Chewing, talking, giving our face some shape, helping out with our smiles—teeth play an important role in our lives. But the health of your teeth may indicate your odds of developing dementia, new evidence published in the Journal of the American Geriatrics Society claims.
Researchers from Finland found specifically that gum disease or poor periodontal health – diseases of the tooth-supporting/surrounding structures – and tooth loss (which often results from untreated gum diseases) increased the risk of both milder cognitive decline and dementia.
“A key point is that poor periodontal health is a modifiable risk factor. It can be addressed through self-care measures and regular use of basic oral health services,” Sam Asher, MPH, lead researcher from the Institute of Dentistry at the University of Eastern Finland, told Seasons. “This may lower dementia risk to some extent, although currently, we cannot say for sure how much.”
Asher and his colleagues combined and reviewed data from 47 other previously published studies and observed that tooth loss, deep pockets around teeth in the gums, or bone loss in the tooth sockets were linked to a 21% higher risk of dementia and a 23% higher risk of milder cognitive decline.
Another key finding was that oral health care services sustained over time and adequate oral health support are especially important in people who already have some cognitive impairment that affects their ability to maintain good periodontal health.
Oral health care services … and adequate oral health support are especially important in people who already have some cognitive impairment.
However, he noted there were some limitations to the study because they found that the overall quality of currently available evidence was relatively low and many studies had methodological problems.
Even though this “puts some limitations on the conclusions that can be drawn from the current evidence,” Asher said prevention and treatment of periodontal conditions are significant in older adults who are at increased risk for dementia.
“Overall, practicing adequate oral hygiene measures is paramount for maintaining good oral health, which may positively influence health and well-being in general,” he said.
Link between dementia risk and poor oral hygiene
According to Tim Donley, DDS, MSD, an expert in the treatment of gum disease and dental implants, more research is needed to understand the link between oral health and dementia.
However, he told Seasons these increased risks may be due to the presence of plaque and bacteria that can build up along the gums and between the teeth if a proper oral care regimen is not followed. Bacteria between and around the teeth can also move under the gumline and cause chronic inflammation, known as gingivitis and periodontitis.
“Long-standing gum disease can slowly destroy the supporting bone around the teeth leading to tooth loss. Left untreated, the damage may get worse,” Donley said. “Ongoing gingivitis and periodontal disease can affect your overall health, and as found in this study, may lead to decreased cognitive function.”
He added that certain bacteria found in the mouth can move from the mouth to the brain and potentially “affect or destroy nerve cells.” However, ongoing research is looking to uncover the exact ways these bacteria can lead to dementia and decreased cognition.
In addition, periodontal inflammation has been shown to increase systemic inflammation, which he said, in turn, may contribute to neuroinflammation, a risk factor for dementia. Tooth loss has also been suggested to increase the risk of impaired cognition because problems with chewing or a weaker biting force can lead to nutritional deficits, chemical imbalances or even changes to the brain that impact brain function.
Problems with chewing or a weaker biting force can lead to nutritional deficits, chemical imbalances or even changes to the brain that impact brain function.
Lastly, Asher said poor periodontal health and dementia share several risk factors including cardiovascular and metabolic diseases.
“Shared risk factors might also be one of the possible mechanisms by which poor periodontal health can adversely impact cognition,” he added.
How to help an older adult maintain good oral health
While this study does not prove poor oral health or gum problems actually cause dementia, having and maintaining good oral health is always important, health experts say.
Timothy Quirt, DDS, MBA, senior vice president of clinical operations at Heartland Dental, said caregivers can help their loved ones maintain their oral health by focusing on proper brushing techniques, diet and regular hygiene visits to the dentist, which he said can all have a direct influence on patients’ physical, psychological and social health.
“Prevention starts with the basics. Brushing, flossing and regular hygiene visits with the dentist are the backbone of dental hygiene,” he said. “Treating dental conditions early helps prevent long-term implications, including cognitive disease such as dementia.”
Here are some other things you can do to help maintain good oral health, according to Donley:
- Maintain an adequate self-care oral hygiene routine that includes brushing your teeth twice daily for about two minutes.
- Floss daily to remove plaque and food particles between the teeth and below the gum line.
- Regularly visit dental professionals for routine cleanings, checkups and monitoring for gum disease.
“We all know the lifestyle changes necessary to reduce your chances for the chronic diseases of aging: lose weight, improve nutritional intake, monitor your blood pressure, cut out tobacco or excessive alcohol use, and adequate sleep and hydration,” Donley said. “It’s time to add oral health to the list and use the tools that give you the best chance to maintain optimal oral care.”