Bacteria in the mouth linked to potentially fatal brain abscesses

Dr Alex George reveals best time to brush your teeth

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Many people understand the importance of good oral hygiene. It can mean the difference between healthy teeth and tooth decay, as well as issues such as gum disease and bad breath. However, having certain bacteria in the mouth could lead to even more serious implications, researchers have suggested.

A new study has found that bacteria linked to oral infections may also be a contributory factor in developing potentially life-threatening abscesses on the brain.

The paper, published in the Journal of Dentistry, analysed brain abscesses and their association with bacteria that occur in the oral cavity.

As part of the research, a team from University of Plymouth and University Hospitals Plymouth NHS Trust studied the records of 87 patients admitted to hospital with brain abscesses.

They also used microbiological data obtained from abscess sampling and peripheral cultures.

The team was then able to investigate whether oral bacteria was present.

It was found that 52 of the participants, for whom no cause of the abscesses was established, were three times more likely to have oral bacteria – compared to the patients for whom the cause was known.

These patients also carried significantly higher counts of Streptococcus anginosus, a bacteria that can lead to pharyngitis, bacteremia, and infections in internal organs such as the brain, lung, and liver.

A brain abscess is a pus-filled swelling in the brain that typically occurs when bacteria or fungi enter the brain tissue after an infection or severe head injury.

In a university release, lead study author – Doctor Holly Roy – said the findings stressed the importance of good oral hygiene.

“While many potential causes of brain abscesses are recognised, the origin of infection often remains clinically unidentified,” she explained.

“However, it was still surprising to frequently find orally occurring bacteria in brain abscesses of unexplained origin.

“It highlights the importance of using more sensitive techniques to assess the oral cavity as a potential bacterial source in brain abscess patients.

“It also highlights the importance of improving dental care and oral hygiene more generally.”

The study concluded: “These findings suggest that the oral cavity could be considered as a source of occult infection in cases of brain abscess where no clear cause has been identified.

“Future studies should include oral screening and microbiome analysis to better understand the mechanisms involved and develop approaches for prevention.

“Oral bacteria may be an under-recognised cause of brain abscesses.

“Careful review of oral health in brain abscess patients may help establish causation, particularly in patients with no cause for their abscess identified.”

The study comes as part of ongoing research taking place within the University’s oral microbiome research group, to consider the links between the oral microbiome and a range of cardiovascular and neurological conditions.

And other clinical trials are currently underway to explore the links between gum health and Alzheimer’s disease.

Symptoms of a brain abscess include:

• Headache – which is often severe, located in a single section of the head and cannot be relieved with painkillers
• Changes in mental state – such as confusion or irritability
• Problems with nerve function – such as muscle weakness, slurred speech or paralysis on one side of the body
• A high temperature
• Seizures (fits)
• Feeling or being sick
• Stiff neck
• Changes in vision – such as blurring, greying of vision or double vision.

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