Dental Health and Dementia: More than Forgetfulness
Introduction

Impaired cognitive function has been associated with worsening oral health parameters, including caries rates and periodontal clinical parameters, in cross-sectional studies.^15-17 Epidemiologic studies have also shown that individuals with increased systemic inflammation, including elevated proinflammatory markers and cardiovascular diseases, have a higher risk of developing dementia and more rapid progression of dementia symptoms over time.^18-20 Periodontal diseases are initiated by bacterial biofilm, which induces an inflammatory response causing an increase in both local and systemic pro-inflammatory markers and resulting in periodontal pocket formation, alveolar bone resorption, and, ultimately, tooth loss.^21,22 Both the elevated inflammatory state and oral bacteria and their byproducts associated with periodontitis have been linked to dementia.^1,2,23-25 Additionally, patients with dementia and their caregivers must manage delivery of preventative oral hygiene measures, which can be increasingly difficult as dementia severity increases.^26,27 Due to the number of individuals affected by both periodontal disease²⁸ and dementia⁸ and the progressive nature of both diseases, the understanding of the interaction between periodontal disease and dementia and treatment strategies for promotion of optimal oral health in patients suffering with dementia is of utmost importance to the dental practitioner.