Oral health impacts brain health

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Poor oral health may contribute to a decline in brain health, according to new research

Poor oral health may contribute to a decline in brain health, according to new research. (Image: Shutterstock / Oakland Images)
Dental Tribune UK & Ireland

Dental Tribune UK & Ireland

Tue. 21 February 2023


The link between oral health and systemic heath has been long understood by dental experts. Now preliminary research, to be presented at the American Stroke Association’s International Stroke Conference 2023, suggests there may be a link between oral health and brain health. Adults with poor oral health may be more likely to show signs of declining brain health than those with healthy teeth and gums. Early treatment of poor oral health may lead to significant brain health benefits.

Periodontal disease, missing teeth and other signs of poor oral health and poor brushing habits and lack of plaque removal can increase stroke risk, according to studies. Previous research has found that gum disease and other oral health concerns are linked to heart disease risk factors and other conditions like high blood pressure.

“What hasn’t been clear is whether poor oral health affected brain health, meaning the functional status of a person’s brain, which we are now able to understand better using neuroimaging tools such as magnetic resonance imaging (MRI),” said study author Cyprien Rivier, M.D., M.S., a postdoctoral fellow in neurology at the Yale School of Medicine in New Haven, Connecticut. “Studying oral health is especially important because poor oral health happens frequently and is an easily modifiable risk factor.”

Between 2014 and 2021, researchers in this study analysed the potential link between oral health and brain health among about 40,000 adults (46% men, with an average age of 57 years) without a history of stroke, enrolled in the U.K. Biobank. Participants were screened for 105 genetic variants known to predispose persons to have cavities, dentures and missing teeth later in life, and the relationship between the burden of these genetic risk factors for poor oral health and brain health was evaluated.

Signs of poor brain health were screened via MRI images of the participants’ brains, including white matter hyperintensities, defined as accumulated damage in the brain’s white matter, which may impair memory, balance and mobility and microstructural damage, which is the degree to which the fine architecture of the brain has changed in comparison to images for a normal brain scan of a healthy adult of similar age.

The analysis found:

  • People who were genetically prone to cavities, missing teeth or needing dentures had a higher burden of silent cerebrovascular disease, as represented by a 24% increase in the amount of white matter hyperintensities visible on the MRI images.
  • Those with overall genetically poor oral health had increased damage to the fine architecture of the brain, as represented by a 43% change in microstructural damage scores visible on the MRI scans. Microstructural damage scores are whole-brain summaries of the damage sustained by the fine architecture of each brain region.

“Poor oral health may cause declines in brain health, so we need to be extra careful with our oral hygiene because it has implications far beyond the mouth,” Rivier said. “However, this study is preliminary, and more evidence needs to be gathered – ideally through clinical trials – to confirm improving oral health in the population will lead to brain health benefits.”

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