Tooth Loss Increases Risk of Dementia and Reduced Cognitive Function

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      JDR CTR publishes systematic review that shows an association between tooth loss and reduced cognitive function in adults.

      The International and American Associations for Dental Research (IADR/AADR) have published an article titled “Tooth Loss Increases the Risk of Diminished Cognitive Function: A Systematic Review and Meta-analysis” in the OnlineFirst portion of the JDR Clinical & Translational Research. In it, Cerutti-Kopplin et al systematically assessed the association between oral health and cognitive function in adult populations.

      The increase of cognitive impairment and its pathologic correlates, such as dementia and Alzheimer’s disease, in aging populations is progressing worldwide and creating a significant burden on health systems. Better insight into the nature and extent of the association between oral health and cognitive function is of great importance since it could lead to preventive interventions for cognitive performance. Therefore, the objective of this review was to systematically examine if tooth loss leads to cognitive impairment and its most prevalent pathologic correlate (dementia).

      Eligible study reports were identified by searching the MEDLINE (via Ovoid), EMBASE, PsycoINFO and Cochrane Library databases. Pooled hazard ratios with 95 percent confidence intervals were calculated with a random effects model. From 1,251 identified articles, 10 were included in the systematic review and eight in the meta-analysis. Random effects analysis showed, with statistically low heterogeneity, that individuals with less than 20 teeth were at a 20 percent higher risk for developing cognitive decline (hazard ratios equal 1.26, 95 percent confidence intervals equal 1.14 to 1.40) and dementia (hazard ratios equal 1.22, 95 percent confidence intervals equal 1.04 to 1.43) than those with greater than or equal to 20 teeth.

      Image shows a dental x-ray.
      Based on the published literature, the results of this study show that the risk for cognitive impairment and dementia increases with loss of teeth. Image is for illustrative purposes only.

      Based on the published literature, the results of this study show that the risk for cognitive impairment and dementia increases with loss of teeth. This information suggests that oral health strategies aimed to preserve teeth may be important in reducing risk of systemic disease.

      About this neurology research

      Source: Ingrid Thomas – International & American Association for Dental Research
      Image Credit: The image is in the public domain.
      Original Research: Abstract for “Tooth Loss Increases the Risk of Diminished Cognitive Function: A Systematic Review and Meta-analysis” by D. Cerutti-Kopplin, J. Feine, D.M. Padilha, R.F. de Souza, M. Ahmadi, P. Rompré, L. Booij, and E. Emami in JDR Clinical & Translational Research. Published online February 26 2016 doi:10.1177/2380084416633102

      Abstract

      Tooth Loss Increases the Risk of Diminished Cognitive Function: A Systematic Review and Meta-analysis

      Emerging evidence suggests that oral health is associated with cognitive function. This review aims to systematically assess this association in adult populations via prospective cohort study designs. Eligible study reports were identified by searching the MEDLINE (via Ovoid), EMBASE, PsycoINFO, and Cochrane Library databases. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated with a random effects model. From 1,251 identified articles, 10 were included in the systematic review and 8 in the meta-analysis. Random effects analysis showed, with statistically low heterogeneity, that individuals with suboptimal dentition (<20 teeth) were at a 20% higher risk for developing cognitive decline (HR = 1.26, 95% CI = 1.14 to 1.40) and dementia (HR = 1.22, 95% CI = 1.04 to 1.43) than those with optimal dentition (≥20 teeth). Studies on the association between periodontal disease and cognitive status showed conflicting results. Within the limits of the quality of published evidence, this meta-analysis lends further support to the hypothesis that tooth loss is associated with an increased risk of cognitive impairment and dementia.

      Knowledge Transfer Statement: Based on the published literature, the results of this study show that the risk for cognitive impairment and dementia increases with loss of teeth. This information adds to the evidence showing links between oral and general health and suggests that oral health strategies aimed to preserve teeth may be important in reducing risk of systemic disease.

      “Tooth Loss Increases the Risk of Diminished Cognitive Function: A Systematic Review and Meta-analysis” by D. Cerutti-Kopplin, J. Feine, D.M. Padilha, R.F. de Souza, M. Ahmadi, P. Rompré, L. Booij, and E. Emami in JDR Clinical & Translational Research. Published online February 26 2016 doi:10.1177/2380084416633102

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      4 Comments

      1. Oh for goodness sake! Tooth loss is ASSOCIATED with dementia. But to say that improving cleaning your teeth will prevent it is like saying wearing wellingtons and using umbrellas are associated with each other – so if you limit the use of umbrellas there will be less wearing of wellingtons! Missing the cause behind those two observed effects – which is the rain. Inflammation is underlying cause behind both dementia and tooth loss – address inflammation and reduce both. Please Neuroscience News, you need a 101 in statistics. I expect better.

      2. Sorry that I meant to add that perhaps the conclusions of this meta-analysis should be reversed…that tooth loss and poor dental conditions are a result of diminished cognitive function rather than the reverse, as stated in the abstract above. As the live-in caregiver for my mother for almost two years, I can attest that it is challenging, if not impossible, to get a person with dementia (even in the earliest stages) to brush their teeth or even rinse their mouths (among many personal care activities).

      3. I know this report is about a research study but here is what I can tell you about teeth and Alzheimer’s with my late mother and her sister. Mom had lost many of her teeth by her early 70s. Her older sister however (whose son-in-law was a dentist and she had free regular dental care) had all of her teeth, all in excellent condition, until her mid-80s. It was only once that she was in the mid-late stages of the disease caregivers were unable to care for her teeth. She, like Mom, were diagnosed with ALZ in their mid-late 70s. Sadly, Aunt M thus had to have all of her teeth removed due to major oral infections. (Both of my maternal grandparents also had dementia but I can only remember them having dentures.) In sum, given that my mother and her sister had completely opposite experiences with their teeth, I would not say dental care is a good indicator of dementias of any kind. Just my two cents.

      4. I’m puzzled. Does the study account for timing of loss of teeth, compared to onset of dementia?
        It seems to me, that ot moght be more likely for the loss of teeth to be a result of dementia, not a cause of dementia. A person with developing dementia would be prone to neglecting personal care, neglectful of good oral hygiene. . . . and the loss of teeth would be a result.

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