Oral health and dementia

The significance of maintaining oral health cannot be underestimated… Deborah Lyle says why

In addition to more immediate problems such as gingivitis and periodontitis, there is an ever growing list of chronic disorders elsewhere in the body that correlate with oral disease, including cardiovascular disease, osteoporosis, diabetes, adverse pregnancy outcomes, and dementia.

Dementia is the collective term for the deterioration of intellectual faculties, such as memory and cognitive ability, resulting from diseases or conditions of the brain.

One in 50 people in the UK between 65 and 70 years of age develop some form of dementia, and one in five people aged over 80.[i] This is likely to be due in part to a range of conditions more prevalent in older people, such as higher blood pressure, weaker immune system, heart disease and stroke.

Alzheimer’s disease is the most common type of dementia and currently affects approximately 496,000 people in the UK.[ii] Sufferers experience changes in brain structure and chemistry, which lead to the death of brain cells. A progressive disease, symptoms worsen over time as more parts of the brain are damaged.

Risk factors of Alzheimer’s disease include raised systolic blood pressure and high serum cholesterol concentration[iii], smoking[iv], and even moderate to severe head injury in early adulthood[v]. On the other hand, oestrogen replacement therapy has been found to reduce the risk of developing the disease[vi],[vii], as has a strict adherence to the Mediterranean diet[viii].

A long-term study in a retirement home in California[ix] has demonstrated a connection between oral hygiene habits and number of teeth with dementia. Women who brushed their teeth less than once a day had up to 65% increased risk of developing dementia compared to those who brushed three times a day. Men with significant tooth loss who did not wear dentures were found to be 91% more likely to develop dementia than men who had enough remaining natural teeth for adequate food chewing function (≥10 upper and ≥6 lower teeth).

Interestingly, the latter case study followed the oral hygiene habits of older patients, demonstrating the importance of maintaining oral health at all life stages, rather than assuming that prevention can only take place at an early age to make a difference.

Match ability

To establish and maintain an oral hygiene routine in elderly patients, we need to recommend products that match their lifestyle and ability. Likely to have less manual dexterity than their younger counterparts, most older patients will struggle with using string floss, for example. In addition to regular tooth brushing with fluoride toothpaste, the oral irrigator, or Water Flosser, is a useful adjunct that has proven highly successful in clinical studies, and is suitable for most patients of varying ages and levels of mobility.

Water flossers have been shown to drastically reduce plaque biofilm, gingivitis, probing pocket depth and bleeding. The Waterpik Water Flosser has a wealth of scientific evidence to demonstrate its effectiveness, proving to be 51% more effective than string floss for reducing gingivitis[x] and twice as effective as string floss for reducing gingival bleeding.[xi] Indeed, the Waterpik Water Flosser removes 99.9% of biofilm from treated areas after just one three-second treatment.[xii], [xiii]

Oral hygiene innovations such as the Water Flosser have transformed our ability to help our patients to achieve better oral and systemic health and enjoy a greatly enhanced quality of life.

 • References available on request

For more information on Waterpik Water Flossers please speak to your wholesaler or visit www.waterpik.co.uk. Waterpik products are widely available in Boots stores and selected Lloyds Pharmacies

Deborah received her Bachelor of Science degree in Dental Hygiene and Psychology from the University of Bridgeport and her Master of Science degree from the University of Missouri – Kansas City.  She has 18 years clinical experience in dental hygiene in the United States and Saudi Arabia with an emphasis in periodontal therapy.  Along with her clinical experience, Deborah has been a full time faculty member at the University of Medicine & Dentistry of New Jersey, Forsyth School for Dental Hygienists and Western Kentucky University.  She has contributed to Dr. Esther M. Wilkins’ 7th, 8th, 9th and 10th editions of Clinical Practice of the Dental Hygienist and the 2nd and 3rd edition of Dental Hygiene Theory and Practice by Darby & Walsh. She has written numerous evidence-based articles on the incorporation of pharmacotherapeutics into practice, risk factors, diabetes, systemic disease and therapeutic devices. Deborah has presented numerous continuing education programs to dental and dental hygiene practitioners and students and is an editorial board member for the Journal of Dental Hygiene, Modern Hygienist, RDH, and Journal of Practical Hygiene and conducted several studies that have been published in peer-reviewed journals.  Currently, Deborah is the Director of Professional and Clinical Affairs for Waterpik, Inc.

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