Oral Health in Alzheimer's Disease: a Multicenter Case-control Study

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2018 Feb 25

PMID 29476334

Citations 27

Authors

F Aragon

M A Zea-Sevilla

J Montero

P Sancho

R Corral

C Tejedor

B Frades-Payo

V Paredes-Gallardo

A Albaladejo

Affiliations

Soon will be listed here.

Abstract

Objectives: The aim of this case-control study was to carry out an oral health assessment on a group of Alzheimer's patients and to establish a hypothesis regarding the implication of the characteristics of the disease and the treatment of oral health.

Materials And Methods: A total of 70 Alzheimer's patients, residents at the Alzheimer Center Reina Sofia Foundation (Madrid, Spain) and at the Alzheimer State Reference Center (Salamanca, Spain), and 36 controls (companions/acquaintances), were studied by oral examination and saliva sampling. The oral health indices DMFT/DMFS, CPI, the prosthetic condition, oral hygiene, saliva volume, and pH, as well as the specific microbiological parameters governing the risk of developing caries were assessed.

Results: Alzheimer's patients exhibited, as compared to the control group, (1) fewer teeth (10.9 ± 10.5 vs 23.7 ± 6.5), (2) fewer obturations (2.2 ± 3.4 vs 6.6 ± 5.6), (3) fewer periodontally healthy sextants (0.1 ± 0.4 vs 1.4 ± 2.2), (4) worse oral hygiene (43.1 vs 72.2% brushed), (5) greater use of removable prostheses (47.8 vs 8.4%), (6) higher incidence of candida infection (11.8 vs 0.0%) and cheilitis (15.9 vs 0.0%), (7) lower salivary flow (0.6 ± 0.6 vs 1.1 ± 0.6), and (8) lower buffering capacity (46 vs 80%).

Conclusions: After taking into account the influence of age, Alzheimer's patients had worse oral health (caries and periodontal disease), more mucosal lesions (cheilitis and candidiasis), and worse saliva quantity and quality.

Clinical Relevance: Clinicians should be aware of the implications of Alzheimer's disease in oral health, in order to stablish the effective preventive measures and the optimal treatment plan.

Citing Articles

An Update of Salivary Biomarkers for the Diagnosis of Alzheimer's Disease.

Guo H, Yang R, Cheng W, Li Q, Du M Int J Mol Sci. 2025; 26(5).

PMID: 40076682 PMC: 11900270. DOI: 10.3390/ijms26052059.

The Role of Genetic, Environmental, and Dietary Factors in Alzheimer's Disease: A Narrative Review.

Mertas B, Bosgelmez I Int J Mol Sci. 2025; 26(3).

PMID: 39940989 PMC: 11818526. DOI: 10.3390/ijms26031222.

Characteristics of the oral microbiome in youth exposed to caregiving adversity.

Gancz N, Querdasi F, Chu K, Towner E, Taylor E, Callaghan B Brain Behav Immun Health. 2024; 41:100850.

PMID: 39280088 PMC: 11401114. DOI: 10.1016/j.bbih.2024.100850.

Unraveling brain aging through the lens of oral microbiota.

Hu Q, Wang S, Zhang W, Qu J, Liu G Neural Regen Res. 2024; 20(7):1930-1943.

PMID: 38993126 PMC: 11691463. DOI: 10.4103/NRR.NRR-D-23-01761.

From teeth to brain: dental caries causally affects the cortical thickness of the banks of the superior temporal sulcus.

Wang M, Wang Z, Yu Y, Zhao D, Shen Z, Wei F BMC Oral Health. 2024; 24(1):124.

PMID: 38263072 PMC: 10807149. DOI: 10.1186/s12903-024-03899-2.

References

Tsakos G, Watt R, Rouxel P, de Oliveira C, Demakakos P . Tooth loss associated with physical and cognitive decline in older adults. J Am Geriatr Soc. 2014; 63(1):91-9. DOI: 10.1111/jgs.13190. View

Singhrao S, Harding A, Simmons T, Robinson S, Kesavalu L, Crean S . Oral inflammation, tooth loss, risk factors, and association with progression of Alzheimer's disease. J Alzheimers Dis. 2014; 42(3):723-37. DOI: 10.3233/JAD-140387. View

Vergona K . A self-reported survey of Alzheimer's centers in Southwestern Pennsylvania. Spec Care Dentist. 2005; 25(3):164-70. DOI: 10.1111/j.1754-4505.2005.tb01428.x. View

