As we age, our risk factors for cognitive impairment such as dementia and Alzheimer’s skyrocket. In fact, one out of nine people over the age of 65 have Alzheimer’s here in the US. While some of the factors leading to these problems are likely genetic, tireless research in the past few decades has deepened our understanding of how these disorders start, as well as how we might be able to protect ourselves. Perhaps surprisingly, excellent oral health may be one way to reduce risk factors for dementia and Alzheimer’s.
Cognitive Decline and Tooth Loss
Researchers have known for a long time that Alzheimer’s and dementia are linked with tooth loss. After all, as patients’ cognitive ability declines they are less able to care for themselves. Most Alzheimer’s patients struggle with self-care habits like brushing their teeth. Over time, they usually develop oral health problems such as severe gingivitis and periodontal disease.
Worsening self-care leads rapidly to decay, gum disease and tooth loss. These problems progress very quickly in patients suffering with cognitive decline. Researchers have urged for many years for caregivers to pay special attention to patients’ teeth and oral health who cannot do so for themselves. However, more recent studies indicate that the relationship between tooth loss and dementia might actually go the other direction as well.
The Facts: Less Teeth Means More Risk
Let’s take a look at the data. Dr. Bei Wu of NYU’s Rory Meyers College of Nursing recently worked with colleagues to collate data from 14 longitudinal studies. Altogether, they evaluated data from 34,000 people, nearly 5,000 of whom were suffering from cognitive decline associated with dementia, Alzheimer’s, or a similar progressive degenerative disorder.
Even after controlling for other factors, the researchers concluded that adults missing teeth were 1.48 times more likely to develop cognitive decline, and 1.28 times more likely to be diagnosed with dementia. This is strong evidence of a causative link between missing teeth and developing impaired cognition.
We Don’t Know Exactly Why Losing Teeth Can Lead to Cognitive Decline
There are many hypotheses as to why missing teeth would make patients more likely to develop cognitive decline, dementia, and Alzheimer’s. Very likely, it is a combination of factors.
One of these factors is inflammation. Advanced gum disease that leads to tooth loss means tons of inflammation. As we have discussed in previous blog posts, that inflammation does not stay isolated to your mouth. Inflammatory markers and even the bacteria themselves can travel throughout your whole body, impacting other areas. The blood supply to your teeth and gums is in very close proximity to the blood vessels to your brain, so it stands to reason that oral health would impact cognitive health!
However, there are likely other factors involved as well. Missing teeth means more difficulty chewing and eating. For most people, when the eating gets hard, the food gets less nutritious. There is a strong correlation between tooth loss and insufficient nutrition. A poor diet with insufficient nutrients is likely another factor that could increase risk factors for impaired brain function.
Prevention: Keep More Teeth to Keep Your Brain Healthy
The great news from this study is that there is so much we can do to lower our risk factors for Alzheimer’s just by taking care of our oral health!
Ideally, that means starting early to prevent gum disease. If you needed one more reason to floss every day and brush really well, this is it! The more teeth you keep over your lifetime, the lower the impact on your risk for cognitive impairment.
Remember gum disease is not the only thing that leads to missing teeth. Cracks, fractures, deep decay, and injuries can also potentially cost you some pearly whites. So be sure to get your regular dental health checks and cleanings so that we can repair any damage early in the process, before you risk losing a tooth.
Interestingly, this research also shows that the risk factors for dementia associated with tooth loss are dose dependent. What does that mean? That means that the risk increased per tooth lost. Each missing tooth accounts for a 1.4% increased risk for cognitive impairment and 1.1% increased risk for a dementia diagnosis.
Already Missing Teeth? It’s Not Too Late!
Great news for patients already missing teeth: replacing teeth is effective in mitigating that increased risk. If you are only missing a few teeth, replacing chewing surfaces takes the extra burden off your other teeth. By maintaining a full set of chompers, you make it less likely that you will lose more teeth in the future.
Even for those patients missing all or most of their teeth, replacing them will still help to reduce the risks to your brain. About 24% of adults missing teeth developed cognitive decline if they did not have dentures. On the other hand, only about 17% of patients with dentures developed cognitive problems.
No matter what stage of life you are in, great oral care benefits your whole body and brain health. Don’t wait to schedule an appointment for your next oral health exam. If you are missing teeth, talk options with your dentist. Whether you go for implants, bridges, or partial dentures, every tooth you replace will help. Don’t underestimate the benefit of protecting your teeth from cracks, too. If your dentist recommends a night guard or other grinding prevention, remember it is also an investment in your long-term cognitive health as well. Keep smiling, Orlando!