Researchers are now urging that oral health be considered an important factor in the cognitive decline of older adults, with new studies suggesting that every missing tooth could raise the risk of dementia by over one percent.
A recent letter published in The Lancet highlights the overlooked link between oral health and dementia. While numerous risk factors for cognitive decline, such as hearing loss and high cholesterol, have been identified, the role of oral health has not been fully explored.
The Missing Link: Oral Health and Cognitive Decline
Dr. Bei Wu, an expert in the field, has been studying the connection between poor oral health and dementia for nearly two decades. Her research has consistently shown that poor oral hygiene is significantly linked to cognitive decline and the onset of dementia. Wu’s team also discovered that older adults who receive proper gum treatment have a nearly 40% lower risk of developing dementia.
Though experts agree that there is a clear connection between oral health and dementia, the reasons for this relationship remain unclear. Wu and her team are working to understand the underlying causes, including inflammation and infection.
The Impact of Tooth Loss on Dementia Risk
A comprehensive 2021 meta-analysis conducted by Wu’s team, involving over 34,000 older adults, found that each lost tooth is linked to an increased risk of cognitive impairment (1.4%) and dementia (1.1%). Furthermore, individuals with extensive tooth loss have a 48% greater chance of cognitive decline and a 28% higher risk of developing dementia. Interestingly, this risk is significantly reduced for individuals using dentures, suggesting that replacement teeth may help mitigate the effect.
Additionally, a 2023 study indicated that people with total tooth loss could still reduce their dementia risk by maintaining regular dental care, reinforcing the idea that ongoing oral health management plays a critical role.
Why Does Oral Health Affect Dementia Risk?
Although the exact mechanisms remain under investigation, several theories are being explored. Poor nutrition caused by missing teeth could contribute to dementia, as proper chewing is vital for overall health. Furthermore, inflammation caused by gum disease could lead to brain inflammation, a known risk factor for cognitive decline.
Another possibility is that bacteria from gum infections could enter the bloodstream through open sores in the mouth, leading to systemic inflammation and potentially affecting the brain.
The Debate: Cause or Correlation?
While Wu’s team and other experts have established a strong association between poor oral health and dementia, some researchers question whether this link is causal or if both conditions stem from a common underlying factor. For example, some studies suggest that individuals with dementia might struggle to maintain proper oral hygiene due to functional impairments.
Nonetheless, experts like Dr. Roger Wong, a clinical professor in geriatric medicine, emphasize the importance of maintaining good oral health, regardless of whether a direct causal relationship with dementia is established.
The Takeaway: Prioritize Oral Health
Despite the ongoing debate about the exact cause of the connection, experts agree that good oral health is crucial for overall well-being. Dr. Wong advises that maintaining oral hygiene should not be postponed, stating that “oral health is important, not just for our brains but for our quality of life too.” Regular dental check-ups, gum treatments, and maintaining a healthy diet are essential for reducing the risk of cognitive decline, regardless of its direct link to dementia.
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