentist has had nothing but nice things to say since then. (Except "When are you going to get those wisdom teeth out?")
posted by Autumnheart at 11:02 AM on January 24, 2019 [1 favorite]
So the article is interesting, especially the mouse model data. I was wondering why such a potentially dogma-shifting study was in Plos One- not a bad journal but certainly not a top one. I found the clinical components of the study to be lacking in rigor - for example, they show detection of P. Gingivalis in CSF of AD patients, but they don't show any results from non-AD controls- so it's possible that everyone has trace amounts of this DNA in their CSF. Showing a gel of your PCR product and sequencing products in no way makes up for the lack of suitable controls. And the dot blots were pretty weak sauce. They do call the human data 'pilot', but their discussion lacks a limitations section noting the potential shortcomings of their experiments and analyses. I don't mean to imply that the study is worthless and their findings aren't correct- they could certainly pan out to be true. But they could also pan out to be not true, and the media coverage seems to be exaggerating the strength of the evidence. Will be interesting to see how this area of research progresses!
posted by emd3737 at 11:21 AM on January 24, 2019 [13 favorites]
posted by emd3737 at 11:21 AM on January 24, 2019 [13 favorites]
Somehow, I feel like we've been here been here before. (Which doesn't mean it's wrong. But, a spot check of the papers in the article don't inspire too much confidence that it's right.)
posted by eotvos at 11:34 AM on January 24, 2019
posted by eotvos at 11:34 AM on January 24, 2019
My oldest friend has Alzheimer's. Her husband is an oral surgeon, and former Director of oral health of the state of Connecticut, and professor at UConn. I REALLY think she flossed.
posted by DMelanogaster at 11:37 AM on January 24, 2019 [3 favorites]
posted by DMelanogaster at 11:37 AM on January 24, 2019 [3 favorites]
There's also recent research that links schizophrenia to the Epstein-Barr virus, (aka, mononucleosis).
posted by 1970s Antihero at 11:39 AM on January 24, 2019 [3 favorites]
posted by 1970s Antihero at 11:39 AM on January 24, 2019 [3 favorites]
What Jpfed said - it happened to my husband and the blood clot killed him. In his case it was visible first in his eye socket, treating that triggered shingles all over his face, treating that triggered another infection in his throat, they got rid of that and it moved down as a bacterial mess on the outside of his lung and then added MRSA on top of that. Other than the MRSA, that the only thing they got to culture from all that was something typical of a gum infection, and we were waiting on insurance approval for an oral surgeon when he died.
In other words, immunosuppressants and poor dental hygiene are a bad combination even if the Alzheimer's connection is another false trail.
posted by buildmyworld at 1:09 PM on January 24, 2019 [12 favorites]
In other words, immunosuppressants and poor dental hygiene are a bad combination even if the Alzheimer's connection is another false trail.
posted by buildmyworld at 1:09 PM on January 24, 2019 [12 favorites]
TIL why so many people on metro have nasty-ass breath. That is something flossing provably helps.
posted by aspersioncast at 1:24 PM on January 24, 2019 [1 favorite]
posted by aspersioncast at 1:24 PM on January 24, 2019 [1 favorite]
Current working hypothesis in my lab group is that any proinflammatory trigger can exacerbate AD propensity. We’re not at a point where we’d argue causality, but the evidence linking inflammation to AD is solid. Bacterial load can cause a systemic inflammatory response. I buy the data here but don’t necessarily think the claim of causality is going to be The Answer to why AD develops. There’s probably multiple causes; the inflammatory reaction seems to be a pretty critical step though, no matter what triggers it.
posted by caution live frogs at 1:44 PM on January 24, 2019 [20 favorites]
posted by caution live frogs at 1:44 PM on January 24, 2019 [20 favorites]
I have always had generically horrible teeth/everything else is wrong with my mouth and will also be seeing a periodontist for life and will always have something bleeding there (thanks, horrible complications from wisdom teeth surgery! why the fuck didn't you just let me keep them?). I am guaranfuckingteed to get Alzheimer's if they're right.
posted by jenfullmoon at 5:31 PM on January 24, 2019 [1 favorite]
posted by jenfullmoon at 5:31 PM on January 24, 2019 [1 favorite]
its benefits are unproven.
Proven just fine as far as I'm concerned, since when I started flossing every day in addition to brushing, my gums stopped bleeding.
posted by Armed Only With Hubris at 6:44 PM on January 24, 2019 [1 favorite]
Proven just fine as far as I'm concerned, since when I started flossing every day in addition to brushing, my gums stopped bleeding.
posted by Armed Only With Hubris at 6:44 PM on January 24, 2019 [1 favorite]
Option 1: it's bullshit--My oldest friend has Alzheimer's. Her husband is an oral surgeon, and former Director of oral health of the state of Connecticut, and professor at UConn. I REALLY think she flossed.
