Poor dental health is linked to the heart disease and dementia. So why do we neglect it?


A new study published in the Journal of Gerontology Series A finds that if you don't take good care of your teeth, you're more likely to develop inflammation, reduced brain size, and heart damage. At first glance, this may seem far-fetched—what do teeth have to do with the brain and heart? But as one of the researchers, Dr. Benjamin Trumbull, told Salon, our culture makes the mistake of “thinking about health by dividing the body into two parts,” putting the mouth in one category and everything else in another. one type.

“To some extent, we've lost this understanding of overall health and dental health.”

In fact, oral health can have a profound impact on the rest of the body. Scientists who recently published a paper learned this by examining more than 700 sets of teeth—all from members of a little-known South American tribe.

The Chimane people are indigenous people of the Bolivian lowlands, and their lives are much simpler than those of most humans. While the rest of us thrive/obsess in a world of post-industrial technology, this community lives a traditional lifestyle of finding and growing their own food. They are not affected by problems such as pollution, physical inactivity and poor diet that contribute to the epidemic of heart disease and brain disease in industrialized societies. So when researchers draw links between everyone's oral health and cardiovascular and brain health, they can feel more reassured that the findings won't be confounded by irrelevant variables.

The study found that while oral hygiene was generally poorer in this community, rates of dementia and cardiovascular disease were also lower. However, people with extensive tooth damage have higher rates of inflammation, brain tissue loss, and aortic valve calcification. In contrast, damaged and lost teeth were not associated with coronary artery calcium or thoracic aortic calcium.

“I think this really highlights the importance of oral health in overall health,” Trumbull, a professor at Arizona State University's Center for Evolution and Medicine, told Salon via email. Trumbull points to the adage “Don't put a gift in your mouth” as evidence of a long-standing suspicion of a link between health and examining animals' teeth. Culturally, however, humans often fail to apply the same logic to themselves as horses.


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“We're essentially living outside of the manufacturer's recommended warranty coverage for our bodies.”

“To some extent, we've lost this understanding of overall health and dental health,” Trumbull said. “Now we distinguish health insurance from dental insurance, but in reality they both impact our health and aging.”

So why do we arbitrarily carve out dentistry as its own separate form of health care that insurance covers unequally? In fact, teeth are often viewed as an “aesthetic” problem, despite clear evidence that this is not the case. In fact, the website for Covered California, the largest state-level health insurance marketplace in the United States, makes this clear: “Adult dental insurance is not considered an essential health benefit and therefore is offered separately from health insurance. No financial assistance is available for purchase. These dental plans.

Even before this study, however, scientists had established strong links between oral health and inflammation, cardiovascular and brain health. However, the new paper makes the case by showing that this link exists in a population that is not only free of the environmental scourges of industrialization and factory farming, but also free of social injustices—particularly those that negatively impact oral health. The connection becomes clearer.

The Tsimane people “have a much smaller socioeconomic gradient and have little access to modern dentistry,” Trumbull said. “This makes it possible to actually examine the association between oral health and chronic disease without confounding it with social factors” — namely the fact that industrialized societies such as the United States tend to provide poorer dental care to people of lower socioeconomic status. .

“That's what's really unique about this paper – we can assess the association between dental health and cardiovascular and brain health without any contamination by socioeconomic status,” Trumbull said.

The new paper also provides useful background for research on how oral health connects to other forms of health. A paper published in January in the journal BMC Oral Health found that tooth decay reduces cortical thickness in BANKSSTS, an area of ​​the brain critical for language-related functions and among the most affected in Alzheimer's disease. area.

Likewise, a paper published in January in the European Journal of Preventive Cardiology determined that people who use dentures are more likely to develop coronary artery disease, stroke, myocardial infarction, heart failure and type 2 diabetes. A 2022 paper published in the International Journal of Dentistry also determined that people with severe tooth loss and diabetes, as well as those with only severe tooth loss, were more likely to have elevated serum C-reactive protein (CRP) levels. Inflammatory liver enzymes. Studies have also found that people who floss regularly may have lower CRP levels.

There's still a lot we don't understand about how our mouths and other parts of our health are intertwined.Just last week, researchers at the Fred Hutchinson Cancer Center in Seattle reported in the journal Nature that a bacterium that lives in our mouths, called Fusobacterium nucleatumassociated with an increase in colorectal tumors.

However, most previous studies have left open the possibility that some external factors, such as diet or environment, may explain the association between the oral cavity and these diseases. Thanks to Trumbull and the extensive team of researchers who have joined him—including anthropologists, cardiologists, neurologists, radiologists, and dentists—researchers can now study a large group of people in whom postindustrial society is fundamentally does not exist.

The experience was more than educational—Trumbull found it inspiring.

“It has been one of the greatest honors of my life to work with Tsimané over the past fifteen years,” said Trumbull. “Modern urban living is evolutionarily novel – for 99 percent of human history we were hunter-gatherers. Our sedentary lifestyle today is very different from other humans in the past.”

Because post-industrial urban life is so unusual compared to what our physiology was designed for, “we're essentially living outside the manufacturers' recommended warranties for our bodies,” Trumbull says. “Most of human evolution occurred in traditional subsistence populations, but almost all health studies have been done in urban centers, so we don't really know much about what health was like before electricity, cars and grocery stores.”

“Working with a population like the Tsimane is an amazing experience to better understand the health issues people faced before living in cities,” Trumbull added.

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