Dental Tribune International

Study confirms gingival recession increases risk of Alzheimer’s disease

By Franziska Beier, Dental Tribune International
June 14, 2021

GREIFSWALD, Germany: Periodontitis has been associated with a risk for Alzheimer’s disease in previous studies. The long-term Study of Health in Pomerania (SHIP) has been researching the influence of dental diseases on people’s general health since 1997 and has found that inflammatory gingival recession owing to periodontitis increases the risk of myocardial infarction and dementia, among other things. Now, in a recent study, researchers from the University of Greifswald have confirmed the previous findings regarding a connection with Alzheimer’s disease.

“It is very difficult to conduct methodologically meaningful studies on the effects of periodontitis […]. Only recently developed statistical models allow us to simulate a controlled clinical trial by pooling available data from treated patients and untreated people with the disease,” explained lead author Dr Christian Schwahn from the dental prosthodontics polyclinic at the University of Greifswald in a university press release.

According to Schwahn, the relationship between the treatment of gingival disease and early-onset Alzheimer’s disease has been analysed in a quasi-experimental model for the first time in this study. The researchers analysed data from 177 periodontally treated patients from the Greifswald Approach to Individualised Medicine study and data from 409 untreated participants from the SHIP study.

Magnetic resonance imaging (MRI) data was used as an indicator of the onset of Alzheimer’s disease. This was matched with MRI data from the US Alzheimer’s Disease Neuroimaging Initiative so that it could be used as an individual measure of the brain substance loss typical of Alzheimer’s disease.

Periodontal treatment performed by a specialised dentist showed a positive effect on the loss of brain substance. The effect was described by the researchers as “moderate to strong”.

The results are remarkable in that the periodontal patients were younger than 60 years at the time of the MRI examination and the observation time between dental treatment and the MRI examination was on average 7.3 years, commented co-authors Prof. Thomas Kocher, head of the unit of periodontology, department of restorative dentistry, periodontology, endodontology, and paediatric and preventive dentistry, and Prof. Hans Jürgen Grabe, from the department of psychiatry and psychotherapy.

“Our approach clearly focuses on the prevention and timely treatment of gingival disease […] in order to prevent such potentially consequential damage from the onset,” said Kocher.

Researchers will have to continue to rely on observational studies simulating a controlled clinical trial in this area, as clinical trials with a placebo treatment in an intentionally dentally untreated patient group “are not feasible for ethical and medical reasons”, said Schwahn.

The study, titled “Effect of periodontal treatment on preclinical Alzheimer's disease—results of a trial emulation approach”, was published online on 29 May 2021 in Alzheimer’s and Dementia, ahead of inclusion in an issue.

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