A new study in Japan has once again raised questions about the relationship between oral health and brain health;Most experts agree that there is a striking connection between them.
The study investigated whether oral problems such as periodontitis (gum disease) and tooth loss increase the risk of neurodegenerative diseases such as stroke, Alzheimer's, and other forms of dementia.
The results are clear: both of these problems are related to the faster rate of atrophy of the hippocampus (the part of the brain that controls memory, learning, and emotion). This is an important result, but it is not the first time such a connection has been made.
In March, a study in the United States of more than 40,000 adults who participated in the UK's Biobank research project found that poor oral health appeared to be a key risk factor for stroke and dementia.
In a 2019 literature review, another group of researchers concluded that "overall, the experimental results suggest that the link between oral health and cognition should not be underestimated".
This growing body of research has a huge impact on our understanding of ourselves and preventive intervention strategies in public health.
Satoshi Yamaguchi, lead author of the Japanese study, reflected on his findings: "Preserving more healthy teeth without periodontal disease 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 keep a full set of teeth to stay healthy. We also have to keep our mouths away from periodontal disease, otherwise the brain will pay for it.
This is not just an academic issue. The World Health Organization estimates that severe periodontal disease, characterised by bleeding gum swelling and damage to the supporting tissues of the teeth, affects about 19% of adults worldwide.
In context, this means that more than 1 billion people may be at risk of early cognitive decline due to oral conditions.
To make matters worse, the nature of the relationship between the mouth and the brain seems to be a two-way street, meaning that cognitive decline often leads to poor oral hygiene habits as well.
In fact, neurological disorders like Alzheimer's can make it difficult to properly care for your teeth. People with cognitive decline may forget to brush their teeth or have difficulty coping with regular dental visits. The result can be a vicious cycle where cognitive decline leads to a decline in dental standards, which only exacerbates 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, going to the dentist, and making the most sensible dietary choices possible, they can help older adults protect their mouths from plaque and bacteria, thereby reducing the risk of neurodegenerative diseases.
Similarly, for those who are already showing signs of dementia, families and carers can help people with dementia establish a robust oral health routine tailored specifically for them.
This could include regular reminders on your phone to brush and floss, or providing professional dental tools, such as an electric toothbrush – which is easier to handle. Some dentists even offer home visits for people with dementia who have difficulty making it to appointments on their own.
Encouraging patients to practice other prevention habits, such as chewing sugar-free gum between meals, may also have an impact. Studies have shown that chewing SFG regularly (while brushing your teeth) can help reduce the risk of tooth decay. It's also easy to keep the gum in the patient's sight, so there's no need to be constantly reminded to start chewing.
These small, persistent lifestyle changes can have a huge impact over time, and they are much easier than infrequent invasive dental interventions.
The truth is, given the considerable impact of poor oral health on the entire body, including the brain, we can no longer treat dental care as a secondary issue. Preventive measures are a critical part of keeping teeth and gums intact for the long term, and people with dementia should support this as much as possible.
Of course, the fight against diseases like Alzheimer's can't be limited to oral health alone. Many factors contribute to the development of dementia, and it would be a mistake to exaggerate the influence of the mouth in this process.
Nonetheless, there is evidence that oral health interventions can help combat cognitive decline, and clinicians play a key role in disseminating this message.
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