title: Poor oral health as a chronic, potentially modifiable dementia risk factor: review of the literature.
abstract: Poor oral health, including caries, tooth loss, and periodontitis, is ubiquitous worldwide, and is potentially treatable and preventable. Like adverse oral health conditions, Alzheimer disease and related disorders are also very common among aging populations. Established risk factors for Alzheimer disease include cerebrovascular disease and its vascular risk factors, many of which share associations with evidence of systemic inflammation also identified in periodontitis and other poor oral health states. In this review, we present epidemiologic evidence of links between poor oral health and both prevalent and incident cognitive impairment, and review plausible mechanisms linking these conditions, including evidence from compelling animal models. Considering that a large etiologic fraction of dementia remains unexplained, these studies argue for further multidisciplinary research between oral health conditions, including translational, epidemiologic, and possibly clinical treatment studies.
authors: Department of Neurology, Columbia University, New York, NY 10032, USA. jn2054@columbia.edu
authors: James M
authors: JM
authors: Noble
authors: Nikolaos
authors: N
authors: Scarmeas
authors: Panos N
authors: PN
authors: Papapanou
mesh_terms: D000818:Animals; D003704:Dementia / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D009909:Oral Health; D012307:Risk Factors
references: Am Heart J. 2005 Jun;149(6):1050-4
references: 15976787
references: J Periodontol. 2009 Sep;80(9):1421-32
references: 19722792
references: Clin Exp Immunol. 2006 Jan;143(1):50-7
references: 16367933
references: Ann Neurol. 2007 May;61(5):403-10
references: 17328068
references: Exp Gerontol. 2001 Feb;36(2):283-95
references: 11226743
references: J Clin Periodontol. 2004 Nov;31(11):985-90
references: 15491314
references: Circulation. 2005 Feb 8;111(5):576-82
references: 15699278
references: Behav Brain Res. 1997 Feb;83(1-2):239-42
references: 9062693
references: Alzheimers Dement. 2006 Apr;2(2):110-7
references: 19595867
references: Microcirculation. 2007 Jun-Jul;14(4-5):375-87
references: 17613809
references: Brain Res. 2010 Aug 19;1349:68-75
references: 20599812
references: J Clin Periodontol. 2005 Dec;32(12):1189-99
references: 16268994
references: J Clin Periodontol. 2006 Dec;33(12):855-62
references: 17092237
references: J Dent Res. 1956 Oct;35(5):664-70
references: 13367282
references: Int J Geriatr Psychiatry. 2007 Sep;22(9):850-5
references: 17266172
references: J Clin Periodontol. 2009 Jul;36(7):550-7
references: 19538327
references: Hippocampus. 2008;18(6):542-7
references: 18446825
references: J Can Dent Assoc. 2002 Mar;68(3):182-7
references: 11911815
references: Nat Rev Endocrinol. 2011 Jun 28;7(12):738-48
references: 21709707
references: J Clin Periodontol. 1998 Feb;25(2):134-44
references: 9495612
references: Neurology. 2005 Aug 23;65(4):545-51
references: 16116114
references: Behav Brain Res. 2000 Mar;108(2):145-55
references: 10701658
references: J Am Dent Assoc. 1990 Oct;121(4):532-6
references: 2212346
references: J Dent Res. 2012 Oct;91(10):914-20
references: 22935673
references: Caries Res. 2008;42(6):409-18
references: 18832827
references: J Clin Periodontol. 2001 Mar;28(3):241-9
references: 11284537
references: FEBS Lett. 2008 Jan 9;582(1):97-105
