Research | Published:

Evidence summary: the relationship between oral health and dementia

BDJ volume 223, pages 846853 (15 December 2017) | Download Citation


This is the fourth and final paper of a series of reviews undertaken to explore the relationships between oral health and general medical conditions, in order to support teams within Public Health England, health practitioners and policy makers. This review aimed to explore the most contemporary evidence on whether poor oral health and dementia occurs in the same individuals or populations, to outline the nature of the relationship between these two health outcomes and to discuss the implication of any findings for health services and future research. The review was undertaken by a working group comprising consultant clinicians from medicine and dentistry, trainees, public health and academic staff. Whilst other rapid reviews in the current series limited their search to systematic reviews, this review focused on primary research involving cohort and case-control studies because of the lack of high level evidence in this new and important field. The results suggest that poor oral hygiene is associated with dementia, and more so amongst people in advanced stages of the disease. Suboptimal oral health (gingivitis, dental caries, tooth loss, edentulousness) appears to be associated with increased risk of developing cognitive impairment and dementia. The findings are discussed in relation to patient care and future research.

Key points

  • Suggests that the evidence with regard to an association between oral health and dementia is weak because of the lack of well-designed cohort and case-control studies and variation in how dementia and oral health are defined and measured.

  • Highlights that dementia and cognitive decline are risk factors for poor oral health.

  • Suggests that patients with suboptimal oral health appear to have an associated increased risk of cognitive impairment, but more evidence from different settings is required.

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We would like to acknowledge the support of Carly Tutti of Public Health England during a workshop in preparation for this paper. We further acknowledge the overall support of Public Health England, the Faculty of Dental Surgery of The Royal College of Surgeons of England and The British Dental Association.

Author information


  1. Professor and Consultant in Special Care Dentistry, Head of Division of Public & Child Dental Health, Dublin Dental University Hospital, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland

    • B. Daly
  2. Visiting Professor in Special Care Dentistry, King's College London

    • B. Daly
  3. Consultant in Old Age Psychiatry, South London and Maudsley NHS Trust;

    • A. Thompsell
  4. General Dental Practitioner, Former Dental Core Trainee/Honorary Research Associate, King's College London Dental Institute, Denmark Hill Campus. Bessemer Road, London SE5 9RS

    • J. Sharpling
  5. Specialist in Special Care Dentistry, King's College Hospital NHS Foundation Trust, Bessemer Road, London, SE5 9RS

    • Y. M. Rooney
  6. Consultant in Dental Public Health, Healthcare Public Health Team, PHE East of England, West Wing, Victoria House, Capital Park, Fulbourn, Cambridge, CB21 5XA

    • L. Hillman
  7. Senior Lecturer in Dental Public Health, University of Portsmouth, Dental Academy, William Beatty Building, Hampshire Terrace, Portsmouth

    • K. L. Wanyonyi
  8. National Lead for Dental Public Health Healthy People Division Health and Wellbeing Directorate, Public Health England, Skipton House, Area B, 2nd floor 80 London Road, London SE1 6LH

    • S. White
  9. Dean for International Affairs, Head of Population and Patient Health, Newland-Pedley Professor of Oral Health Strategy, Honorary Consultant in Dental Public Health, King's College London Dental Institute, Denmark Hill Campus. Bessemer Road, London SE5 9RS

    • J. E. Gallagher


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Corresponding author

Correspondence to J. E. Gallagher.

Supplementary information

PDF files

  1. 1.

    Supplementary Table 1

    Cohort and case-control studies: Is dementia (including cognitive decline) a risk factor for poor oral health?

  2. 2.

    Supplementary Table 2

    Cohort and case-control studies: Is poor oral health a risk factor for developing dementia (including cognitive decline)?

  3. 3.

    Supplementary Table 3

    Systematic review on tooth loss and periodontal disease and cognitive impairment

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