Option 2: it's the only explanation--I am guaranfuckingteed to get Alzheimer's if they're right.
Nothing in the article says that this is the *single cause* of Alzheimer's--why is everyone in here so intent on reading it that way?
Lots of factors can lead to, for example, cardiac arrest. If an article addressed just one of them and said "huh research might be pointing to X as a cause of cardiac arrest," would you all immediately assume that either a) you have factor X and therefore are doomed to suffer a heart attack, or b) since your mom/dad/significant other/best friend never had X but suffered a heart attack that the research is obviously wrong?
Seriously, MF generally has better literacy/critical thinking than this jumping to conclusions. This is a very weird thread.
posted by tzikeh at 6:58 PM on January 24, 2019 [8 favorites]
Option 2: it's the only explanation--I am guaranfuckingteed to get Alzheimer's if they're right.
Nothing in the article says that this is the *single cause* of Alzheimer's--why is everyone in here so intent on reading it that way?
Lots of factors can lead to, for example, cardiac arrest. If an article addressed just one of them and said "huh research might be pointing to X as a cause of cardiac arrest," would you all immediately assume that either a) you have factor X and therefore are doomed to suffer a heart attack, or b) since your mom/dad/significant other/best friend never had X but suffered a heart attack that the research is obviously wrong?
Seriously, MF generally has better literacy/critical thinking than this jumping to conclusions. This is a very weird thread.
posted by tzikeh at 6:58 PM on January 24, 2019 [8 favorites]
Is this a good place to mention that Oral B Glide floss leaks PFAS? Great!
posted by unknowncommand at 6:59 PM on January 24, 2019 [4 favorites]
posted by unknowncommand at 6:59 PM on January 24, 2019 [4 favorites]
This was exciting to read and then the comments brought me quickly back down to earth :/ My Dad was diagnosed with Alzheimer’s and passed away shortly after due to a combination of health issues. It was and is devastating. Reading this article was still really heartening despite the flaws mentioned, though.
Also: I’m confused by the multiple people saying a person they knew with impeccable teeth still got Alzheimer’s. Gum disease can be present and serious without necessarily affecting the appearance of one’s teeth. The very cool reason I know this is because I have gotten lots of compliments on my white and straight teeth (parents brought me and my sisters to the dentist and orthodontist as a major priority) and still every time I saw my dentist dude was like “I know you only floss the night before you come here and you have gum disease, pal.”
posted by Kemma80 at 7:05 PM on January 24, 2019 [3 favorites]
Also: I’m confused by the multiple people saying a person they knew with impeccable teeth still got Alzheimer’s. Gum disease can be present and serious without necessarily affecting the appearance of one’s teeth. The very cool reason I know this is because I have gotten lots of compliments on my white and straight teeth (parents brought me and my sisters to the dentist and orthodontist as a major priority) and still every time I saw my dentist dude was like “I know you only floss the night before you come here and you have gum disease, pal.”
posted by Kemma80 at 7:05 PM on January 24, 2019 [3 favorites]
Anecdatum: my dentist / oral hygienists used to tell me I needed to start flossing every visit, and regularly sandblasted my gums to the point of bleeding. Then I got an electric toothbrush with a two minute timer and I never heard peep again.
I still don't floss, but my gums are much better. YMMV.
My memory is so-so. Don't ask Mrs. Condour75 to opine on that.
posted by condour75 at 7:06 PM on January 24, 2019 [1 favorite]
I still don't floss, but my gums are much better. YMMV.
My memory is so-so. Don't ask Mrs. Condour75 to opine on that.
posted by condour75 at 7:06 PM on January 24, 2019 [1 favorite]
For those of us who want to do something about this, one of the articles linked in the main article looks at amyloid load as a function of periodontal disease in normal elderly folks and finds a strong correlation. They include other factors like brushing and flossing, but seem to find that when periodontal disease is also in the equation, brushing and flossing have no effect. This could reasonably mean that brushing and flossing only affect amyloid via periodontal disease, but to my frustration I couldn't find any simple correlations between flossing/brushing and amyloid. The elderly folks in this study were I think all in the same institution, so it may be that all the variation in periodontal disease was not due to anything they were currently doing, but instead either what they had done earlier or genetic predispositions. But it would be nice to know (a) what effect the brushing and flossing had on periodontal disease in this group, and (b) how much of the variation in amyloid was explainable due to the brushing/flossing effect on periodontal disease, vs the unexplained variation in periodontal disease. My guess is that it's mainly the latter, and as with many of these infection correlations, most of the association is due to underlying genetics/inflammation response/immune strength/etc which may in fact be causing both the infections stuff and the brain stuff -- as well as potentially some reverse causation, since it's very easy to imagine even mild behavioral changes having effects on gum health, even putting aside the other ways this mysterious disease may affect things outside the brain.
posted by chortly at 7:21 PM on January 24, 2019
posted by chortly at 7:21 PM on January 24, 2019
Nothing in the article says that this is the *single cause* of Alzheimer's--why is everyone in here so intent on reading it that way?
