Author ORCID Identifier


Date of Graduation


Document Type

Thesis (MS)

Program Affiliation


Degree Name

Masters of Science (MS)

Advisor/Committee Chair

Cameron B. Jeter, PhD

Committee Member

Rodrigo Morales, PhD

Committee Member

June M. Sadowsky, DDS, MPH

Committee Member

Paul E. Schulz, MD

Committee Member

Gena D. Tribble, PhD

Committee Member

Kartik Venkatachalam, PhD


Poor oral health is a predictor of cognitive decline in elderly populations and has been shown to precede dementia. As cognitive decline progresses, patients are likely to move from the community into nursing facilities. We hypothesize that severity of dementia and residency type will impact the oral health of patients with dementia. Fifty-two participants of two dementia levels were recruited from the UTHealth Neurocognitive Disorders Center and two Houston-area nursing homes. A standardized oral health assessment, plaque index, and oral bacteria analysis determined participants’ oral health status. Further, data was collected on participants’ medical history, oral hygiene habits, dietary habits, and swallowing ability. Across dementia level, we found no visible differences in oral health, but we did find microscopic differences in oral bacterial composition between patients with mild and severe dementia. Of the 127 species that significantly differed, bacteria causing periodontitis, tooth decay, and pneumonia were found in greater abundance in patients with severe dementia. Further, patients with severe dementia had significantly worse swallowing ability, which can result in fatal aspiration pneumonia. Across residency type we found that compared to community dwelling patients with dementia, nursing home residents with dementia have significantly worse oral health according to the number of teeth chewing pairs, plaque index, and oral bacteria composition. Of the 138 species that significantly differed across residency type, we found nursing home subjects had greater abundance of oral disease-causing bacteria. Overall, we recommend that oral health assessments of patients with dementia not only include a visual oral iv health screening, but also include an analysis of oral bacteria composition as pathogenic oral species have grave potential to worsen oral and systemic disease.


Neurocognitive disorders, oral microbiome, dementia, elderly, oral health, clinical



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.