Does oral health play a role?
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- Dementia is associated with an increased risk of poor oral health, but the evidence supporting the role of oral health in the development of dementia is mixed.
- A recent meta-analysis that synthesized data from previous studies suggests that periodontal disease and tooth loss are associated with cognitive decline and increased risk of dementia.
- These results highlight the importance of maintaining oral health to reduce the risk of cognitive decline and dementia.
People with dementia are often unable to maintain proper oral hygiene and are at increased risk of poor oral health. However, recent research suggests that this relationship may be bidirectional.
A recent meta-analysis published in
The evidence included in the meta-analyses was of low quality, showing considerable methodological variation. However, a potential impact of cognitive decline on periodontal disease cannot be ruled out.
Dr. Ella Cohn Schwartz, a professor at Ben-Gurion University in Israel, who was not involved in the study, commented: medical news today:
“Poor oral health and suboptimal chewing are known to be potentially modifiable risk factors for cognitive impairment, although evidence to date is limited. It provides a much-needed comprehensive synthesis of numerous longitudinal studies on disease health, cognitive decline, and dementia.”
“This paper does several things, including taking into account reverse causality, covering the spectrum of periodontal disease exacerbations, including tooth loss, and examining both cognitive decline and dementia as a result. Their findings may indicate the importance of policies and interventions to address tooth loss, even partial tooth loss, in old age,” Dr. Kohn-Schwartz added. rice field.
Dementia is characterized by a gradual decline in cognitive functions such as memory, thinking and reasoning, impairing an individual’s ability to carry out daily activities. Dementia is often preceded by mild cognitive decline, such as:
Mild cognitive impairment is accompanied by greater cognitive decline than is normally observed during aging. People with mild cognitive decline have no impairment in daily functioning but are at increased risk of dementia.
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Previous research has shown that factors such as cardiovascular disease, diabetes and an unhealthy diet may increase the risk of dementia.However, the role of oral health in the development of dementia has received less attention. Not.
Until recently, some experts believed that poor oral hygiene due to impaired daily functioning was responsible for the poor oral health seen in people with dementia. However, emerging evidence suggests that poor oral health, including periodontal disease, may contribute to cognitive decline and dementia.
A recent meta-analysis integrated data from previous longitudinal studies examining the potential role of oral health in cognitive decline and dementia. Specifically, this meta-analysis examined the impact of periodontal disease, also known as periodontal disease, on cognitive health.
Gum disease refers to a bacterial infection of the gums that causes inflammation. Inflammation of the gums can damage the tissue and bone that support the teeth, and in severe cases can lead to tooth loss.
Common signs of periodontitis include bleeding gums, loss of tooth-supporting alveolar bone, and tooth loss. Periodontal disease is also characterized by an increase in the depth of periodontal pockets, which are the spaces between the gums and teeth.
The meta-analysis included 24 longitudinal studies that examined the association between cognitive decline and periodontitis and another 23 studies that assessed the association between periodontitis and dementia.
Periodontal health was assessed based on the presence of periodontitis, alveolar bone loss, increased periodontal pocket depth, and tooth loss.
A meta-analysis found that periodontal disease was associated with cognitive decline and an increased risk of dementia. Among the various criteria used to assess periodontal disease, further analysis revealed that tooth loss was also independently associated with cognitive decline and dementia.
Partial tooth loss, with the loss of some but not all teeth, was associated with cognitive decline. In contrast, complete tooth loss, but not partial tooth loss, was associated with an increased risk of dementia.
Previous research has shown that individuals with dementia or mild cognitive impairment may have worse oral health.
Cognitive decline and brain changes associated with mild cognitive impairment and dementia progress gradually over years. Therefore, her study with less than 10 years of follow-up may reflect the impact of cognitive decline on oral health.
Therefore, the researchers reexamined the association between cognitive health and periodontal health after excluding studies with less than 10 years of follow-up. We found a weak association between periinitis and dementia.
The weak association between periodontitis and dementia in this additional analysis indicates that the results of the initial analysis may have been influenced in part by the impact of cognitive impairment on oral health. increase.
Although results from follow-up analyzes indicate that poor oral health may contribute to the development of dementia, some researchers have found that poor oral health and cognitive decline I am skeptical of the evidence linking
This is because dementia and tooth loss share the same risk factors such as low educational attainment, socioeconomic status and diabetes.
Furthermore, people with higher cognitive function in childhood are more likely to have good oral health and access to dental care than those with lower cognitive function in adulthood.
Children with higher cognitive abilities are more likely to maintain better cognitive function into old age. Therefore, poor oral health may not be causally associated with the development of dementia.
Dr. Murray Thomson, professor of dentistry at the University of Otago, who was not involved in the current study, said:
“Given that periodontal disease and cognitive decline share the same risk factors throughout life, the results of this review are not surprising. An important question is that while there is not enough evidence that periodontal disease causes cognitive There is very good evidence that they are susceptible to periodontal disease.”
The authors cautioned against the low quality of the evidence reviewed in meta-analyses. There was considerable variability among the studies studied.
Furthermore, studies evaluating the impact of cognitive decline on periodontal health generally included individuals aged 65 years or older with short follow-up periods. This may have biased the results in favor of a positive association between periodontal health and cognitive decline.
Therefore, further studies conducted using standardized methods are needed to further assess the association between periodontal disease and cognitive health.
However, these results suggest that prevention and early treatment of oral health problems may help reduce the risk of cognitive decline and dementia.
The mechanisms that could explain the effects of periodontal disease on cognitive impairment are poorly understood. Bacterial infections that cause periodontal disease are known to cause an increase in markers of systemic inflammation.
Several studies suggest that systemic inflammation may contribute to the development of dementia. Therefore, systemic inflammation caused by periodontitis could potentially lead to cognitive decline.
The bacterial infection and inflammation associated with periodontitis can also weaken the blood-brain barrier, which prevents toxic substances from entering the brain.
When the blood-brain barrier is weakened, bacteria and inflammatory molecules can enter the brain through the bloodstream and subsequently contribute to brain inflammation. , play an important role in the development of dementia.
Decreased chewing ability due to tooth loss may also contribute to cognitive decline. This is because the process of chewing food is associated with increased blood flow to brain areas involved in cognition, which helps maintain cognitive function.
Furthermore, decreased ability to chew food due to tooth loss may affect diet, such as increased sugar consumption and decreased dietary fiber intake. A related unhealthy diet may also increase the risk of dementia.
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