The New Scientist article talks about the cause, singular, as being gum disease, in the second sentence. Somebody from a drug company calls it a "universal hypothesis of pathogenesis." Now, this might just be poor science writing (more likely clickbaity writing, and in the case of the pharma rep, a lot of dollar signs dancing in their heads) but I am not going to blame any person who reads this article and takes away a belief that gum disease might be the holy grail, particularly people who have seen Alzheimer's impact a loved one.
Speaking more broadly as someone who works in dementia education & care, I have no problem believing that gum disease as a vector for infection could be part of what is going on; there's a growing body of evidence that anything that causes inflammation in the brain may be part of what is going on in Alzheimer's as caution live frogs notes. But there is a lot of work to be done, there are a lot of other risk factors that have evidence behind them as well. I think we're going to find at the end of all this - and I have a lot of hope there will be an end - that the process has been a lot like the blind men and the elephant, and once we get all the pieces together, it will make sense.
posted by nubs at 8:19 PM on January 24, 2019 [2 favorites]
The New Scientist article talks about the cause, singular, as being gum disease, in the second sentence. Somebody from a drug company calls it a "universal hypothesis of pathogenesis." Now, this might just be poor science writing (more likely clickbaity writing, and in the case of the pharma rep, a lot of dollar signs dancing in their heads) but I am not going to blame any person who reads this article and takes away a belief that gum disease might be the holy grail, particularly people who have seen Alzheimer's impact a loved one.
Speaking more broadly as someone who works in dementia education & care, I have no problem believing that gum disease as a vector for infection could be part of what is going on; there's a growing body of evidence that anything that causes inflammation in the brain may be part of what is going on in Alzheimer's as caution live frogs notes. But there is a lot of work to be done, there are a lot of other risk factors that have evidence behind them as well. I think we're going to find at the end of all this - and I have a lot of hope there will be an end - that the process has been a lot like the blind men and the elephant, and once we get all the pieces together, it will make sense.
posted by nubs at 8:19 PM on January 24, 2019 [2 favorites]
Drug discovery chemist Derek Lowe comments:
OK, this is a pretty solid paper. You can find some gaps in it – for example, there is some switching between tau and amyloid markers along the way (the authors do propose that the documented spread of tau pathology is consistent with the idea of neuron-to-neuron bacterial infection). But overall, this is impressive work, and it is the most thorough case I’ve yet seen for an infectious-disease component to Alzheimer’s and the identification of an actual Koch-postulate causative agent. I am very happy to hear that this hypothesis is being put to the test in the clinic, and I am similarly very eager to see what happens. This is the best shot at something new in Alzheimer’s in a long time.posted by metaquarry at 7:31 AM on January 25, 2019 [5 favorites]
Can we connect dental care to the rest of health care now instead of deeming it a largely cosmetic concern?
posted by Selena777 at 8:30 AM on January 25, 2019 [2 favorites]
posted by Selena777 at 8:30 AM on January 25, 2019 [2 favorites]
this tweet thread offers a contrary view if no one’s linked it yet.
posted by juv3nal at 1:09 PM on January 25, 2019 [4 favorites]
posted by juv3nal at 1:09 PM on January 25, 2019 [4 favorites]
Just a bit on animal models to give a perspective that may be helpful to people who mostly follow the discoveries that make the press.
Twenty years ago I thought something like: "Animals got a disease and then we did experiments to determine cause or cure." I knew not everything would pan out of course. But the level of wrongness in my simplistic view was huge.
In fact mice don't actually get Alzheimer's or asthma or cirrhosis in helpful ways. This is obvious if you think about it: A disease 70-year old humans get at low incidence is probably not going to show up in a rodent living a couple years. In fact, if it does show up there are almost certainly fundamental differences in the biology!
