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Tooth Loss – A Risk Factor for Dementia

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Highlights:
  • The dose-response association between tooth loss and dementia risk is identified
  • That means the more the number of teeth is missing, the higher will be the risk of dementia
  • Masticatory dysfunction, gum diseases, and nutritional deficiency related to tooth loss are the other contributing factors
  • Interventions to avoid tooth loss can prevent dementia

Theoral-brain function-related pathogenesisexplored during a meta-analysis study established the dose-response link between tooth loss and dementia risk.

Tooth Loss and Dementia Interconnection

Tooth loss frequently occurs due to decay, gum diseases, tumors, and trauma accompanied by masticatory dysfunction, poor absorption of nutrients, pronunciation difficulty, and aged appearance.

Tooth loss is no longer considered a simple dental problem, but a risk factor for systemic diseasessuch as cardiovascular disease, cancers, obesity, stroke, and mental illnesses.

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Dementia is a progressive degeneration disorder of the central nervous system. Alzheimer's disease (AD) is the most common type accounting for 60-70% of all dementia cases. The main clinical features of dementia include cognitive impairment, abnormal behavior, and decreased ability to run daily life.

As tooth loss and dementia are common age-related diseases, the progressing aging population increased the attention towards the association between oral-brain function disorders.

The Dose- Response Analysis

Though several systematic reviews and meta-analyses have examined the link between tooth loss and cognitive status, a dose-response analysis on relevant cohort studies provided the updated evidence on the relationship between the number of teeth lost and dementia.
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The study population criteria were patients suffering tooth loss, and/or dementia irrespective of gender, age and race with a control group.

Finally, 14 studies were included in their analysis involving a total of 34,074 adults and 4,689 cases of people with diminished cognitive function.

The researchers discovered that the adults with more tooth loss had 1.48 times higher risk of developing cognitive impairment and 1.28 times higher risk of being diagnosed with dementia, even after controlling for other factors. However, adults missing teeth are more likely to have cognitive impairment without dentures (23.8 percent) than those with dentures (16.9 percent).

This revealed that the association between tooth loss and cognitive impairment is not significant when participants had dentures. They also conducted an analysis using a subset of eight studies to determine if there was a dose-response relationship between tooth loss and cognitive impairment.

Their findings confirmed this relationship; for each additional missing tooth risk of cognitive impairment increased a 1.4 percent and 1.1 percent increased risk of being diagnosed with dementia.

Other Contributing Factors

The positive association between the two diseases might occur due to the alteration of chewing ability that decreased cerebral blood circulation and neurotransmitter secretion.

Gum diseases that cause tooth loss also stimulate the release of some cytokines-related to the activation of molecules contributing to neurodegeneration.

Nutritional deficiency related to tooth loss is also regarded as a marker for dementia, especially when the deficiency involves lessened intakes of protein and essential vitamins.

Internal connections between chewing ability, nutrient intakes increased inflammatory markers, psychosocial factors, and the susceptibility among tooth loss patients to the various subtypes of dementia need to be explored in future studies.

What are the Measures to Prevent Dementia?


References:
  1. Tooth Loss Is Associated With Increased Risk of Dementia and With a Dose-Response Relationship - (https://www.frontiersin.org/articles/10.3389/fnagi.2018.00415/full)
  2. Tooth loss as a risk factor for dementia: systematic review and meta-analysis of 21 observational studies - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195976/)


Source: Medindia

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