Home Medizin Schlechte Mundgesundheit führt zu schlechterer Gehirngesundheit

Schlechte Mundgesundheit führt zu schlechterer Gehirngesundheit

von NFI Redaktion

New research suggests that proper care of teeth and gums can offer benefits beyond oral health, including improving brain health.

In a large observational study of middle-aged adults without a history of stroke or dementia, poor oral health was strongly linked to several imaging markers of white matter damage.

„Since the neuroimaging markers evaluated in this study precede stroke and dementia and are established risk factors, our results suggest that oral health, a readily modifiable process, could be a promising target for very early interventions focusing on improving brain health,“ wrote the study’s lead author, Cyprien Rivier, MD, MS, with the Department of Neurology, Yale University School of Medicine, New Haven, Connecticut.

The study was published online on December 20, 2023, in Neurology.

The research data included 40,175 adults (average age 55 years; 53% female) without a history of stroke or dementia, who were enrolled in the UK Biobank from 2006 to 2010 and underwent brain MRI between 2014 and 2016.

Overall, 5470 (14%) participants had poor oral health, defined as the presence of dentures or loose teeth. Those with poor (compared to optimal) oral health were older, more likely to be male, and had a higher prevalence of hypertension, hypercholesterolemia, diabetes, overweight/obesity, and a current or past history of smoking.

In a multivariable model, poor oral health was associated with a 9% increase in white matter hyperintensity (WMH) volume (P < .001), an established marker for clinically silent cerebrovascular diseases.

Poor oral health was also linked to a 10% change in the overall fractional anisotropy (FA) score (P < .001) and a 5% change in the overall mean diffusivity (MD) score (P < .001), two diffusion tensor imaging metrics that accurately represent white matter degeneration.

Genetic analyses using Mendelian randomization confirmed these associations. Individuals genetically predisposed to poor oral health had a 30% increase in WMH volume (P < .001), 43% change in overall FA score (P < .001), and 10% change in overall MD score (P < .01), the researchers reported.

They noted that these results complement earlier epidemiological evidence linking poor oral health to a higher risk of clinical outcomes related to brain health, including cognitive decline.

„Huge Dividends“

The authors of an accompanying editorial praised the authors for „newly and effectively“ examining the consequences of poor oral health by using MRI-defined white matter damage, which is associated with cognitive decline but precedes it by many years and stroke.

„The fact that these imaging changes are observed in asymptomatic individuals gives hope that interventions to improve oral health could have immensely positive effects on later brain health,“ wrote Dr. Steven Kittner, MPH, and Dr. Breana Taylor, with the Department of Neurology at the University of Maryland School of Medicine in Baltimore.

„The mechanisms mediating the association between the genetic risk score of oral health and white matter injuries are likely to be complex, but the authors have taken an important step forward in addressing a hypothesis of immense public health importance,“ they added.

Data from the World Health Organization suggests that nearly 3.5 billion people worldwide are affected by oral diseases, which are largely preventable, with three-quarters of people affected in middle-income countries.

The study was partially funded by grants from the National Institutes of Health, the American Heart Association, and the Neurocritical Care Society Research Fellowship. The authors and editors have disclosed no relevant conflicts of interest.

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