What animal models do is try to mimic the traits of a disease. For example, if you feed a rodent a fast-food like diet you will cause some damage but not for the decades a human liver gets exposed to it. So maybe a better model is giving them carbon tetrachloride, which accelerates the damage? Well, it depends--that might do a better job mimicking the symptoms but it clearly won't do squat if you're investigating how lipid metabolism contributes to the disease. Researchers at this stage spend a ton of time trying to compare traits of the human disease from patients (symptoms, biomarkers, pathways, etc.) with what they know of animal biology to create the best models. And it's still maddeningly uncertain--you might get a positive result in your best model and a negative one in two others that you thought were also relevant and then what? Besides arguments and assertions.
What you really want is something you have some evidence translates into humans. Like everyone's doing testing in the same animal model, one group invents a treatment that works in human. My test does better in animal models then is better in humans. When your discovery is a miracle cure in that same validated model--well, that's when the optimism about "treatment" and not just about the scientific method is warranted.
Of course in lots of things we've never been able to develop animal models we can validate: Cancer has lots of models but none are definitive, Alzheimer's we can't treat in humans so we can't validate the animal research, and so on.
So from my non-biologist observer perspective: The animal part of an experiment like this might turn out to be a great breakthrough, but it could also turn out to be like feeding carbon tetrachloride to a rat, a new way of mimicking a disease model but not what causes the disease in humans.
posted by mark k at 2:35 PM on January 25, 2019 [3 favorites]
Twenty years ago I thought something like: "Animals got a disease and then we did experiments to determine cause or cure." I knew not everything would pan out of course. But the level of wrongness in my simplistic view was huge.
In fact mice don't actually get Alzheimer's or asthma or cirrhosis in helpful ways. This is obvious if you think about it: A disease 70-year old humans get at low incidence is probably not going to show up in a rodent living a couple years. In fact, if it does show up there are almost certainly fundamental differences in the biology!
What animal models do is try to mimic the traits of a disease. For example, if you feed a rodent a fast-food like diet you will cause some damage but not for the decades a human liver gets exposed to it. So maybe a better model is giving them carbon tetrachloride, which accelerates the damage? Well, it depends--that might do a better job mimicking the symptoms but it clearly won't do squat if you're investigating how lipid metabolism contributes to the disease. Researchers at this stage spend a ton of time trying to compare traits of the human disease from patients (symptoms, biomarkers, pathways, etc.) with what they know of animal biology to create the best models. And it's still maddeningly uncertain--you might get a positive result in your best model and a negative one in two others that you thought were also relevant and then what? Besides arguments and assertions.
What you really want is something you have some evidence translates into humans. Like everyone's doing testing in the same animal model, one group invents a treatment that works in human. My test does better in animal models then is better in humans. When your discovery is a miracle cure in that same validated model--well, that's when the optimism about "treatment" and not just about the scientific method is warranted.
Of course in lots of things we've never been able to develop animal models we can validate: Cancer has lots of models but none are definitive, Alzheimer's we can't treat in humans so we can't validate the animal research, and so on.
So from my non-biologist observer perspective: The animal part of an experiment like this might turn out to be a great breakthrough, but it could also turn out to be like feeding carbon tetrachloride to a rat, a new way of mimicking a disease model but not what causes the disease in humans.
posted by mark k at 2:35 PM on January 25, 2019 [3 favorites]
Wow. I knew my decision to have orthodontic treatment in my 50s would pay off, but I never dreamt it could pay off this much.
posted by kandinski at 1:44 PM on January 26, 2019
posted by kandinski at 1:44 PM on January 26, 2019
I will note, for what it's worth, that my father had all of his teeth pulled when he was in his late 20s. When he died, he was in the early stages of Alzheimer’s.
posted by maxwelton at 3:14 PM on January 26, 2019
posted by maxwelton at 3:14 PM on January 26, 2019
juv3nal's tweet link is worth reading:
If someone mentions the occurrence of a phenomenon in AD patients and doesn’t also mention what they found in normal controls, they are bullshitting you.posted by clawsoon at 4:58 AM on January 27, 2019 [2 favorites]
The team found the dang DNA and protein from gingival bacteria in AD patients AND CONTROLS! Then they set a bunch of arbitrary thresholds to claim that there is a pattern with AD.
Study: "In addition, we identified P. gingivalis DNA in AD brains and the cerebrospinal fluid (CSF) of living subjects diagnosed with probable AD"
How many patients, you might ask? "7 of the 10 clinically diagnosed AD patients."
Moral of the story: You can't go from a handful of cases and zero drug testing in humans to "We may finally know what causes Alzheimer’s – and how to stop it"...especially given the long history of failed AD medications and therapies.
I'm immediately reminded of how Joe Gould lost his teeth.
posted by the man of twists and turns at 8:56 PM on January 31, 2019
posted by the man of twists and turns at 8:56 PM on January 31, 2019
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posted by all about eevee at 7:33 AM on January 24, 2019 [9 favorites]