Cognitive Decline and Oral Microbiota. Pro-Inflammatory Conditions Become Risk Factors in Neurodegenerative Disease

Abstract

The growing scientific interest in the correlation between systemic pathologies and periodontal pathologies, shows how chronic infectious-inflammatory diseases, such as periodontitis, have implications with neurodegenerative pathologies, cause of cognitive decline and deprivation of self-sufficiency in the affected subjects. Numerous studies in literature show that pathogenic microorganisms implicated in periodontal disease play an important role in the onset or more likely in the progression of neuro-degenerative diseases. The increase in the average age of the population requires increasing commitment in the management of the needs of the "Aging Society". The appropriateness of clinical management in preventing and removing universally known periodontal pathogens is fully part of the prevention of systemic diseases that impact on social and public health. The minimally invasive "flapless" techniques performed with new-generation instruments represent the preferred approach also for patients presenting polytherapy, guaranteeing them an adequate reduction of the microbial load, a factor which is decisive for oral and systemic health. The correlation between low bacterial load in the oral cavity and systemic health is universally recognized. Conversely, a high proportion of supragingival and subgingival microbial biofilm is associated with numerous pathologies not only of the periodontal type. Clinical and experimental studies have shown the correlation between periodontal disease and some systemic diseases such as Diabetes Mellitus, Preterm Birth, Cardiovascular Disease, Lung Disease and Colorectal cancer. The dissemination, via the bloodstream, of oral pathogenic microorganisms, can determine a systemic inflammatory process and direct contact with vital organs such as the heart and lungs. Recent studies also focus attention on the interest of the brain with respect to invasion by oral bacteria. An anaerobic Gram negative bacterium in particular, could be implicated in the formation of amyloid plaques in Alzheimer's Disease (AD), it is Porphyromonas gingivalis (Pg) [1]. PG is a late colonizer, it is found in mature dental plaque and lives in ecological niches with little oxygen, preferring sub-gingival