The Curious Case Of Ageing Gums And Bone Loss à la Benjamin Button: Can It Be Reversed?
The Curious Case Of Ageing Gums And Bone Loss à la Benjamin Button: Can It Be Reversed?
Director David Fincher’s 2008 film The Curious Case of Benjamin Button is the pinching Fincher twist on a wrinkle in time that F. Scott Fitzgerald bothered to write down.
For those unfamiliar and for those who have forgotten, Benjamin Button completely reverses forward through the entirety of his life.
Fresh from his mother’s womb emerges a wizened old man who grows old young. Mid timeline, when his actual age and appearance match for the first time, for a brief while he and the world in which he lives are in sync; at the end of his life he is an infant – suffering dementia and existing simply to disappear.
He and his real-time-effect love Daisy Fuller are love – trying to exist in the right time and place, running after and away from each other until they’re not. Akin to gums and teeth and dental treatments being embraced by Medicare, let’s hope for that same gracious reconciliation at some point before death.
When Button and Fuller are no longer being as idiotic as the off-with-his-head healthcare system we have, they realise they are indeed each other’s very best ally.
It’s the literary reflection of a relationship – an unbreakable connection between two things. In the Benjamin Button case of curious things, it’s people.
It’s a relationship that could just as equally be that of teeth and gums.
In the same way Benjamin’s and Daisy’s view began to clear being older of age and more aware of how far they’d come, the medical and dental fraternities are seeing mounting research that may start separately, but so often they’re finding themselves meeting in the middle of a completely reciprocal relationship between oral health and overall health.
Wrinkles appear and disappear while we’re all here attempting to find ways to time-stop living into one completely perfect and complete present moment.
Indeed we are insane.
As curious as the age-old joke of being as old as your tongue (and gums) and a little older than your teeth, finally reaching similarly aged bodies, Benjamin’s and Daisy’s very attempt to fix this image of time and space is futility on an exercise bike. Each new moment almost immediately becomes the past; each passing moment bringing them further apart. The reflected mirror is fleeting happiness; moments in a past they know well, to a future of no choice but acceptance.
Like the reality of a mouth that changes with age.
Parts can move and shrink and wrinkle in a way that’s not so different to the Benjamin and Daisy race away from Old Man Time just to run smack-bang into the Grim Reaper in the end.
It’s a run we’re all doing every day. No-one is spared experience – it’s only ever a matter of timing and degree.
Button’s approach to the unsolvable is the inspiration and liberation of limitation. His advantage is the combination of acquired wisdom and the freedom of youthful belief.
It’s the sudden realisation that no matter how much it costs for a six-monthly dental check-up and a professional clean, it’s always better value than having undiagnosed issues needing treatment programmes.
Because bad gums ruin good teeth.
Teeth can be perfectly strong and white and beautiful but without healthy alveolar bone and periodontal membrane to hold them in, then it’s a good picket fence with no postholes and nails.
Damaged and diseased gums lead to tooth loss. There’s a resultant lack of pressure on the jaw bone where there’s no longer a tooth chewing and stimulating its cellular maintenance and eventually it dissolves.
Periodontal disease isn’t always about poor access to dental healthcare or an ineffectual oral hygiene regimen.
A la Benjamin Button, it’s genetics gone wrong and what makes it all the more rapidly disturbing.
There can be a domino effect of health issues with that.
Were dentistry to button that all down with some kind of Benjamin B procedure, it would prove the stunning silence after groundbursts of daisies echoing healthcare failures. Without harsh intervention but simply with medication, the ability to reverse an oral disease that literally can and does kill, has the potential to change the quality and enjoyment of 6 billion lives worldwide.
With research intensifying since 2006, rapamycin, an organ transplant immunosuppressant, has been finding an alternate life as a potential anti-ageing drug, after more than thirty years as an obscure specialist medication first isolated in the early 1970s from bacterium found on Easter Island.
Repurposing pharmaceuticals is not new because capitalism is not new.
Aspirin has been used as antiplatelet medication since the 1950s. It’s been decades of sildenafil for angina being Viagra for erectile dysfunction and the source a lot of really good jokes.
Somehow in the 2000s, whether through boredom or design, it was a drug that had proven to extend the life of yeast, worms, flies and mice. It’s not clear which part of any of that was possibly by accident and amid such latent prank potential.
Though we might not know that, we do know that on average, a mouse will live for 30 months.
By the time 20-month-old mice were part of a rapamycin study, researchers knew they were dealing with the human equivalent of retirees: and that’d be old-style seniors of 65 – way over the under-30 Button ones.
Small doses of rapamycin were given to these mice over a 90-day period and then stopped – with the presupposition that the mice would die within their expected lifespan.
Instead, each lived an extra two months.
For the last mouse of the initial group, the end finally came aged 3 years and 8 months – the phylogenetics of 140 human years.
The drug is thought to mimic calorie restriction – an apparent surety for longevity because of the ability to survive starvation.
They’re nutrient-sensing pathways that include a process by which dysfunctional organelles and molecules are scavenged for energy – a clean-up for detritus that routinely impedes tissue over time.
It’s this process that slows the ageing process, and appears to even reverse it.
Mice, like humans, experience shifts in oral microbiome, inflammation and bone loss as they age.
Research lead author Jonathan An, DDS, PhD, acting assistant professor at the University of Washington’s Department of Oral Health Sciences showed the results of eight weeks of rapamycin being added to the food of middle-aged mice, and the comparison of their oral health with untreated mice of the same age.
A 3D imaging technique measured an increase in periodontal bone in the rapamycin-treated mice. New bone had actually grown during the test period. They experienced less gum inflammation and their oral bacterium was closer to that of healthy young mice.
It all sounds such an exciting, non-intrusive treatment option: until you know that human clinical trials of rapamycin would take decades. Pet dog ones have just begun; because as anyone with an elderly dog knows, sometimes the only difference between them and grandparents is what they eat and where they sleep.
Like a lot of things, already there’s a detected downside: the dosage gives a susceptibility to infection, and may increase the risk of diabetes as is the case with the typically higher amounts required by organ transplant patients.
The endeavour of course is whether the oral health potential of rapamycin outweighs the risks. The benefit of being able to halt, if not reverse the effects of gum disease is a world changer.
The study, Rapamycin Rejuvenates Oral Health in Ageing Mice doesn’t quite have that F. Scott Fitzgerald metaphoric style.
However, his own originality quota wanes with a Daisy who turn up in The Great Gatsby a mere three years later.
So although the Benjamin Button button essentially showed up in 1925, it’s yet to be pressed.
Which makes it a Benjamin Button Benjamin Button button, and another temporary something you can’t unthink; like seeing the letter ‘G’ as an ever-circling arrow.
The more we learn the more we know that the hierarchy of good health is governed by genetics. After that it’s a crapshoot.
As always, the smart money for maintaining good oral health is on routine dental care: the six-monthly check ups, the professional cleaning. The regular and professional perusal of your gums because only a dentist can tell you what the real story is there.
It’s the difference between never having to choose bone-loss treatments and gums ageing gracefully, and having to wish really hard for science to catch up with the fiction part much faster than it always did to before.
What was right with Benjamin Button was not the age or the circumstance but when he said, “Our lives are defined by opportunities; even the ones we miss.”
Give yourself the opportunity of a longer, healthier life.
Completely miss the idea of a repurposed drug replacing a highly trained dental professional anytime soon.
Make that appointment with your dentist.
And in six months, do it again so you’ll finally meet somewhere in the middle.
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