By Dr. Joseph D. Lim
(First of two parts)
The fourth of the reviews looked at the link between oral health and dementia. The results suggest that poor oral hygiene is associated with dementia, and more so among people in advanced stages of the disease.
Suboptimal oral health (gingivitis, dental caries, tooth loss, edentulousness) appears to be associated with increased risk of developing cognitive impairment and dementia.
Dementia is described in the International Classification of Disease (Version 10) as “a syndrome due to disease of the brain, usually of a chronic or progressive nature, in which there is disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not clouded.
“The impairments of cognitive function are commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behavior, or motivation. This syndrome occurs in Alzheimer’s disease, in cerebrovascular disease, and in other conditions primarily or secondarily affecting the brain.”
Here, the umbrella term “dementia” is used to include cognitive impairment, acknowledging that there is more than one type of dementia.
Take notice that dementia is not a specific disease, rather it is a set of symptoms that are the manifestations of different pathology.
The common causes of dementia are Alzheimer’s disease (AD) and vascular dementia. AD is a physical disease where proteins build up to form structures called “plaques and tangles” in the brain. This leads to the loss of connections between nerve cells, and eventually to the death of nerve cells and loss of brain tissue. There is also a shortage of some important chemicals in the brain.
Memory difficulties are usually the earliest symptoms of AD; other symptoms will involve problems with aspects of thinking, reasoning, perception, or communication. There is currently no cure for dementia, although a number of risk factors have been identified, and modification of these risk factor may impact on the presentation and progression of the condition.
The risk factors for dementia include low educational attainment in early life. A higher level of education appears to delay the onset of dementia by several years. Hypertension, Type II diabetes, hyperlipidaemia, cognitive activity, social activity, exercise, alcohol use, diet and smoking also play a role in the development of dementia.
People with moderate and advanced levels of dementia are more dependent on others for their daily oral care. They may lose the capacity to clean their teeth regularly resulting in more dental plaque accumulation and increasing the risk of developing periodontal disease and dental caries.
(To be continued)
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Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De La Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; Member, American Academy of Implant Dentistry and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com./WDJ