Gum disease, tooth loss linked to increased risk of dementia in new study

A new study evaluates evidence suggesting that oral and cognitive health may be linked. Image credit: Gabrielle Lurie/The San Francisco Chronicle via Getty Images.
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 meta-analysis synthesizing data from previous studies showed that gum disease and tooth loss are associated with an increased risk of cognitive decline and dementia.

These results emphasize the importance of maintaining oral health to reduce the risk of cognitive decline and dementia.
Individuals with dementia are often unable to maintain proper oral hygiene and face an increased risk of poor oral health. However, recent studies suggest that this relationship can be bidirectional.

A recent meta-analysis published in the Journal of the American Geriatrics SocietyTrusted Source suggests that gum disease and tooth loss may indeed be associated with later cognitive decline and dementia. The evidence included in the meta-analysis showed considerable methodological variation and low quality. However, the potential impact of cognitive decline on gum disease cannot be ruled out.

Dr. Ella Cohn-Schwartz, a professor at Ben-Gurion University, Israel, who was not involved in this research, commented on it for Medical News Today. Poor oral health and suboptimal mastication have been found to be potentially modifiable risk factors for cognitive impairment, but prior evidence is limited. This meta-analysis provides a much-needed comprehensive synthesis of the large number of longitudinal studies on periodontal health, decline cognitive, and dementia.

This paper is novel in several aspects, such as taking into account reverse causation, covering the spectrum of periodontal deterioration, including tooth loss, and examining both cognitive decline and dementia as outcomes. Their findings may indicate the importance of policies and interventions that address loss teeth, even partial loss, in old age,” added Dr. Cohn-Schwartz.

Dementia and gum disease Dementia is characterized by a gradual decline in cognitive function, including memory, thinking, and reasoning, which affects an individual’s ability to perform daily activities. Dementia is often preceded by a milder form of cognitive decline, such as mild cognitive impairment Trusted Source. Mild cognitive impairment involves a decline in cognitive function that is greater than that typically observed in aging. Individuals with milder cognitive decline do not show deficits in daily functioning but face an increased risk of dementia.

Around 55 million people worldwide are living with dementia and the prevalence of this condition may increase to an estimated 139 million by 2050. There is a lack of effective treatments for cognitive decline and dementia, making it important to understand what can be modified. risk factors for this condition. 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 impaired 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, can 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, a meta-analysis examined the effects of periodontitis, also known as gum disease, on cognitive health.

Periodontitis refers to a bacterial infection of the gums that causes inflammation. Gum inflammation can damage the tissue and bone that supports the teeth and can lead to tooth loss in severe cases. Common signs of periodontitis include bleeding gums, loss of alveolar bone that supports teeth, and tooth loss. Periodontitis is also characterized by an increase in the depth of the periodontal pocket, which is the space between the gums and teeth.

The relationship between oral and cognitive health
The meta-analysis included 24 longitudinal studies examining the relationship between cognitive decline and periodontitis, and another 23 studies evaluating the relationship between periodontitis and dementia.

It assesses periodontal health assessed based on the presence of periodontitis, alveolar bone loss, increased periodontal pocket depth, and tooth loss. A meta-analysis revealed that periodontitis is 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 associated with cognitive decline and dementia.

Partial tooth loss, which involves the loss of some but not all teeth, is associated with cognitive decline. Conversely, complete tooth loss, but not partial tooth loss, is associated with an increased risk of dementia. Reverse causality? Previous studies have shown that individuals with dementia or mild cognitive impairment can lead to poor oral health.

The decline in cognitive function and changes in the brain associated with mild cognitive impairment or dementia occur gradually over many years. Studies with a follow-up period of less than 10 years thus potentially reflect the effects of cognitive decline on oral health. Therefore, the researchers re-examined the relationship between cognitive health and periodontal health after excluding studies with a follow-up period of less than 10 years. After excluding these studies, the meta-analysis found a weaker association between periodontitis and dementia.

Gum disease, tooth loss linked to increased risk of dementia in new study

The weaker association between periodontitis and dementia in this additional analysis suggests that the results from the initial analysis may be partially influenced by the impact of cognitive decline on oral health. Although results in follow-up analyzes suggest that poor oral health may contribute to the development of dementia, some researchers remain skeptical about the evidence linking poor oral health to cognitive decline. This is because dementia and tooth loss share the same risk factors, such as low education levels, socioeconomic status and diabetes.

Additionally, individuals with higher cognitive functioning in childhood tend to have better oral health and access to dental care in adulthood than those with lower cognitive ability early in life. Children with higher cognitive abilities are also more likely to maintain better cognitive function in old age. Therefore, poor oral health may not have a causal role in the development of dementia. Dr Murray Thomson, a professor of dentistry at the University of Otago, who was not involved in the current research, stated:

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