Can I get Alzheimer's from that Root Canal?

You may start hearing this question (see title) from your patients. The reason for this question is a somewhat complicated nonetheless intriguing—and terrifying—story.

The Study that Started it All

It all started with a study published in Nature last week¹. It reported evidence of amyloid-β pathology, the peptides associated with Alzheimer's disease, in the brains of people between the ages of 36 and 51 who died from Creutzfeldt-Jakob disease (CJD). These individuals contracted CJD from human growth hormone (hGH) injections that were extracted from the pituitary glands of cadavers who were infected with CJD prions. (NB: This type of hormone injection treatment was terminated in 1985. CJD has a long incubation period, so cases of CJD from hGH injections are still emerging.)

It's very unusual to find this degree of amyloid pathology in relatively young people, so researchers investigated whether these individuals showed any signs of having early on-set or other pathogenic mutations associated with Alzheimer's disease. None did. Their explanation: iatrogenic transmission, just like the prions.

The Terrifying Implications

Scientists stumbled across the amyloid pathology during autopsy studies, but its implications are alarming. First, if confirmed, it means that Alzheimer's disease is transmissible between humans (earlier animal studies have shown transmission is possible).2 Secondly, other patients who received hGH extracts could be infected with Alzheimer's disease (as if their risk of getting CJD from the extracts wasn't already horrific enough).

Although it's still unclear exactly how the transmission happened, the scientific community is concerned. A Nature.com article about the study sums it up:

...[S]ome scientists worry that the findings may have broader implications: that Alzheimer’s could be passed on by other routes through which CJD can be transmitted, such as blood transfusions or contaminated surgical instruments.3


What Does this Have to do with Root Canals?

Contamination through surgical instruments—this is where dentistry comes into play. Several British news outlets reported the study's findings and interviewed members of the scientific community. One expert, the director of the Medical Research Council Prion Unit at University College London to be exact, was quoted in The Daily Mirror as stating:

"The [amyloid] seeds will potentially stick to metal surfaces whatever the instrument is. Certainly, there are potential risks with dentistry where it’s impacting on nervous tissue, for example root canal treatments… If you are speculating that amyloid beta seeds might be transferred by instruments, one would have to consider whether certain types of dental procedure might be relevant."4

The root canal quote was used in the second paragraph of a New York Post article published on September 10.5

Here's your forewarning. Be prepared.

Sources

  1. http://www.nature.com/nature/journal/v525/n7568/full/nature15369.html
  2. http://www.sciencemag.org/content/313/5794/1781
  3. http://www.nature.com/news/autopsies-reveal-signs-of-alzheimer-s-in-growth-hormone-patients-1.18331
  4. http://www.mirror.co.uk/news/technology-science/science/alzheimers-can-spread-human-human-6413725
  5. http://nypost.com/2015/09/10/study-shows-alzheimers-may-be-spread-from-person-to-person/
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