As the population ages and the prevalence of Alzheimer’s disease and other forms of dementia grows, scientists around the world are doing extensive research to find out what triggers cognitive decline. We know from other articles that we’ve featured here on the AgingOptions Blog that, while there seems to be no single dominant cause for dementia, the finger of blame has been pointed at everything from heredity to obesity to poor diet.
Now comes a study out of Finland, described in this recent article from HealthDay, that strongly suggests another culprit related to cognitive decline: poor oral health. The article, written by HealthDay reporter Steven Reinberg, explains that there is much more than a casual link between the health of your mouth and the health of your brain. While scientists are hesitant to suggest that bad oral health causes dementia, the statistics seem hard to ignore. The report was published online September 8 in the Journal of the American Geriatrics Society .
Researchers Analyze Nearly 50 Previous Studies
Gum disease has never been a diagnosis we want to get. But now comes new research indicating that the effects of this uncomfortable condition might be far more devastating than we thought, according to the HealthDay report.
“In a review of 47 previously published studies, researchers in Finland found that tooth loss, deep pockets around teeth in the gums, or bone loss in the tooth sockets was tied to a 21 percent higher risk of dementia and a 23 percent higher risk of milder cognitive decline,” the article states.
According to the report, tooth loss, which is an indicator of gum disease (also known as periodontal disease), has been linked to a 23 percent higher risk of mental decline and a 13 percent higher risk of dementia specifically.
“Maintaining adequate periodontal health, including retention of healthy natural teeth, seems to be important also in the context of preventing cognitive decline and dementia,” said lead researcher Sam Asher, from the Institute of Dentistry at the University of Eastern Finland in Kuopio.
Good Oral Health Especially Important for Seniors
The article concludes that it’s tough to draw a direct cause and effect solution. “Asher noted that the study can’t prove that gum problems actually cause dementia,” Reinberg writes. “Still, prevention and treatment of periodontal conditions are particularly important in older adults who are at increased risk for dementia.”
Asher said, “Our results also emphasize the importance of oral health care in people who already have some degree of cognitive decline or dementia. These individuals often develop difficulties with maintaining oral hygiene and using professional oral health services.”
Based on this research, says the article, Asher believes it essential for dentists be informed of these findings, adding, “Oral health professionals need to be particularly aware of early changes in periodontal health and oral self-care that often occur at older ages due to cognitive decline.” In other words, your dentist could be on the front lines of dementia detection.
Up to 15 Percent of World’s Population at Risk
This is widespread problem, says HealthDay. “About 10 percent to 15 percent of the global adult population has gum inflammation known as periodontitis, the researchers pointed out in background notes. In severe cases, it leads to tooth loss. What’s more, prior research has linked this condition to heart disease and diabetes – but not necessarily dementia.
Asher adds, “Future research needs to focus on providing higher-quality evidence to help both the general public and dental health care professionals with more specific oral health care strategies to prevent dementia.”
Inflammation Could Be One Culprit
Dr. Sam Gandy, who did not take part in the study, says that there appears to be a link between different types of inflammation in the body—including gum disease, herpes, IBS, and others—and inflammation in the brain. “These associations do not necessarily involve direct invasion of the brain by microbes, but we still understand relatively little about the molecular basis for how systemic inflammation aggravates brain inflammation,” he told HealthDay.
But more research is required in this field to really understand the correlation. Treating gum disease, for example, doesn’t seem to improve the condition of Alzheimer’s patients, but it does affect markers linked to Alzheimer’s.
“This sort of result, taken together, raises the possibility that biomarkers may, at least under some circumstances, be misleading. There is still no acceptable substitute for the large, long, expensive, randomized clinical trials in which meaningful clinical benefit can be established,” Gandy says.
Some Experts Remain Skeptical
Not everyone is convinced by this study’s linking of inflammation and brain decline. Dr. Jeremy Koppel, a geriatric psychiatrist, points out that correlation and causation are not the same thing. “You don’t know if they got the periodontal disease because they have Alzheimer’s or they got Alzheimer’s because of the gum disease,” he says.
Koppel also points out that the study indicates that the risk for dementia from periodontal disease is very low. “The risk may be pretty much neutral when compared with known risks for the disease,” he says, and those risks include smoking and unhealthy diet.
While he remains skeptical, Koppel doesn’t completely discount the important of oral health as it relates to dementia and cognitive decline. “People are interested in looking at the saliva for biomarkers of the proteins in the brain that are related to Alzheimer’s,” he says, and adds, “But whether the mouth may have other secrets hasn’t really been explored.”
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(originally reported at https://consumer.healthday.com)