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Review
. 2019 Mar;36(1):2-7.
doi: 10.1111/ger.12380. Epub 2018 Nov 27.

Mind your teeth-The relationship between mastication and cognition

Roxane A F Weijenberg  1 , Suzanne Delwel  1   2 , Bach Van Ho  1 , Claar D van der Maarel-Wierink  3 , Frank Lobbezoo  1
Affiliations
Review

Mind your teeth-The relationship between mastication and cognition

Roxane A F Weijenberg et al. Gerodontology. 2019 Mar.

Abstract

This article explores the multifactorial relationship between mastication and cognition, with a focus on dementia. Older persons, especially those with dementia, are at great risk of suffering from oral health problems such as orofacial pain and loss of natural teeth. A possible explanation could be that the cognitive and motor impairments resulting from dementia cause a decrease in self-care and as such, a worsening of oral health. An alternative explanation is that cognition and oral health influence each other. Animal studies show that a decrease in masticatory activity, for example, due to a soft diet or loss of teeth, causes memory loss and neuronal degeneration. The relationship between mastication and cognition has also been researched in human studies, but a cause-effect relationship has not been proven. It is likely that multiple factors play a role in this relationship, such as self-care, nutrition, stress and pain.

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Figures

Figure 1
Figure 1
Interactions between mastication, cognition, stress and pain. Mastication has a regulatory effect on stress and also has positive effects on cognition and pain perception.12 In animals, reduced masticatory activity is linked to cognitive decline.5 Excessive mastication, however, can also cause pain.17 Pain causes stress32 and has a negative influence on masticatory activity,33 and on cognition.34 Cognitive changes such as dementia can both alter pain perception and limit pain communication.33 Cognitive decline can also have a negative effect on oral health.33 Research has not yet clearly revealed the nature of the influence that cognition may have on stress.35 Stress can lead to bruxism and/or oral parafunction12 and can also heighten sensitivity to pain (hyperalgesia).36 Although short‐term stress has a performance‐heightening effect, chronic stress has a negative effect on cognition12
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