Poor Oral Health Can Increase Your Likelihood of Dementia

Brush, floss, see the dentist, repeat. All set, right? Maybe not.

Leaders in functional medicine are emphasizing a strong but little-considered link: poor oral health can increase your risk of dementia and other neurodegenerative diseases.

PALM Health’s Dr. Sita Kedia, neurologist and functional medicine physician, and Dr. Jane Gelfand, functional medicine physician, weigh in on the idea.

“I admit that I myself didn’t think enough about oral health for a long time,” says Dr. Gelfand. “But there’s a clear biological mechanism at play here.”

Your oral cavity has a whole microbiome of its own, kind of like the gut, with a delicate balance of bacteria (good and bad) and other microbes. And just like the gut, if there is a chronic imbalance in that microbiome, it can lead to inflammation.

Inflammation doesn’t just stick around in the local area of the imbalance. It travels — through the bloodstream, through the lymphatic system. “When oral bacteria stay out of balance and infections smolder, they continuously fuel inflammation throughout the body, raising the risk of other chronic illnesses, especially those involving the brain,” says Dr. Kedia.

This isn’t just theory — here’s what recent science is showing:

• Gum disease may increase the risk of dementia. A large study led by the NIA showed a link between gum disease and dementia, most likely because the bacteria present in the mouth due to gum disease made its way into the bloodstream and reached the brain, causing dementia-like pathology.
• Poor oral health may correlate with structural brain damage. A UK Biobank study (40,000+ adults) linked poor oral health to more white matter lesions, which are brain changes associated with cognitive decline.
• Moderate to severe gum disease may link to atrophy of the hippocampus. A Japanese study showed that gum disease, especially when the affected teeth were retained, was associated with faster atrophy of the hippocampus, a brain area critical for memory.

So, routine oral care is paramount. Dr. Kedia and Dr. Gelfand remind us that protecting your mouth — and by extension, your brain — involves more than just toothpaste and floss.

• Brush and floss twice daily (yes, it still matters).
• Visit your dentist twice a year. Keep an eye out for signs of gingivitis or gum recession early.
• Try oral probiotics or pH-balancing rinses to restore microbial balance.
• Use toothpaste with nanohydroxyapatite. This ingredient is shown to help remineralize enamel and build up the bone in teeth.
• Skip traditional mouthwash. Most mouthwashes will kill off all good bacteria in addition to the bad, compromising the oral microbiome the way an antibiotic can compromise the gut biome.
• Discuss old metal fillings with your dentist, especially if your mouth tends to be acidic, you grind your teeth, or the fillings are worn or cracked. Fillings can release trace amounts of heavy metals, which in certain individuals can cause issues elsewhere.
• Treat the root cause, not just symptoms. Chronic oral dysbiosis and periodontal diseases are a systemic risk, not a local issue.

The next time your dentist tells you that you need to floss more, don’t shrug it off. And if you’re already a consistent brusher, flosser, and dentist-goer, take the next steps in the list above to protect not only your teeth, gums, and mouth, but also your cognitive and neurological health. It could be one of the major keys to a long, healthy life.