Stein P, Desrosiers M, Donegan S, Yepes J, Kryscio R . Tooth loss, dementia and neuropathology in the Nun study. J Am Dent Assoc. 2007; 138(10):1314-22. DOI: 10.14219/jada.archive.2007.0046. View

Uppoor A, Lohi H, Nayak D . Periodontitis and Alzheimer's disease: oral systemic link still on the rise?. Gerodontology. 2012; 30(3):239-42. DOI: 10.1111/j.1741-2358.2012.00660.x. View

Syrjala A, Ylostalo P, Ruoppi P, Komulainen K, Hartikainen S, Sulkava R . Dementia and oral health among subjects aged 75 years or older. Gerodontology. 2010; 29(1):36-42. DOI: 10.1111/j.1741-2358.2010.00396.x. View

Brennan L, Strauss J . Cognitive impairment in older adults and oral health considerations: treatment and management. Dent Clin North Am. 2014; 58(4):815-28. DOI: 10.1016/j.cden.2014.07.001. View

Jellinger K, Attems J . Prevalence of dementia disorders in the oldest-old: an autopsy study. Acta Neuropathol. 2010; 119(4):421-33. DOI: 10.1007/s00401-010-0654-5. View

Cummings J . Alzheimer's disease. N Engl J Med. 2004; 351(1):56-67. DOI: 10.1056/NEJMra040223. View

10.

Abbayya K, Puthanakar N, Naduwinmani S, Chidambar Y . Association between Periodontitis and Alzheimer's Disease. N Am J Med Sci. 2015; 7(6):241-6. PMC: 4488989. DOI: 10.4103/1947-2714.159325. View

11.

Ruiz-Medina P, Bravo M, Gil-Montoya J, Montero J . Discrimination of functional capacity for oral hygiene in elderly Spanish people by the Barthel General Index. Community Dent Oral Epidemiol. 2005; 33(5):363-9. DOI: 10.1111/j.1600-0528.2005.00222.x. View

12.

Zickert I, Emilson C, KRASSE B . Correlation of level and duration of Streptococcus mutans infection with incidence of dental caries. Infect Immun. 1983; 39(2):982-5. PMC: 348045. DOI: 10.1128/iai.39.2.982-985.1983. View

13.

Ellefsen B, Holm-Pedersen P, Morse D, Schroll M, Andersen B, Waldemar G . Assessing caries increments in elderly patients with and without dementia: a one-year follow-up study. J Am Dent Assoc. 2009; 140(11):1392-400. DOI: 10.14219/jada.archive.2009.0076. View

14.

Sano M, Egelko S, Jin S, Cummings J, Clark C, Pawluczyk S . Spanish instrument protocol: new treatment efficacy instruments for Spanish-speaking patients in Alzheimer disease clinical trials. Alzheimer Dis Assoc Disord. 2006; 20(4):232-41. PMC: 3526370. DOI: 10.1097/01.wad.0000213862.20108.f5. View

15.

Ellefsen B, Morse D, Waldemar G, Holm-Pedersen P . Indicators for root caries in Danish persons with recently diagnosed Alzheimer's disease. Gerodontology. 2012; 29(3):194-202. DOI: 10.1111/j.1741-2358.2011.00560.x. View

16.

Turner L, Balasubramaniam R, Hersh E, Stoopler E . Drug therapy in Alzheimer disease: an update for the oral health care provider. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106(4):467-76. DOI: 10.1016/j.tripleo.2008.06.009. View

17.

Henry R, Smith B . Managing older patients who have neurologic disease: Alzheimer disease and cerebrovascular accident. Dent Clin North Am. 2009; 53(2):269-94, ix. DOI: 10.1016/j.cden.2008.12.011. View

18.

McKhann G, Knopman D, Chertkow H, Hyman B, Jack Jr C, Kawas C . The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011; 7(3):263-9. PMC: 3312024. DOI: 10.1016/j.jalz.2011.03.005. View

19.

Kim J, Won C, Kim B, Choi H . Predictability of various serial subtractions on global deterioration scale according to education level. Korean J Fam Med. 2013; 34(5):327-33. PMC: 3791340. DOI: 10.4082/kjfm.2013.34.5.327. View

20.

Chen X, Shuman S, Hodges J, Gatewood L, Xu J . Patterns of tooth loss in older adults with and without dementia: a retrospective study based on a Minnesota cohort. J Am Geriatr Soc. 2010; 58(12):2300-7. DOI: 10.1111/j.1532-5415.2010.03192.x. View