Key Points
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Suggests that the evidence with regard to an association between oral health and dementia is weak because of the lack of well-designed cohort and case-control studies and variation in how dementia and oral health are defined and measured.
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Highlights that dementia and cognitive decline are risk factors for poor oral health.
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Suggests that patients with suboptimal oral health appear to have an associated increased risk of cognitive impairment, but more evidence from different settings is required.
Abstract
This is the fourth and final paper of a series of reviews undertaken to explore the relationships between oral health and general medical conditions, in order to support teams within Public Health England, health practitioners and policy makers. This review aimed to explore the most contemporary evidence on whether poor oral health and dementia occurs in the same individuals or populations, to outline the nature of the relationship between these two health outcomes and to discuss the implication of any findings for health services and future research. The review was undertaken by a working group comprising consultant clinicians from medicine and dentistry, trainees, public health and academic staff. Whilst other rapid reviews in the current series limited their search to systematic reviews, this review focused on primary research involving cohort and case-control studies because of the lack of high level evidence in this new and important field. The results suggest that poor oral hygiene is associated with dementia, and more so amongst people in advanced stages of the disease. Suboptimal oral health (gingivitis, dental caries, tooth loss, edentulousness) appears to be associated with increased risk of developing cognitive impairment and dementia. The findings are discussed in relation to patient care and future research.
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Acknowledgements
We would like to acknowledge the support of Carly Tutti of Public Health England during a workshop in preparation for this paper. We further acknowledge the overall support of Public Health England, the Faculty of Dental Surgery of The Royal College of Surgeons of England and The British Dental Association.
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Supplementary Table 1
Cohort and case-control studies: Is dementia (including cognitive decline) a risk factor for poor oral health? (PDF 174 kb)
Supplementary Table 2
Cohort and case-control studies: Is poor oral health a risk factor for developing dementia (including cognitive decline)? (PDF 216 kb)
Supplementary Table 3
Systematic review on tooth loss and periodontal disease and cognitive impairment (PDF 92 kb)
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Daly, B., Thompsell, A., Sharpling, J. et al. Evidence summary: the relationship between oral health and dementia. Br Dent J 223, 846–853 (2017). https://doi.org/10.1038/sj.bdj.2017.992
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DOI: https://doi.org/10.1038/sj.bdj.2017.992
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