Oral Hygiene and Brain Health

The human body is a system of interconnected systems, each influencing the others in profound ways. This interconnectedness becomes particularly clear when we consider the relationship between neurodegenerative diseases, such as Parkinson’s and Alzheimer’s, and oral health which at first migth seem unrelated. The oral microbiome is a link that not only deepens our understanding of disease progression but also opens doors to empowering strategies for better care.

Emerging research has revealed that the oral microbiome—a bustling community of bacteria in our mouths—plays a significant role in brain health.

Some oral bacteria, particularly harmful pathogens like Porphyromonas gingivalis, have been implicated in neuroinflammation and the progression of diseases like Alzheimer’s. Likewise, our research at The BioCollective has uncovered related findings, including elevated levels of Porphyromonas benonis in the gut of individuals with Parkinson’s, a close relative of P. gingivalis. This potential link underscores the importance of the oral-gut-brain axis, a fascinating and critical avenue for exploration.

At the same time, chronic oral infections—such as dental caries, gum disease, and infections related to root canals—create reservoirs of endotoxin-producing bacteria that may drive systemic inflammation. Endotoxins, or lipopolysaccharides (LPS), are toxic molecules released by certain bacteria that can cross into the bloodstream and even breach the blood-brain barrier. These toxins can trigger widespread inflammation, potentially contributing to the progression of neurodegenerative diseases. For a deeper discussion of endotoxins and Parkinson's please see this blog post. (https://www.marthasquest.com/post/rethinking-parkinson-s-disease-1.)

However, oral hygiene may become increasingly difficult for individuals living with Parkinson’s or Alzheimer’s due to challenges like the loss of fine motor skills or declining cognitive function. This makes it even more important to stay vigilant about oral health, as it may help slow or prevent harmful bacterial activity that could contribute to disease progression. Let’s explore the science, the challenges, and some practical ways to care for the oral microbiome, even in the face of these conditions.

The Oral Microbiome and Brain Health: What the Science Says

The connection between oral health and neurodegenerative diseases starts with Porphyromonas gingivalis, a known oral pathogen often associated with gum disease. Research has found this bacterium in the brains of people with Alzheimer’s disease, along with its toxic byproducts, known as gingipains. These gingipains are proteases—enzymes that degrade proteins—which allow P. gingivalis to infiltrate tissues, evade immune defenses, and trigger chronic inflammation. When this process extends to the brain, it can exacerbate neuroinflammation, a hallmark of Alzheimer’s pathology.

Compounding this issue, P. gingivalis thrives in iron-rich environments. This is where the microbial ecosystem becomes even more interesting—and concerning. Our BioCollective research has shown that Porphyromonas benonis, a gut microbe closely related to P. gingivalis, is elevated in individuals with Parkinson’s. Both of these species of bacteria appear to be cross-fed iron by Streptococcus species (see my previous talks and writings about the connection with chronic childhood strep infections and risk of PD) , which are also part of the oral microbiome. Iron, while essential for many cellular processes, becomes a double-edged sword in this scenario, fueling the virulence of these pathogens.

Other chronic dental conditions, such as caries (cavities), infected root canals, and gum disease, further exacerbate the problem by creating safe havens for endotoxin-producing bacteria. These conditions lead to the buildup of biofilms, plaque, and inflamed gum tissue, where bacteria like P. gingivalis and other anaerobes thrive. Endotoxins produced by these pathogens can leak into the bloodstream through inflamed or damaged gum tissue, contributing to a cascade of systemic inflammation. Once in circulation, endotoxins can even cross the blood-brain barrier, contributing to neuroinflammation that may exacerbate Parkinson’s and Alzheimer’s progression.

The Unique Challenges of Oral Hygiene in Parkinson’s and Alzheimer’s

For individuals living with Parkinson’s or Alzheimer’s, maintaining oral hygiene can be particularly challenging. The fine motor skills required to effectively brush and floss can diminish as the diseases progress. Tasks that were once routine—like brushing for two minutes or navigating floss between teeth—can become frustrating and overwhelming. Complicating matters, memory impairment in Alzheimer’s may lead to forgetting oral care routines entirely, while tremors in Parkinson’s can make brushing and flossing feel physically impossible. These challenges allow harmful bacteria to flourish, increasing the risk of gum disease, dental caries, root canal infections, and the release of endotoxins.

