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Moderating Effects of Oral Bacteria and Tooth Loss on Cognitive Performance.

H Luo1, A R Kamer2, Z Xu3

  • 1Brody School of Medicine, East Carolina University, Greenville, NC, USA.

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|March 2, 2026
PubMed
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Tooth loss impacts cognitive function, particularly verbal fluency, depending on oral microbiome health. Maintaining oral health is crucial for older adults to support brain health.

Keywords:
cognitiondysbiotic indexmissing teethmodifying effectsolder adultsoral microbiome

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Area of Science:

  • Neuroscience
  • Microbiology
  • Gerontology

Background:

  • The oral microbiome may impact brain health and cognitive decline.
  • Limited research exists on how the oral microbiome modifies the tooth loss-cognition relationship.

Purpose of the Study:

  • To investigate the interaction between tooth loss and oral dysbiosis on cognitive performance in older adults.

Main Methods:

  • Utilized data from the 2011-2012 National Health and Nutrition Examination Survey (n=677, ages 60-69).
  • Assessed cognitive performance using standardized tests.
  • Defined significant tooth loss (≥10 teeth) and high oral dysbiosis (upper tertile of specific bacterial ratios).

Main Results:

  • A significant interaction was found between tooth loss and oral dysbiosis on the Animal Fluency Test (AFT).
  • Participants with higher oral dysbiosis and fewer missing teeth exhibited lower scores on the AFT.

Conclusions:

  • The impact of tooth loss on verbal fluency is contingent on oral bacterial balance.
  • High oral dysbiosis may negatively affect verbal fluency when tooth loss is minimal.
  • Promoting periodontal health to reduce oral dysbiosis is recommended for older adults.