Journal of Korean Dental Science

Korean Academy of Dental Science (대한치의학회)
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Strategies for Managing Dementia Patients through Improving Oral Health and Occlusal Rehabilitation: A Review and Meta-analysis

  • Yeon-Hee Lee (Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Kyung Hee University School of Dentistry) ;
  • Sung-Woo Lee (Department of Oral Medicine and Oral Diagnosis, Seoul National University School of Dentistry) ;
  • Hak Young Rhee (Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine) ;
  • Min Kyu Sim (Department of Industrial Engineering, Seoul National University of Science and Technology (SeoulTech)) ;
  • Su-Jin Jeong (Kyung Hee University Medical Center, Medical Science Research Institute, Statistics Support Part) ;
  • Chang Won Won (Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University)
  • Received : 2023.10.13
  • Accepted : 2023.10.27
  • Published : 2023.12.30
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Abstract

Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.

Keywords

Acknowledgement

This research was supported by the National Research Foundation of Korea Grant (NRF/2020R1F1A1070072) obtained from Y.-H.L. and funded by the Korean government. This work was supported by the Korea Medical Device Development Fund grant funded by the Korean government (Ministry of Science and ICT, Ministry of Trade, Industry, and Energy, Ministry of Health & Welfare, Republic of Korea, Ministry of Food and Drug Safety) (Project Number: KMDF_PR_20200901_0023, 9991006696).

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