
Brush your teeth – postpone Alzheimer's - conse_lad
https://www.eurekalert.org/pub_releases/2019-06/tuob-byt060319.php
======
Someone1234
P. gingivalis has been shown that it can migrate from the mouth to the brain.
It is also found in the brains of Alzheimer's sufferers. But we don't know yet
if it is THE cause of Alzheimer's. Which is to say "more research is needed to
prove a cause and effect link."

This is still fresh science, the ink is still wet. It might ultimately prove
that the cause of Alzheimer's is P. gingivalis (which is Nobel Prize levels of
incredible). However, this single 2018 study is far from the body of evidence
needed to make a claim on causal link.

That being said: Please brush and floss. There's no downside. Even if it is
unlinked to Alzheimer's you've gained something and lost nothing. You'll thank
yourself in the long run either way.

PS - I'm not even calling the science here bad (it is not). I am simply
saying, this is the start of a marathon and the article is treating it like
the end. Ten years ago similar articles on prion-based infections causing
Alzheimer's was the hotness, until it wasn't.

~~~
azangru
> Ten years ago similar articles on prion-based infections causing Alzheimer's
> was the hotness, until it wasn't.

I think it was not so long ago that I saw an article linking herpes viruses to
Alzheimer's (which sounded much more plausible than an oral bacterium).
Something must be causing those amyloid deposits...

~~~
fooey
I don't know where I picked up the idea, but I've long thought that it makes a
kind of sense that oral plaque and gum disease would be linked to heart and
brain diseases.

~~~
johnnycab
>I don't know where I picked up the idea

It is possible that you might have been pre-conditioned to think that way by
the colossal dental industry; which has put out a fair amount of graphic
imagery ranging from the saccharine to alarming, surrounding various aspects
of oral hygiene and endorsing a variety of bacteria destroying toothpastes &
mouth-washes to plaque-hunting rotating brushes in multitude of configurations
etc., which compounded by this topic appearing with some regularity on HN
might be reinforcing some of your preconceived notions.

Regardless, maintaining _basic_ oral hygiene should be de rigueur, despite how
feasible or tenuous the link(s) to other conditions might be.

------
JohnJamesRambo
This is going to sound like a shill but I have to recommend the new Gum
Detoxify toothpaste from Crest and thought I'd share it with other Hacker News
readers. It has stannous fluoride and that is supposed to work better and
actually kill bacteria around your gums. The reviews for it seemed crazy
positive so I thought I would try it and it has been a product that actually
does what it says.

I have to say, I wake up without morning breath pretty much now, which is
insane. And I have been feeling better...

Here is a paper comparing stannous fluoride with the traditional type.
[https://www.ncbi.nlm.nih.gov/pubmed/30797255](https://www.ncbi.nlm.nih.gov/pubmed/30797255)
"Antimicrobial effects of a stannous fluoride toothpaste in distinct oral
microenvironments."

~~~
atombender
There's also nano-hydroxyapatite (n-Ha), a bioactive form of calcium apatite
that has been found to stick to dentine and help remineralize your teeth [1]
[2].

It's popular in Japan, where it's even added to things like sports drinks.
It's not easy to get in the West yet. The only toothpaste I know with n-Ha is
Boka [3], and there's a more expensive Japanese one on Amazon called Apagard
Premio [4].

[1]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252862/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252862/)

[2]
[https://www.sciencedirect.com/science/article/pii/S030057121...](https://www.sciencedirect.com/science/article/pii/S0300571211000832)

[3] [https://www.boka.com/products/ela-mint-
toothpaste](https://www.boka.com/products/ela-mint-toothpaste)

[4] [https://www.amazon.com/Apagard-Premio-toothpaste-
nanohydroxy...](https://www.amazon.com/Apagard-Premio-toothpaste-
nanohydroxyapatite-remineralizing/dp/B0016GCZSC)

~~~
gamblor956
The Apagard Premio stuff works. After my dentist saw my results he started
importing it to sell out of his own practice.

------
js2
I shared this with a biostatistician friend and he replied:

There has been epidemiologic evidence of associations between periodontal
disease and several diseases/outcomes, including heart attacks, strokes and
(in pregnant women) premature and/or low birthweight babies. Clinical trials
of treatments for periodontal disease have thus far not shown any benefit in
terms of these outcomes. For example:

[https://www.ncbi.nlm.nih.gov/pubmed/19701034](https://www.ncbi.nlm.nih.gov/pubmed/19701034)

~~~
AstralStorm
What is his idea of the true instrumental variable? Immune system? Different
genetics in collagen or lipids?

