is ignoring your teeth bad for your brain?

oral hygiene "has implications far beyond the mouth," according to new research.

by dave yasvinski

published feb 13, 2023

last updated feb 16, 2023

3 minute read

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3 minute read

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new study indicates poor oral health may be related to declining brain health. getty

people who pay attention to their pearly whites may have one more reason to smile thanks to new research linking healthy teeth to a healthy mind. the preliminary study, set to be presented this week at international stroke conference 2023, found that people who are predisposed to poor oral health may be forced to grin and bear the consequences later in life. the team of researchers also found that seeking early treatment for overlooked oral issues may lead to significant benefits to brain health.

previous research has shown that the consequences of ignoring good dental hygiene, including cavities and gum disease, are linked to high blood pressure and other risk factors associated with heart disease.

“what hasn’t been clear is whether poor oral health affected brain health, meaning the functional status of a person’s brain, which we are now able to understand better using neuroimaging tools such as magnetic resonance imaging or mri,” said cyprien rivier, study author and a postdoctoral fellow in neurology at the yale school of medicine in new haven, connecticut.

“studying oral health is especially important because poor oral health happens frequently and is an easily modifiable risk factor — everyone can effectively improve their oral health with minimal time and financial investment.”

to explore the relationship, researchers studied the health data of around 40,000 adults (46 per cent male, with an average age of 57 years) without a history of stroke who were enrolled in the u.k. biobank, a large-scale biomedical database that contains the health information of about half a million participants. the group was screened for 105 genetic variants known to make a person more likely to experience cavities, dentures and missing teeth as they grow older.

evidence of poor brain health was determined by looking at mri images of these patients. the team focused on two things: white matter hyperintensities, which represent accumulated damage in the brain’s white matter, and can impair balance, memory and mobility; and microstructural damage, or the degree to which the fine architecture of the brain has changed compared to images of a healthy brain of the same age.

the team found that people who were predisposed to poor oral health had 24 per cent increase in the amount of white matter hyperintensities that equates to a higher burden of a silent cerebrovascular disease (or silent stroke). this group also had a 43 per cent change in microstructural damage scores on their mris compared to healthy brains.

“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,” rivier said. “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.”

the study had a few shortcomings, including the fact that the u.k. biobank includes people who are predominantly of european ancestry, with 94 per cent of participants listing their race as white. the research, therefore, would benefit from including patients from more diverse backgrounds.

although the study was unable to prove a causal relationship between oral and brain health, its findings should prompt more research, according joseph p. broderick, an american stroke association council member and volunteer expert who was not involved in the study.

“environmental factors such as smoking and health conditions such as diabetes are much stronger risk factors for poor oral health than any genetic marker — except for rare genetic conditions associated with poor oral health, such as defective or missing enamel,” broderick said. “it is still good advice to pay attention to oral hygiene and health. however, since people with poor brain health are likely to be less attentive to good oral health compared to those with normal brain health, it is impossible to prove cause and effect.

“also, genetic profiles for increased risk of oral health may overlap with genetic risk factors for other chronic health conditions like diabetes, hypertension, stroke, infections, etc. that are known to be related to brain imaging markers.”

dave yasvinski is a writer with healthing.ca

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