This creates a vicious cycle: poor oral hygiene fosters bacterial overgrowth and inflammation, which in turn may drive systemic and neuroinflammation that worsens disease progression. However, with thoughtful adaptations and proactive care, it’s possible to reduce bacterial load and support oral and overall health.

Practical Tips for Supporting Oral Health

1. Invest in an Electric Toothbrush - Electric toothbrushes can be a game-changer for those with limited dexterity. Many models feature larger, easy-to-grip handles, built-in timers, and oscillating or rotating heads that clean more effectively than manual brushing.

   
   

2. Use a Biofilm Disruptor Harmful oral pathogens like Porphyromonas gingivalis often hide in biofilms—complex bacterial communities that are notoriously difficult to remove. A product like the Daily Dental Care lozenge (https://dailydentalcares.com) is designed specifically to target and disrupt biofilms. Developed by a doctor for her grandmother with Alzheimer’s, it uses gentle, effective ingredients to break down these microbial strongholds, making it easier to manage harmful bacteria. Adding this lozenge to your routine can complement brushing and rinsing, especially for those at higher risk of neurodegenerative diseases.

   
   

3. Try Tools Like Brush Picks or Interdental Cleaners Toothpicks such as The Doctor’s Brush Picks, soft interdental cleaners or old fashioned wooden toothpicks can be easier to handle than traditional floss. These tools are effective at removing food particles and plaque from between teeth, areas where bacteria tend to thrive.

   
   

4. Rinse Thoroughly After Every Meal Even if brushing isn’t possible after a meal, simply rinsing the mouth thoroughly with water can help wash away food particles and sugars that feed harmful bacteria. Consider adding a gentle, alcohol-free antimicrobial rinse (without fluoride) to reduce bacterial load.

   
   

5. Limit Processed Carbohydrates and Sugary Foods Sugary and starchy foods that stick to teeth provide a feast for bacteria like Streptococcus, which produce acids that weaken enamel and promote gum inflammation. A diet rich in whole, unprocessed foods supports both oral and gut health while starving harmful pathogens.

   
   

6. Use Adaptive Tools for Better Grip For those with advanced motor difficulties, adaptive tools like toothbrush holders, foam handles, or wrist straps can make brushing easier. Caregivers can also assist with brushing when necessary. Here is a resource for a number of adaptive tools.

   
   

7. Focus on Gum Health Gentle gum massage with a soft brush or clean finger can stimulate circulation and help keep gums healthy. Regular dental check-ups are also crucial for professional cleanings and to catch issues early.

   
   

Compassionate Care for Changing Needs

It’s important to approach oral hygiene with patience and compassion, both for yourself and for loved ones managing Parkinson’s or Alzheimer’s. Changes in abilities can be frustrating, but even small, consistent efforts can make a meaningful difference. Emphasize progress over perfection, and remember that each step toward better oral care is a step toward supporting overall health and well-being.

We really started focusing on oral health with John about 5 yerars ago, not too late to make a difference but wish we had paid closer attention and known more of the connections earlier. John had some infected teeth that he kept putting off dealing with for some time. When he actually had three of them removed, including an old root canal, he felt instantly better. When addressing this sort of dental work it is important to deal with a dentist who is well trained in holistic/biological dentistry, as the removal of these teeth can release a lot of endotoxins and potential heavy metals like mercury which must be handled with great care. An additional consideration is the use of anethesia in dental work as anethesia can also have longer term cognitive effects especially for those over 60 so discuss the options carefully before processing with any general anesthesis.

As we’ve seen, the connection between the oral microbiome and neurodegenerative diseases is a compelling reminder of that everythign is connected. Chronic dental infections, biofilms, and endotoxin-producing bacteria highlight the importance of maintaining oral health to reduce systemic inflammation. By nurturing the oral microbiome through thoughtful care and preventative strategies, we not only protect our teeth and gums but also take proactive steps toward supporting brain health.

For a deeper dive into the role of endotoxins in systemic and brain health, keep an eye out for my upcoming deep dive on endotoxin on the BiotiQuest blog. .

If you or someone you love is navigating Parkinson’s or Alzheimer’s, consider discussing these ideas with your healthcare provider or dentist to create a tailored plan that aligns with your unique needs. Every effort counts in empowering your health journey—one mindful choice at a time.

With Gratitude,