Poor Oral Health Linked to Decline in Brain Health

Scientists suggest that people genetically prone to cavities and tooth loss may be at higher risk of declining brain health than those without oral health issues.

Preliminary research to be presented at the Feb. 8 through 10, 2023, American Stroke Association’s International Stroke Conference in Dallas has found that poor oral health may negatively affect brain health. But treating dental cavities, gum disease, and other symptoms of poor oral health early may help reduce the risks.

According to a press release, from 2014 to 2021, researchers examined possible links between oral health and brain health using about 40,000 adult participants from the UK Biobank. The participants did not have a history of stroke.

The team screened the participants for 105 genetic variants related to poor oral health. They also looked at whether they had missing teeth or dentures later in life.

To investigate the associations between oral and brain health, the team examined the participant’s brain MRI images looking for white matter and microstructural damage.

After compiling the data, the scientists found that the participants with genetic variants that predisposed them to oral health problems such as cavities and tooth loss also had a higher burden of silent cerebrovascular disease — a risk factor for future strokes. Among these participants, the research team saw a 24% increase in white matter hyper-intensities on MRI images.

In addition, the adults with genetic variant-related poor oral health also showed a 43% increase in brain microstructural damage scores.

However, the study had some limitations. Specifically, the participants were predominantly white and of European ancestry. Therefore, more investigations are needed with participants from diverse racial and ethnic backgrounds.

"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," study author Cyprien Rivier, M.D., M.S., a postdoctoral fellow in neurology at the Yale School of Medicine said in the press release.

"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," Rivier added.

What are the links between oral health and health problems?

According to Jessica Pharar, DMD, founder of the Pharar Foundation in Las Vegas, poor oral health can increase inflammation and bacteria in the body.

"This is associated with a myriad of diseases, including diabetes, stroke, heart attack, kidney disease, dementia, and Alzheimer's disease," Pharar told Healthnews.

In fact, as a dentist, I have discovered my patient has diabetes before their doctor," she explained. "Changes in your body are often first seen in your mouth. If you have uncontrolled gum disease, it makes you at a higher risk for certain types of cancers and diabetes.

She went on to explain that, “Uncontrolled gum disease increases your risk of a heart [attack] from 200-400%." Pharar said. "All the bacteria that flows from your mouth deposits into your heart and creates an environment that makes you prone to a heart attack."

Pharar says that symptoms of poor oral health include bleeding during tooth brushing and mouth or tooth pain. She also noted that bleeding is a sign that bacteria are present in the gums — causing inflammation. Moreover, pain may indicate damage is already occurring.

"Those bacteria eventually cause cavities on your teeth. You don't always develop pain when you have poor oral health, [but] pain is a good sign that things are not doing well. Often, pain comes when major damage has been done to your oral health," she explained.

However, Pharar says that a person can improve oral health by brushing thoroughly, cleaning the tongue, and using floss or a water flosser to clean between the teeth.

Pharar said, "It's never too late to take care of your mouth, even if there are severe problems. Speak to a dental professional to help address your severe problems and get them fixed so you can better maintain your oral health."