references: 18053812
references: Lancet. 2000 Nov 11;356(9242):1627-31
references: 11089820
references: J Am Geriatr Soc. 2007 Sep;55(9):1410-4
references: 17767683
references: Am Heart J. 2006 Jan;151(1):47
references: 16368290
references: Cerebrovasc Dis. 2005;20(4):226-32
references: 16123541
references: Brain Res. 1977 Aug 26;132(2):347-54
references: 890485
references: Jpn J Infect Dis. 2001 Apr;54(2):69-71
references: 11427744
references: JAMA. 1998 Mar 11;279(10):751-5
references: 9508150
references: Gerodontology. 1993 Dec;10(2):76-82
references: 7713530
references: Community Dent Oral Epidemiol. 2005 Apr;33(2):81-92
references: 15725170
references: Arterioscler Thromb Vasc Biol. 2000 Oct;20(10):2255-60
references: 11031212
references: Community Dent Oral Epidemiol. 2003 Dec;31 Suppl 1:3-23
references: 15015736
references: Stroke. 2004 Nov;35(11 Suppl 1):2712-9
references: 15472106
references: J Dent Res. 2007 Jan;86(1):35-40
references: 17189460
references: Arch Neurol. 2003 Feb;60(2):161-3
references: 12580698
references: Periodontol 2000. 2010 Jun;53:28-44
references: 20403103
references: Stroke. 2004 Sep;35(9):2020-3
references: 15232116
references: J Dent Res. 2004 Feb;83(2):156-60
references: 14742655
references: Gerodontology. 2012 Mar;29(1):36-42
references: 20604811
references: J Am Dent Assoc. 1992 Jan;123(1):53-8
references: 1740573
references: Neuroepidemiology. 2006;26(3):140-6
references: 16493200
references: J Dent Res. 1997 Dec;76(12):1833-9
references: 9390476
references: Lancet Neurol. 2011 Sep;10(9):819-28
references: 21775213
references: Arch Neurol. 2003 Aug;60(8):1119-22
references: 12925369
references: N Engl J Med. 2010 Jan 28;362(4):329-44
references: 20107219
references: J Dent Res. 2011 Mar;90(3):294-303
references: 20924061
references: Arch Intern Med. 2003 Jul 14;163(13):1524-8
references: 12860573
references: Lancet. 1998 Jun 20;351(9119):1840-3
references: 9652667
references: J Dent Res. 1953 Jun;32(3):322-7
references: 13061670
references: Compend Contin Educ Dent. 2009 Sep;30(7):430-9
references: 19757736
references: Neurobiol Aging. 2005 Dec;26 Suppl 1:65-9
references: 16266773
references: N Engl J Med. 2002 Feb 14;346(7):476-83
references: 11844848
references: Curr Atheroscler Rep. 2004 Jul;6(4):261-6
references: 15191699
references: Public Health Nutr. 2001 Jun;4(3):797-803
references: 11415487
references: J Am Geriatr Soc. 2012 Oct;60(10):1951-6
references: 23035667
references: J Clin Periodontol. 1999 Jun;26(6):374-80
references: 10382577
references: Atherosclerosis. 2007 Jul;193(1):222-8
references: 16872615
references: Am J Epidemiol. 2001 Oct 1;154(7):635-41
references: 11581097
references: J Periodontol. 2004 Dec;75(12):1694-700
references: 15732873
references: J Dent Res. 2010 May;89(5):473-7
references: 20139337
references: J Periodontol. 1990 Aug;61(8):521-8
references: 2391631
references: J Public Health Dent. 2000 Fall;60(4):304-7
references: 11243051
references: Arch Neurol. 2010 Jan;67(1):87-92
references: 20065134
references: J Am Geriatr Soc. 2002 Mar;50(3):430-3
references: 11943036
references: Alzheimers Dement. 2012 May;8(3):196-203
references: 22546352
references: Age Ageing. 2007 Jan;36(1):23-9
references: 17124253
references: Dement Geriatr Cogn Disord. 2011;31(6):424-30
references: 21757907
references: JAMA. 2004 Dec 15;292(23):2901-8
references: 15598922
references: Ann Neurol. 2006 Jun;59(6):912-21
