An article published in Experimental Biology and Medicine (Volume 245, Issue 3, February, 2020) (https://journals.sagepub.com/doi/pdf/10.1177/1535370220904924) describes an association between dental health and dementia. The study, led by Dr. J. L. Caffrey, in the Physiology and Cardiovascular Research Institute at the University of North Texas Health Science Center in Fort Worth, Texas (USA), reports that a history of chronic dental health issues increase the odds of dementia.
As the world population successfully ages, increasing numbers of the elderly are experiencing mental lapses that gradually progresses into Alzheimer's disease. Despite the prodigious societal and medical cost of this emerging pandemic, a clear cause and resulting therapeutic approach remain elusive. Recent studies suggest that damage to the brain results from local inflammatory cells defending the brain against a recurrent though low-level microbial assault. This hypothesis suggests that any process which helps maintain an infectious reservoir (chronic oral, lung and/or gastrointestinal illness), promotes the access of the resident microorganisms to the brain, or compromises the brain's ability to exclude microbes from entry would increase the odds associated with acquiring dementia. One corollary within this hypothesis suggests that the microorganisms which populate the mouth have a privileged route of access to the brain by traveling backward along the short nerves between the brain and mouth.
In the current study, Dr. Caffrey and colleagues examined the association between oral health and dementia using an unprecedented number of new dementia cases (200,000+) identified in the National Insurance Database for the entire population of Taiwan. There were more women affected than men which appeared to result from their greater representation in the aging population. Factors that alter perfusion or oxygenation of the brain like stroke, hypertension, diabetes and pneumonia increased the odds of dementia. Records from the prior 10 years indicated that dental procedures that quickly restored homeostasis lowered the odds of dementia and a history of chronic dental problems raised the odds of dementia. Dr. Caffrey said, "Prevention and delay are key goals in the approach to dementia. Good dental care and perhaps simple daily dental hygiene with regular brushing and rinsing with an antibacterial mouthwash may be a productive intervention, especially among populations already having increasing difficulty performing their own routine daily care. Second, the impressive analytical power of this broad database strongly suggests that a coalition is needed among patients, the medical/dental establishment and major cloud-based enterprises to create an even better worldwide resource database to allow the research community to efficiently examine a wide spectrum of current and future public health issues with a never-before-realized confidence and precision."
Dr. Steven R. Goodman, Editor-in-Chief of Experimental Biology & Medicine, said, "Caffrey and colleagues have utilized the Taiwan National Insurance database to study associations with dementia. They demonstrate an association between good dental health and decreased occurrence of dementia. These results, while not demonstrating causation, suggest that an important prevention procedure could be steps as simple as daily use of anti-microbial mouthwash and seeing dentists on a regular schedule."
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