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Periodontics

Beyond the mouth: the impact of periodontal disease on dementia

Evidence-Based Dentistry volume 24, pages 138–139 (2023)Cite this article

Subjects

Abstract

Data sources

The authors searched Medline via PubMed, Scopus, CINAHL, Web of Science, and PsycINFO for relevant studies published until April 2022.

Study selection

Longitudinal studies that assessed periodontal health as the exposure and cognitive decline and/or dementia as the outcome were included. Case reports, reviews, cross-sectional studies, and animal studies were excluded.

Data extraction and synthesis

Two authors independently reviewed studies for inclusion, extracted data, and assessed study quality. Meta-analysis was conducted to generate pooled odds ratios (ORs) for cognitive decline and hazard ratios (HRs) for dementia. Sources of heterogeneity were explored through subgroup analyses.

Results

A total of 24 studies were included for cognitive decline and 23 for dementia. Poor periodontal health was associated with increased odds of cognitive decline (OR = 1.23; 95% CI: 1.05–1.44) and dementia (HR = 1.21; 95% CI: 1.07–1.38). Tooth loss also appeared to increase the risk independently. However, significant heterogeneity existed between studies.

Conclusions

Poor periodontal health may increase the risk of cognitive decline and dementia, but the quality of evidence was low. Further high-quality, longitudinal studies with standardized assessments are needed to establish causality.

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References

  1. Harding A, Singhrao SK. Periodontitis and dementia: a bidirectional relationship? J Dent Res. 2022;101:245–6.

    Article  PubMed  Google Scholar 

  2. Larvin H, Gao C, Kang J, Aggarwal VR, Pavitt S, Wu J. The impact of study factors in the association of periodontal disease and cognitive disorders: systematic review and meta-analysis. Age Ageing. 2023;52:afad015.

    Article  PubMed  Google Scholar 

  3. Nazir M, Al-Ansari A, Al-Khalifa K, Alhareky M, Gaffar B, Almas K. Global prevalence of periodontal disease and lack of its surveillance. Sci World J. 2020;2020:2146160.

    Article  Google Scholar 

  4. Guo H, Chang S, Pi X, Hua F, Jiang H, Liu C, et al. The effect of periodontitis on dementia and cognitive impairment: a meta-analysis. Int J Environ Res Public Health. 2021;18:6823.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kamer AR, Pirraglia E, Tsui W, Rusinek H, Vallabhajosula S, Mosconi L, et al. Periodontal disease associates with higher brain amyloid load in normal elderly. Neurobiol Aging. 2015;36:627–33.

    Article  PubMed  Google Scholar 

  6. Ma KS, Hasturk H, Carreras I, Dedeoglu A, Veeravalli JJ, Huang JY, et al. Dementia and the risk of periodontitis: a population-based cohort study. J Dent Res. 2022;101:270–7.

    Article  PubMed  Google Scholar 

  7. Pisani F, Pisani V, Arcangeli F, Harding A, Singhrao SK. The mechanistic pathways of periodontal pathogens entering the brain: the potential role of treponema denticola in tracing Alzheimer’s disease pathology. Int J Environ Res Public Health. 2022;19:9386.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Sansores-España D, Carrillo-Avila A, Melgar-Rodriguez S, Díaz-Zuñiga J, Martínez-Aguilar V. Periodontitis and Alzheimer´s disease. Med Oral Patol Oral Cir Bucal. 2021;26:e43–8.

    Article  PubMed  Google Scholar 

  9. Chen C-K, Wu Y-T, Chang Y-C. Association between chronic periodontitis and the risk of Alzheimer’s disease: a retrospective, population-based, matched-cohort study. Alzheimers Res Ther. 2017;9:56.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Dominy SS, Lynch C, Ermini F, Benedyk M, Marczyk A, Konradi A, et al. Porphyromonas gingivalis in Alzheimer’s disease brains: evidence for disease causation and treatment with small-molecule inhibitors. Sci Adv. 2019;5:eaau3333.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Benson GS, Bauer C, Hausner L, Couturier S, Lewczuk P, Peters O, et al. Don’t forget about tau: the effects of ApoE4 genotype on Alzheimer’s disease cerebrospinal fluid biomarkers in subjects with mild cognitive impairment-data from the Dementia Competence Network. J Neural Transm (Vienna). 2022;129:477–86.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran

    Morteza Banakar

  2. Department of Pediatric Dentistry, Faculty of Dentistry, Shahed University, Tehran, Iran

    Morteza Banakar, Yoones Sadabadi & Majid Mehran

  3. Department of Oral Medicine, Faculty of Dentistry, Shahed University, Tehran, Iran

    Farid Abbasi

Authors
  1. Morteza Banakar
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  2. Yoones Sadabadi
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  3. Majid Mehran
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  4. Farid Abbasi
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Corresponding author

Correspondence to Morteza Banakar.

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The authors declare no competing interests.

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Banakar, M., Sadabadi, Y., Mehran, M. et al. Beyond the mouth: the impact of periodontal disease on dementia. Evid Based Dent 24, 138–139 (2023). https://doi.org/10.1038/s41432-023-00925-0

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  • DOI: https://doi.org/10.1038/s41432-023-00925-0

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