Dementia risk: Does oral health play a role?
Although dementia is associated with an increased risk of poor oral health, evidence supporting the role of oral health in the development of dementia has been mixed.
A recent study suggests that gum disease and tooth loss are associated with an increased risk of cognitive decline and dementia. These results underscore the importance of preserving oral health to reduce the risk of cognitive decline and dementia.
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Individuals with dementia are often unable to maintain proper oral hygiene and are at increased risk of poor oral health. However, recent studies suggest that this relationship could be bidirectional.
A recent meta-analysis published in the Journal of the American Geriatrics Society suggests that gum disease and tooth loss could indeed be associated with later cognitive decline and dementia.
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According to Dr. Ella Cohn-Schwartz, a professor at Ben-Gurion University, Israel, “poor oral health and non-optimal mastication have been found to be potentially modifiable risk factors for cognitive impairment.”
Dementia and gum disease
Dementia is characterized by a gradual decline in cognitive function, including memory, thinking, and reasoning, which impairs the ability of the individual to perform daily activities.
Around 55 million people across the globe are currently living with dementia, and the prevalence of this condition may rise to an estimated 139 million by 2050. There is a lack of effective treatments for cognitive decline and dementia, making it vital to understand the modifiable risk factors for these conditions.
Previous studies have shown that factors such as cardiovascular disease, diabetes, and an unhealthy diet can increase the risk of dementia. However, the role of oral health in the development of dementia has received less attention.
Until recently, some experts thought that inadequate oral hygiene due to the impairment of daily functioning was responsible for the poor oral health observed in individuals with dementia. However, emerging evidence suggests that poor oral health, including gum disease, could contribute to cognitive decline and dementia.
A recent meta-analysis synthesized data from previous longitudinal studies examining the potential role of oral health in cognitive decline and dementia. Specifically, the meta-analysis examined the impact of periodontitis, also known as gum disease, on cognitive health.
Periodontitis refers to the bacterial infection of gums that causes inflammation. The inflammation of the gums can damage the tissue and bones that support the teeth and can lead to tooth loss in severe cases.
The common signs of periodontitis include bleeding gums, loss of alveolar bones that support the teeth, and tooth loss. Periodontitis is also characterized by an increase in the depth of periodontal pockets, which are the spaces between gums and teeth.
Link between oral and cognitive health
The study included 24 longitudinal studies examining the association between cognitive decline and periodontitis, and another 23 studies assessing the link between periodontitis and dementia.
It evaluated periodontal health assessed based on the presence of periodontitis, alveolar bone loss, increased periodontal pocket depth, and tooth loss.
The meta-analysis revealed that periodontitis was associated with an increased risk of cognitive decline and dementia. Among the various criteria used to assess periodontitis, further analysis revealed that tooth loss was also independently linked to cognitive decline and dementia.
Partial tooth loss, involving the loss of a few but not all teeth, was associated with cognitive decline. In contrast, complete tooth loss, but not partial tooth loss, was linked to an increased risk of dementia.
The mechanisms that could explain the impact of periodontal health on cognitive impairment are not well understood. The bacterial infection responsible for gum disease is known to cause an increase in markers of systemic inflammation.
Several studies suggest that systemic inflammation may contribute to the development of dementia. Thus, systemic inflammation induced by periodontitis could potentially lead to a decline in cognitive function.
The bacterial infection and inflammation involved in periodontitis could also weaken the blood-brain barrier, which prevents toxic substances from entering the brain.
Weakening of the blood-brain barrier could allow the bacteria and inflammatory molecules to enter the brain via the bloodstream, subsequently contributing to brain inflammation. Periodontitis could thus cause brain inflammation, which plays a critical role in the development of dementia.
Deficits in chewing ability due to tooth loss may also contribute to the decline in cognitive function. This is because the process of chewing food is associated with increased blood flow to brain regions involved in cognition and helps maintain cognitive function.
Furthermore, the reduced ability to chew food due to tooth loss may influence dietary habits, including higher sugar consumption and a lower intake of dietary fiber. Unhealthy dietary habits associated with the decline in chewing ability due to tooth loss could also increase the risk of dementia.
There is still much research that needs to be done in this area to fully understand the association between the risks of dementia and poor oral health.
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Read more on Dementia Risk: Does oral health play a role? at https://www.medicalnewstoday.com/articles/gum-disease-tooth-loss-linked-to-increased-dementia-risk-in-new-review