By OMBOKI MONAYO
To families that are providing care to the elderly, optimum oral health is a key pillar in ensuring that their loved ones enjoy the required quality of life in their sunset years.
Emerging research highlights a profound connection between oral health and Alzheimer’s disease (AD), emphasizing that poor oral hygiene may significantly increase the risk of cognitive decline.
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According to the National Institutes of Health, “the percentage of people with Alzheimer’s dementia increases dramatically with age. About 5% of people aged 65 to 74, as well as 13.2% of people aged between 75 and 84, and 33.4% of people aged 85 or older have Alzheimer’s dementia”.
Studies reveal that individuals with poor oral health have more than double the risk of developing AD, with conditions like tooth loss raising the risk by over three-fold. Chronic inflammation from periodontal disease, caused by bacteria such as Porphyromonas gingivalis, can compromise the blood-brain barrier, allowing harmful bacteria and toxins to enter the brain.
Dr Smita Mehra, who is the Principal Dentist at The Neem Tree Dental Practice, highlighted the connection between Alzheimer’s and oral health in a MedicineNet interview.
“Alzheimer’s is a degenerative disease that most commonly affects those aged 60 and over, and its connection with oral health is focused on the long-term impact of caring for teeth and gums in patients, as the disease progresses,” she said.
This bacterium has been found in the brains of dementia patients, suggesting a direct link between oral health and neurodegeneration.
Dr. Patrick Amoth, Director General for Health in Kenya, emphasizes that, “Oral health is an integral component of general health,” underscoring the need to integrate dental care into broader health strategies to combat AD and related dementias.
Alzheimer’s patients face unique oral health challenges that exacerbate their condition. Cognitive decline often leads to neglected oral hygiene, resulting in cavities, gum disease, and biofilm accumulation.
Systemic inflammation
Studies show that AD patients are 69% more likely to develop periodontal disease, which can contribute to systemic inflammation and further cognitive deterioration.
Many medications for AD also cause dry mouth, increasing the risk of cavities and making it difficult to wear dentures.
“A dry mouth due to aging or complex medicine combinations can also lead to dental cavities, as well as difficulty swallowing or sometimes even speaking. With Alzheimer’s, the overall presentation of the patient is key. Simply put, these are the signs of neglect,” Dr Mehra says.
Additionally, patients may struggle to communicate dental pain, leading to untreated issues.
Caregivers play a vital role in maintaining oral hygiene for these individuals, ensuring regular brushing, flossing, and dental check-ups to prevent complications that can impact overall health and quality of life.
Detection of dental complications is a vital component in safeguarding their well-being.
Earlier diagnosis
“The earlier a patient is diagnosed, the sooner they can be educated on how to effectively clean and care for their oral health through simple, digestible instructions, almost like muscle memory,” Dr Mehra notes.
The connection between oral and cognitive health has global implications, with varying challenges and awareness levels across regions.
In Kenya, where dental health awareness is still developing, the Kenya National Oral Health Policy (2022–2030) emphasizes empowering communities to promote oral health, particularly for the elderly.
Dr. Miriam Muriithi, Kenya’s Chief Dental Officer, advocates for integrating oral health into general health programs, noting that “most oral diseases are preventable.” In contrast, countries like the U.S. and the U.K. have more established dental care systems but still face high rates of dementia, highlighting the ongoing need for preventive measures.
Maintaining good oral hygiene is crucial for seniors to prevent tooth decay and gum disease. Key daily practices include brushing twice daily with fluoride toothpaste, flossing once a day, and using an antiseptic mouthwash once or twice daily. Regular dental check-ups are also essential for cleanings and oral exams, as plaque can build up quickly and lead to serious dental issues, especially if oral hygiene is neglected.
Observations and recommendations
During a dental check-up, seniors can expect a thorough history and examination. It is recommended that the home caregiver be present to take note of the dentist’s observations and recommendations for the patient.
Dentists will ask about recent changes in oral health, such as sensitivity, difficulty chewing, or any sores or bleeding. The oral exam includes checking the face, neck, bite, jaw, lymph nodes, and interior mouth surfaces for signs of infection, oral cancer, or other abnormalities. The condition of teeth, fillings, and any appliances like dentures will also be assessed.
For seniors with dentures or dental appliances, the dentist will inquire about their use and examine them for wear or damage. They will also check the mouth for any irritation caused by these devices.
By following these hygiene practices and attending regular dental visits, seniors can maintain their oral health and reduce the risk of complications.
Healthcare providers globally are encouraged to prioritize regular dental check-ups, proper oral hygiene practices, and caregiver education to reduce the risks associated with poor oral health. As research continues to explore the oral-brain connection, maintaining excellent oral hygiene emerges as a powerful strategy in preserving cognitive function and enhancing quality of life.
As medical understanding of Alzheimer’s Disease evolves, it is becoming clear that your mouth might be a window to your brain’s health, no matter your age.
