Figure 1.

Schematic to show the knock on effect from an oral condition such as periodontitis to the development of co-morbid states in the order of periodontal disease cardiovascular and Alzheimer’s disease (AD) with input from the metabolic disorder like type 2 diabetes (T2DM). These conditions disturb mental health. Mitigation through educational programmes and improved lifestyles involving better oral hygiene, cessation of smoking, nutritional intervention especially prebiotics providing a balance of neurochemicals from the GI-tract-brain-axis. Together with dental intervention, diet and change in life styles potentially will provide improved cognition. GI tract microbiome having input on the brains health through microbial changes whereby γ-aminobutyric acid (GABA) deficit affects behavior. Abbreviations: ENS, enteric nervous system; SES, socio-economic status; GI, gastrointestinal.