------
iicc
The Research Article:
[https://advances.sciencemag.org/content/5/1/eaau3333](https://advances.sciencemag.org/content/5/1/eaau3333)

------
rc_hadoken
Zimbabwean here but live in Canada now. There are numerous older people back
in Zimbabwe who probably haven't seen a toothbrush aside from an ad in a
newspaper (they are 70+ years of age). No Alzheimer's to speak of its possible
this is an anecdote but I don't hear of its prevalence there or other non-
north--american countries. But then again those countries don't have as big of
a media footprint and research. I still think it's something westerners do (or
do not do!) that causes its prevalence here.

~~~
KMag
At least in the mid-2000s, Zimbabwe had the lowest life expectancy in the
world, according to the WHO. There are differences in distribution,
particularly skewed due to infant and childhood mortality rates, but I'd still
expect to see significantly lower rates of late-onset diseases in Zimbabwe.
Even looking at the percentage of 70+ year-olds with a given disease, I'd
expect significant survivor bias; if people don't live long once they get a
given disease, the percentage of the population with that disease is low. You
need to be much healthier in Zimbabwe in order to reach old age.

Differences in access to diagnosis can also skew statistics. We don't actually
ever know prevalence of a given disease, only diagnosis rates (and perhaps
gross estimates of underdiagnosis and false positive diagnostic rates).

Given the factors above, looking at any late-onset disease, I'd expect that
the percentage of people living long enough to be diagnosed is much lower in
Zimbabwe. Even when just looking at people over the age of 70, I'd expect the
percentage living with any given disease that significantly affects life
expectancy to be much lower in Zimbabwe.

Having a good healthcare system deceptively skews lots of health-related
statistics.

As far as factors related to the article, Western diet is probably much higher
in sugar and meat than an average Zimbabwean diet over the past 70 years. I
have several dentist friends here in Hong Kong who mention patients being
skeptical about modern dental practices because their grandparents never had
problems, forgetting that their grandparents had diets much higher in plants
and much lower in sugar.

------
axl
A lot of brain diseases are proving difficult to treat due to the “blood-brain
barrier”[1]. Could this bacteria be genetically modified to achieve this
purpose? If so, the bacteria, when absorbed through the gums could be used
benevolently to provide treatment for all sorts of brain diseases.

[1]:
[https://en.wikipedia.org/wiki/Blood–brain_barrier](https://en.wikipedia.org/wiki/Blood–brain_barrier)

~~~
AstralStorm
Yes, because giving people meningitis or worse is an excellent way of treating
them. To death.

There are many ways to pass BBB but few of them are actually safe. This one is
not.

------
arcticfox
I wish there was some way to compare / visualize where I should be putting my
effort on this stuff.

Surely I should do better taking care of my gums (flossing...:|), but I also
need to improve my diet and exercise, among other things.

I'd hate to find out that the things in my life that I do manage to fix turn
out to be more difficult and less effectual than other options...

~~~
fooey
Twice a day of brush, floss, and rinse is the bare minimum to keep healthy
teeth and gums

I bought a nice electric toothbrush and water flosser, so I feel like I get a
better job done faster (Sonicare and Waterpik)

~~~
Avery3R
You should not rinse directly after brushing. Toothpaste has a higher
concentration of fluoride than any mouthwash, if you're going to use a rinse
the recommendation is to wait 30 mins after brushing, and you should never
rinse with water

~~~
treerock
> you should never rinse with water

This is going to be a stupid question. What do you rinse with?

~~~
awfully
You don’t. You spit it out and go about your day.

~~~
germinalphrase
Is this common advice? I would find having my mouth coated with toothpaste
residue to be extremely off putting. You would also end up swallowing quite a
bit, yes?

~~~
awfully
It’s common advice from all the dentists and hygienists I’ve ever seen, and
it’s not something that comes up in conversation among my friends here but
from personal experience I wanna say all or most of my partners I’ve ever seen
brush their teeth they do the same. If it helps, this is in Europe, so we (as
in dentists here) may have differing guidelines as you.

From what I know, the gist is that fluoride is mineralized into enamel which
strengthens it (not sure if this is the correct phrasing). Whatever the
correct phrase is, it works by direct prolonged contact. Not rinsing is a way
to guarantee this contact, but even if you do there’s still fluoride in your
saliva to do some good.

I imagine the taste depends on your toothpaste. I use a plain one (Elmex) that
doesn’t really have a taste, and the taste goes away fast enough that I don’t
notice it.

As far as swallowing goes, not really. Most of it gets spat out. Besides,
(some) astronauts in space just swallow it all instead of spitting cause it’s
cleaner :)

[https://www.quora.com/International-Space-Station-Is-it-
ok-t...](https://www.quora.com/International-Space-Station-Is-it-ok-to-
swallow-toothpaste-as-Chris-Hadfield-does-in-this-video)

Yes I know fluoride can be toxic but the amount you’d swallow (a _small_ pea
sized dab is all you need, all those pictures of the entire brush covered by
toothpaste is advertisement to get you to think you need that much) is
probably not going to have any effect.

------
a_imho
I've always wondered what is the order of importance when it comes to oral
hygiene. Brush, paste, duration, technique. Further which is more important,
brushing, flossing or a good mouthwash? Is there anything that survives a
chlorhexidine rinse?

~~~
martinpw
For what it's worth, my dentist told me he didn't care if his patients brushed
their teeth or not, as long as they flossed.

~~~
edmundsauto
My dentist always said, "brushing is for you, flossing is for me." (He meant
that brushing is to remove the bad taste teeth fuzz, but flossing is what
keeps my teeth and gums healthy.)

~~~
awfully
I’ve heard the saying “you only need to floss between the teeth you want to
keep” in response to the question “do I _really_ need to floss?”

------
kerng
Wow, this is the kind of article that amazes me on HN. And why I keep coming
back.

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dharma1
How about mouthwash?

