By Dr. Joseph Lim
Dementia or cognitive decline has long been associated with poor oral health.
The link may be obvious. Individuals with dementia are often unable to maintain proper oral hygiene, thus compromising oral health. However, the evidence has been mixed.
Other studies have suggested that the risk of dementia increases with cardiovascular disease, diabetes, an unhealthy diet, and poor oral health. Emerging evidence suggests that poor oral health, including gum disease, could contribute to cognitive decline and dementia.
Now comes a new review of medical literature suggesting that gum disease and tooth loss could indeed be associated with later cognitive decline and dementia.
The new study carried out by the University of Eastern Finland is published in the Journal of the American Geriatrics Society.
Comprehensive literature search was conducted on five electronic databases for relevant studies published until April 2022. It found 2,132 studies for cognitive decline and 2023 for dementia, from which 47 studies (24 for cognitive decline and 23 for dementia) were included in the review.
The long-term studies followed the dental and cognitive health of study participants, especially those who had no dementia at the start of the study.
They found that those with poor dental health were 23 percent more likely to experience cognitive decline in the future and 21 percent more likely to experience dementia. “Poor periodontal health and tooth loss appear to increase the risk of both cognitive decline and dementia,” the study observed.
They also found that tooth loss was an independent risk factor for dementia.
The review revealed that gum disease was associated with an increased risk of cognitive decline and dementia. Partial tooth loss, involving the loss of a few but not all teeth, was associated with cognitive decline. On the other hand, complete tooth loss — and not partial loss — was linked to an increased risk of dementia.
Gum disease is an inflammation of the gums that can damage the tissue and bones that support the teeth; in severe cases, it may lead to tooth loss. It is characterized by bleeding gums, loss of alveolar bones that support the teeth, deeper of spaces between gums and teeth — and tooth loss.
About 55 million people worldwide have dementia, and the numbers could rise to around 139 million by 2050, according to Medical News Today.
Dementia is often preceded by milder forms of cognitive decline which allows a person to think and perform daily tasks normally. True dementia means a gradual decline in cognitive functions such as memory, thinking, and reasoning. It impacts on a person’s daily activities.
Moreover, individuals with higher cognitive function in childhood tend to have better oral health and access to dental care in adulthood than those with lower cognitive ability in early life.
Children with higher cognitive abilities are also more likely to maintain better cognitive function in old age. Thus, poor oral health may not have a causal role in the development of dementia.
“Maintaining oral health is perhaps even more important for people who already have some degree of cognitive decline or dementia,” said Sam Asher, a public health researcher at the University of Eastern Finland and the study’s lead author.
“Overall, practicing adequate oral hygiene measures is paramount for maintaining good oral health, which may positively influence health and well-being in general.”
There are no effective treatments for both cognitive decline and dementia. Thus, it is important to maintain good oral health at all times.
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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