Abstract
Dementia is characterized by a range of cognitive defects with impaired activities of daily living that have implications for patient oral health. Objectives. A case-control study was made of the impact of dementia upon oral health. A total of 152 patients were included: 69 with dementia and 83 controls from the region of Murcia (Spain). The Global Deterioration Scale (GDS) was used to classify the patients and an oral exploration was carried out. Odds ratios (ORs) and confidence intervals (CIs) were estimated using regression models. The patients with more severe disease were significantly more likely to have fewer natural teeth (OR 11.00, 95%CI 1.28–23.22; p = 0.001), a higher plaque index (p = 0.001), and a greater bleeding index (p = 0.001) than the control group. These findings suggest that older adults with dementia have deficient oral health. A higher bleeding index increases the risk of deterioration of cognitive function. The oral hygiene and health of older people with dementia need to be improved.
Highlights
Dementia is characterized by a range of cognitive defects with memory loss that result in different health problems
We found the oral health of people with dementia to be poor, and the degree of dementia was seen to play an important role in this respect—severe dementia being associated with a greater probability of having fewer teeth in the mouth than among the controls
The severity of cognitive impairment does play a role in the oral health of older people with dementia, with increasing cognitive impairment being associated with greater plaque scores and oral disease [17,19,20]
Summary
Dementia is characterized by a range of cognitive defects with memory loss that result in different health problems. There is increasing consensus that the production and accumulation of amyloid-β peptide are central to the pathogenesis of Alzheimer’s disease. One possible way that links both diseases (dementia and oral diseases) could be the invasion of the brain tissue by periodontal bacteria that reside in the dental biofilm (i.e., Aggregatibacter actinomycetescomitans; Tannerella forsythia, Porphyromonas gingivalis, and Treponema denticola) and their products [4]. This invasion may occur through the bloodstream or via peripheral nerves and would accelerate neuroinflammation. Periodontal-derived cytokines could reach the brain by either systemic or neural via, increasing brain cytokine levels [4,9]
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