Health of mouth, mind intertwined

Q: My sister’s husband is 73, and his teeth and gums are really starting to go. At the same time, it seems he’s starting to experience a little mental slippage. Could the two be related? Arthur B., Springfield, Virginia

A: The health of your mouth and the rest of your body are intertwined — especially when you look at the relationship of dental and oral infections to various forms of dementia. You’re right that your brother-in-law’s ailing gums and teeth may play a role in his cognitive decline. Oral bacterial infections cause gingivitis, the first stage of gum disease. Symptoms include swollen or receding gums, easy bleeding and bad breath. That can lead to the more advanced periodontal disease, which affects the gums, teeth and surrounding bone. It may cause loose teeth and painful chewing. That whole process ramps up inflammation, changes your oral biome and spreads bacteria and inflammation throughout your body, including to your brain.

A recent retrospective study examined South Korean health data from 2005 to 2015 and found that people with periodontal disease had a 6% higher risk for developing dementia than people who didn’t have those oral health problems. The researchers also looked at data from the U.S. National Health Information Database and postulated that decreasing prevalence of dementia risk factors such as chronic periodontitis by 20% could reduce the prevalence of dementia in 2050 by more than 15%.

One theory is that bacteria in oral plaque that fuels periodontitis enter the bloodstream and then cross the blood/brain barrier. There, they cause inflammation of brain tissue and possibly the development of toxic proteins, which could build up over time and lead to the development of dementias.

So if you can talk to your sister or brother in-law about getting medical care for his teeth and gums, you may help slow his decline. Antibiotics can control or cure periodontitis, along with conscientious brushing, flossing and regular teeth cleanings.