references: 16622828
references: N Engl J Med. 2007 Mar 1;356(9):911-20
references: 17329698
references: Brain Res. 1999 Apr 24;826(1):148-53
references: 10216208
references: Dementia. 1994 Nov-Dec;5(6):314-26
references: 7866485
references: Neurology. 1999 Dec 10;53(9):1937-42
references: 10599761
references: J Neuroimmunol. 2009 Nov 30;216(1-2):92-7
references: 19767111
references: Lancet. 1996 Apr 27;347(9009):1141-5
references: 8609748
references: Int J Geriatr Psychiatry. 1999 Jun;14(6):481-93
references: 10398359
references: Neurology. 2005 Feb 8;64(3):494-500
references: 15699381
references: J Clin Periodontol. 2008 Apr;35(4):277-90
references: 18294231
references: Psychosom Med. 2012 Apr;74(3):241-8
references: 22408130
references: Gerodontology. 2002 Dec;19(2):80-94
references: 12542217
references: Anaerobe. 2008 Feb;14(1):49-54
references: 17869137
references: J Dent Res. 2010 Sep;89(9):879-902
references: 20639510
references: Annu Rev Pathol. 2006;1:297-329
references: 18039117
references: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 May;95(5):559-69
references: 12738947
references: Gerodontology. 2004 Mar;21(1):17-26
references: 15074536
references: J Neurosci. 1984 Sep;4(9):2281-90
references: 6481447
references: J Am Geriatr Soc. 2010 Apr;58(4):713-8
references: 20398152
references: Int Dent J. 2006 Aug;56(4 Suppl 1):256-62
references: 16972401
references: Am J Epidemiol. 1997 Feb 15;145(4):301-8
references: 9054233
references: J Periodontol. 2006 Jan;77(1):15-20
references: 16579698
references: Diabetes. 2002 Apr;51(4):1256-62
references: 11916953
references: BMJ. 2005 Jun 11;330(7504):1360
references: 15863436
references: J Neurol Neurosurg Psychiatry. 2009 Nov;80(11):1206-11
references: 19419981
references: J Dent Res. 2007 Apr;86(4):306-19
references: 17384024
references: Lancet. 1997 Jan 18;349(9046):151-4
references: 9111537
references: Circulation. 2002 Mar 5;105(9):1135-43
references: 11877368
references: Chest. 2007 May;131(5):1557-66
references: 17494805
references: J Periodontol. 2007 Oct;78(10):1911-25
references: 18062113
references: Clin Microbiol Rev. 2002 Apr;15(2):167-93
references: 11932229
references: Behav Brain Res. 2013 Sep 1;252:318-25
references: 23773908
references: J Am Dent Assoc. 1999 Jan;130(1):57-64
references: 9919032
references: J Am Geriatr Soc. 2005 Sep;53(9):1532-7
references: 16137283
references: Acta Odontol Scand. 2007 Apr;65(2):103-8
references: 17453428
references: NPJ Aging Mech Dis. 2017 Nov 6;3:15
references: 29134111
references: Am J Epidemiol. 2000 Feb 1;151(3):273-82
references: 10670552
references: J Periodontal Res. 2005 Feb;40(1):36-42
references: 15613077
references: J Periodontol. 2000 Oct;71(10):1528-34
references: 11063384
references: J Periodontal Res. 1996 Oct;31(7):508-15
references: 8915955
references: J Periodontol. 1994 Jan;65(1):2-7
references: 8133411
references: Behav Brain Res. 2002 Jan 7;128(1):19-25
references: 11755686
references: Arch Neurol. 2006 Dec;63(12):1709-17
references: 17030648
references: Oral Dis. 2000 Nov;6(6):335-50
references: 11355266
references: Arch Intern Med. 2005 Feb 14;165(3):321-6
references: 15710796
references: Neurology. 1999 Apr 22;52(7):1408-12
references: 10227626
references: J Am Dent Assoc. 2007 Oct;138(10):1314-22; quiz 1381-2
references: 17908844
references: Annu Rev Neurosci. 2003;26:81-104
references: 12574495