In a review of 47 previously published studies, researchers in Finland found that tooth loss, and deep pockets around it teeth In the gums, or bone loss in dental cavities was associated with a 21% higher risk of dementia and 23% higher risk of mild cognitive decline.
According to the study, tooth loss itself – an indicator of gum disease – was linked to a 23% increased risk of cognitive (mental) decline and a 13% increased risk of dementia.
“Maintaining adequate gum health, including maintaining healthy normal teeth, also appears to be important in the context of preventing cognitive decline and dementia,” said lead researcher Sam Asher, of the University of Eastern Finland Dental Institute in Kuopio.
Asher pointed out that the study could not prove this gum problems It actually causes dementia. However, prevention and treatment of gum disease is especially important in older adults who are at increased risk of developing dementia, he said.
“Our findings also underscore the importance of oral hygiene in people who already have some degree of cognitive decline or dementia. These individuals often have difficulties maintaining oral hygiene and using professional oral health services,” Asher said.
He added that dentists should take note. “Oral hygienists should be particularly aware of the early changes in gum health and oral self-care that often occur at older ages due to cognitive decline,” Asher said.
In Background Notes, the researchers noted that about 10% to 15% of adults in the world suffer from gingivitis known as periodontitis. In severe cases, it leads to tooth loss, and previous research has linked this to heart disease and diabetes.
“Future research needs to focus on providing high-quality evidence to help both the general public and dental healthcare professionals with more specific oral health care strategies to prevent dementia,” Asher added.
“There is growing evidence that systemic inflammation and encephalitis are linked in some way,” said Dr. Sam Gandy, director of the Mount Sinai Center for Cognitive Health in New York City.
Gandhi, who was not involved in the study, said periodontal disease, and systemic viral diseases, including herpes, COVID-19, and inflammatory bowel syndrome, among others, are capable of causing encephalitis.
“These associations do not necessarily involve direct invasion of the brain by microbes, but we still understand relatively little about the molecular basis of how systemic inflammation exacerbates encephalitis,” he added.
Research in this area is still obscure. According to a recent trial, treating gum disease in Alzheimer’s patients did not affect their condition, although it did affect signs associated with Alzheimer’s disease, Gandhi said.
“These kind of results, taken together, raise the possibility that biomarkers, at least under some circumstances, may be misleading. There is as yet no acceptable alternative to large, lengthy and expensive randomized clinical trials in which a meaningful clinical benefit can be demonstrated,” he said.
This study cannot prove that inflammation from dental disease causes dementia, Dr. Jeremy Koppel, geriatric psychiatrist, and colleagues agree.–Director of the Northwell Health Litwin Zucker Center for Alzheimer’s Research in Manhasset, New York
“You don’t know if they had gum disease because they had Alzheimer’s or because they had Alzheimer’s because of gum disease,” said Kopel, who played no role in the research.
He noted that in this study, the risk of developing dementia related to periodontal disease was very low. “The risks may be largely neutral when compared to the known risks of disease,” Koppel said. These risks include smoking and an unhealthy diet, according to the study.
Koeppel does not discount the importance of what happens in the mouth as it relates to Alzheimer’s disease. He said the research is being done on saliva to see what it has to say about conditions in the brain.
“People are interested in checking their saliva for biomarkers of proteins in the brain that are associated with Alzheimer’s disease,” Koppel said.
He said anti-inflammatory therapies are already a treatment target for Alzheimer’s disease.
“But whether the mouth contains other secrets has not really been explored,” he added.
The report was published online on September 8 at Journal of the American Geriatrics Society .
To learn more about dementia, head over to the US National Institute on Aging.
Sources: Sam Asher, MPH, Institute of Dental, University of Eastern Finland, Kuopio; Jeremy Coppel, MD, geriatric psychiatrist, shared–Director of Northwell Health Litwin Zucker Center for Alzheimer’s Research, Manhasset, NY; Sam Gandy, MD, PhD, director of the Mount Sinai Center for Cognitive Health, New York City; yournal of the American Geriatrics Association, September 8, 2022, online