A new study in Japan has again raised questions about the link between oral health and brain health; which most experts agree are surprisingly interrelated.
It investigates whether oral problems such as periodontitis (gum disease) and tooth loss can increase the risk of neurodegenerative disorders such as stroke, Alzheimer’s and other forms of dementia.
The results are clear: both problems are associated with a faster rate of atrophy in the hippocampus, the part of the brain that controls memory, learning and emotions. This is a significant result, but not the first time such a connection has been made.
In March, a US study of more than 40,000 adults involved in the UK Biobank research project found that poor oral health appears to be a key risk factor for stroke and dementia.
In a 2019 literature review, another group of researchers concluded that “taken together, the experimental findings suggest that the relationship between oral health and cognition cannot be underestimated.”
This growing body of research has enormous implications for both our understanding of the body and preventive public health intervention strategies.
Satoshi Yamaguchi, lead author of the Japanese study, reflected on his findings: “maintaining more healthy periodontal-free teeth may help protect brain health… Regular dental visits are important to control the progression of periodontal disease.”
In other words, it’s not enough to simply maintain a full set of teeth to be healthy. We also need to protect our mouths from periodontal disease, otherwise the brain may suffer the price.
This is not just an academic concern. The World Health Organization estimates that severe periodontal disease, characterized by bleeding/swollen gums and damage to the supporting tissue of the teeth, affects about 19 percent of the world’s adult population.
For context, this means that more than 1 billion people may be at risk of early cognitive decline due to the condition of their mouths.
Even worse, the nature of the connection between the mouth and the brain appears to be bidirectional, meaning that cognitive decline tends to lead to poorer oral health habits as well.
Indeed, neurological diseases such as Alzheimer’s can make proper dental care difficult. People with cognitive decline may forget to brush their teeth or have trouble keeping up with routine trips to the dentist. The result can be a vicious cycle in which cognitive decline leads to a decline in dental standards, which only worsens the condition.
To prevent this snowball effect, policymakers and health experts must intervene early to nip the problem in the bud.
By emphasizing the value of brushing, flossing, visiting the dentist, and making good dietary choices whenever possible, they can help seniors protect their mouths from plaque and bacteria—and thus reduce the risk of neurodegenerative diseases. diseases.
Likewise, for those who are already showing signs of dementia, families and caregivers can help dementia patients build a robust oral health routine tailored specifically for them.
This could include scheduled phone reminders to brush and floss or providing specialist dental tools such as electric toothbrushes – which can be easier to operate. Some dentists even offer home visits for dementia patients who find it difficult to attend appointments on their own.
Encouraging patients to adopt other preventive habits, such as using sugar-free gum between meals, may also have an impact. Research shows that regular chewing of SFG (along with brushing your teeth) can help reduce the risk of tooth decay. It is also easy to leave packets of gum lying in plain sight of patients, negating the need for constant reminders to start chewing.
These types of small, consistent lifestyle changes can make a huge difference over time and are significantly easier to maintain than more infrequent and intrusive dental interventions.
The fact is, given the significant impact of poor oral health on the wider body (including the brain), we simply cannot afford to continue to treat dental care as secondary care. Preventive measures are a crucial part of maintaining the long-term integrity of the teeth and gums, and patients with dementia should be supported to do this whenever possible.
Of course, the fight against diseases like Alzheimer’s cannot be reduced to oral health alone. Many factors contribute to the onset of dementia and it would be wrong to exaggerate the influence of the mouth on this process.
However, the evidence is clear that oral health interventions can help combat cognitive decline, and clinicians have a key role in spreading this message.
Dr Ben Atkins BDS is a former president of the Oral Health Foundation and a general dentist. He is also a long-standing trustee of the charity and owns a group of dental practices in the North West of England.