Researchers Find Further Evidence of Oral-Systemic Link in Bolivian Amazon

Yet another study is confirming the link between oral pathogenic pathways and systemic health issues, including cardiovascular and brain health. Researchers at Arizona State University (ASU) conducted a study of the Tsimane people, an indigenous subsistence population in the Bolivian Amazon with poor dental health, but minimal cardiovascular disease and dementia.1

The study was initiated at the request of the Tsimane, hoping to improve their access to dental care. Likewise, the opportunity to study this population, with whom the researchers have worked for 20 years, was beneficial as they sought to untangle the oral-systemic relationship from other factors.1,2


Studying the Tsimane allowed the researchers to eliminate variables present in other populations that might otherwise skew results. Benjamin Trumble, PhD, an associate professor at ASU’s School of Human Evolution and Social Change, the Institute of Human Origins, and the Center for Evolution and Medicine, notes that in the United States, people of low socioeconomic status are often at higher risk for both chronic diseases of aging and lack of access to dental insurance or good dental care. He observes that poor diet, pollution, and lack of physical activity are contributing factors.1,2

“In the US, it is very difficult to disentangle the role of oral health in chronic disease,” explains Trumble. “The Tsimane have far less of a socioeconomic gradient and very little access to modern dentistry. This makes it possible to examine associations between oral health and chronic disease without confounding social factors.”2


The study revealed clear connections between oral, cardiac, and cognitive health. The findings are particularly amazing considering the study population is known to have minimal levels of cardiovascular disease and dementia.2

The team found a strong association between poor oral health and higher levels of inflammation, smaller brain volumes (dementia), and aortic valve calcification (cardiovascular disease). For instance, they determined that aortic valve calcification and brain tissue loss were higher in those having more teeth with exposed pulp. Tooth loss was highly prevalent, with 2.2 teeth lost per decade and a two-fold greater loss in women.1


Overall, the study affirms the association between dental health and indicators of chronic diseases in the absence of extraneous factors, even in a population with low cardiovascular and dementia risk factors.

As a bonus and through working with local dentists, the research has improved access to healthcare for the study population. “In order to apply for future grants, and to ask the various Bolivian health agencies for help, we had to first collect preliminary data to show that there is a major unmet need for dental care in this population, and that it has important impacts for health,” Trumble remarks.2


  1. Trumble BC, Schwartz M, Ozga AT, et al. Poor oral health is associated with inflammation, aortic valve calcification, and brain volume among forager-farmers. J Gerontol A Biol Sci Med Sci. 2024 Jan 31:glae013.
  2. Pomerantz N. New ASU research shows how poor oral health affect the heart, brain.
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