WE CONTINUE our focus on the possible link between periodontal or severe gum disease and cognitive impairment and dementia.
Periodontal disease, as it is, may cause tooth and bone loss.
It progresses in stages, starting with gingivitis characterized by red, swollen and sensitive gums. This is the gum problem that may induce bleeding during brushing and flossing.
When untreated, gingivitis may lead to early periodontal disease. This is the stage when pockets of tartar, plaque and bacteria form in the gums around the teeth.
The pockets cause inflammation, decay and the beginning of bone loss.
This is the part when the condition requires procedures like dental cleaning, root planing and scaling.
When no treatment is made, periodontal disease progresses into advanced periodontitis. It is at this stage that the bony support of the tooth bone structure may be destroyed. The result is the loss of the tooth.
The link between periodontal disease and dementia was found in a study conducted at the University of Minnesota School of Public Health in Minneapolis.
The researchers evaluated participants in the Atherosclerosis Risk in Communities study, a multicenter, community-based study of American adults aged 45 to 64 years at the start of the study.
They included participants who underwent clinical periodontal examination during the study. A subgroup of participants who underwent assessments for dementia and mild cognitive impairment were later assessed between 2011 and 2013.
The smaller group of participants provide the link between gum disease, Alzheimer’s and vascular dementia, says Ryan T. Demmer, PhD, an Associate Professor in the Division of Epidemiology and Community Health at the University of Minnesota School of Public Health and the study author.
Alzheimer’s disease, for which there is no cure, is the most common form of dementia. It is characterized by memory loss. Vascular dementia is caused by an impaired flow of blood to the brain, possibly damaging the brain to cause dementia and affect memory and even judgment.
The study is limited by the fact that initial examinations were made when the participants had an average age of 63. At that age cognitive decline might have started even before the onset of gum disease and tooth loss.
“In the short-term, the main implications are for informing future research studies that can measure actual oral bacterial exposures and better understand mechanisms,” says Dr. Demmer.
“In the long-term, if this is a true causal relationship, better dental insurance, availability of dental care and communication between dentists and physicians could improve population health.”
In our humble opinion, it is best to take good care of our overall oral health. And that includes our teeth and our gums.
Brushing your teeth daily is a must. It’s like social distancing, wearing face masks and shields and washing hands and maintaining good hygiene.
It is also important to visit your dentist regularly, at least once or twice a year, although we must admit this is severely limited during the pandemic.
Dr. Demmer says there is good evidence that treating gum disease could potentially be beneficial to brain health. “Even if future research finds no direct causal links between gum disease and dementia, good oral health is important for good overall health.”
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Dr. Joseph D. Lim is the former Associate Dean of the UE College of Dentistry, former Dean of the College of Dentistry, National University, past president and honorary fellow of the Asian Oral Implant Academy, and honorary fellow of the Japan College of Oral Implantologists. Honorary Life Member of Thai Association of Dental Implantology. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515./PN
