The Mouth Brain Axis

The Mouth Brain Axis

While we may all recognize a connection between our mouths, our brains, and what comes out of the two, this study suggests a two-way street in which mouth disease may adversely affect brain health.  We all know that our mouths can get us in trouble by inflammatory words, but apparently physical inflammation in our mouths may contribute to MRI findings in our brains connected with cognitive health.  This study showed a correlation between gum disease and MRI visible brain changes called white matter hyperintensities.

Anyone in health care for a short time can tell you of a patient bringing in an MRI report which mentions ‘white matter hyperintensities.’  The patient wants, legitimately so, to know what they are and what they mean.  We remember these cases both for their common occurrence and the fact that we usually can’t give a specific answer, except that we see them often, especially as patients age. Beyond that, we acknowledge that they can resemble clearly abnormal changes like those found with multiple sclerosis (an autoimmune brain disease where the similar MRI changes match up with symptoms) and seem to occur more often in those with migraines.

For the most part, these results seem to be signs of micro-damage occurring over time that may or may not result in actual symptoms one day.  Those symptoms can include memory challenges and effects on decision making.  The hyperintense signal on MRI is believed to be just a mark of tiny inflammation or ischemia and its leftover effects on the cells in that brain area.

In the study, researchers looked at over 1,000 adults with an average age of 77 years.  Eight hundred demonstrated some degree of gum disease while 343 did not.  Along with the dental exams, the participants underwent MRIs to look for signs of brain abnormalities, including the hyperintensities.  Those with gum disease were found to have an average 2.83% of brain volume with such hyperintensities versus only 2.52% in those without gum disease.

This difference was statistically significant and continued to be present after factoring out other potential contributors such as diabetes, high blood pressure, smoking, and the usual factors of age, sex, and race.  Despite the finding for these hyperintensities, other brain abnormalities including microbleeds and tiny strokes called lacunar infarcts did not correlate with gum disease presence.  This makes the connection with hyperintensities more impressive and specific.

In helping our patients restore and maintain healthier, more abundant life, recognizing such connections is important.  We therefore address overall gut health which starts with the mouth and encourage dental care with biological dentists not just for mercury removal but for overall mouth health.  We also look forward to more research to guide us in optimizing gum health with not just brushing and flossing but probiotics and health diets that promote dental health.

 

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Original Article:

Jaclyn Meyer, Chylee Martin, Stefanie Wood, Forrest Lowe, Leonardo Bonilha, Hamdi S. Adam, Ryan Demmer, Bruce A. Wasserman, Wayne D. Rosamond, James D. Beck, Souvik Sen. Periodontal Disease Independently Associated With White Matter Hyperintensity Volume. Neurology Open Access, 2025; 1 (4) DOI: 10.1212/WN9.0000000000000037

 

Thanks to Science Daily:

American Academy of Neurology. “Gum disease may quietly damage the brain, scientists warn.” ScienceDaily. ScienceDaily, 29 October 2025. <www.sciencedaily.com/releases/2025/10/251029100147.htm>.

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Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.