Investigating the potential clinical impact of periodontitis on the progression of Alzheimer’s disease : a prospective cohort study

Abstract Objectives This study aimed to investigate the efect of periodontitis and current occlusal relationship on the progression rate of Alzheimer’s disease (AD). Methods Ninety Alzheimer’s patients, who were divided into three groups as Stage I (n=42), Stage II (n=29), and Stage III (n=19), based on the Clinical Dementia Rating Scale, were included in the study. Cognitive status of the patients was evaluated with Standardized Mini-Mental Test (SMMT) at baseline and repeated 6 months later. Clinical periodontal examinations were recorded and occlusal relationship status was classifed according to the Eichner Index. Results Of 90 Alzheimer’s patients, 65 were toothed individuals with periodontitis and 25 were edentulous individuals without active periodontal disease. Stage II and Stage III toothed Alzheimer’s patients had higher percentage of bleeding on probing (BOP%) and clinical attachment level (CAL) values than Stage I patients (p<0.05). Stage III Alzheimer’s patients had signifcantly higher probing pocket depth (PPD) values than Stage I individuals (p<0.05). ?SMMT values showed positive correlation with BOP% (r=0.308, p=0.013) and PPD (r=0.275, p=0.027). Among the evaluated parameters, being in the AD Stage II–Stage III, having periodontitis and age variable had signifcant efects on ?SMMT levels (p<0.05). Conclusions Within the limits of our study, it can be concluded that periodontitis may increase the severity and also accelerate the progression rate of AD. Clinical relevance These results are precious to show the necessity of proper oral hygiene activities and regular dental visits in patients with toothed AD. Clinical trial registration This study was registered and approved by clinical trials (NCT05807100).