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The Association between Tooth Loss and Alzheimer’s Disease: a Systematic Review with Meta-Analysis of Case Control Studies

Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy
Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation Unit, University of Bari Via Piazza Giulio Cesare, 70124 Bari, Italy
Department of Surgical, Oncological and Surgery, University of Palermo, 90121 Palermo, Italy
Author to whom correspondence should be addressed.
Dent. J. 2019, 7(2), 49;
Received: 8 March 2019 / Revised: 17 April 2019 / Accepted: 23 April 2019 / Published: 1 May 2019
(This article belongs to the Special Issue Dental Hygiene and Epidemiology Volume 2)
Alzheimer’s disease is classified as a neurodegenerative condition, a heterogeneous group of illnesses characterized by the slow and progressive loss of one or more functions of the nervous system. Its incidence tends to increase gradually from 65 years of age, up to a prevalence of 4% at age 75. The loss of dental elements is more prevalent in this population and might negatively affect the masticatory capacity, quality of life, and pathogenesis of Alzheimer’s disease. This study investigated problems related to oral health and the loss of dental elements in elderly patients suffering from Alzheimer’s and considered whether local inflammatory processes could affect the etiopathogenesis of Alzheimer’s disease. The purpose of this systematic review is to identify a link between the causes leading to tooth loss and the onset/progression of Alzheimer’s disease. We also studied whether there is a higher incidence of tooth loss (primary outcome) and edentulism (secondary outcome) among Alzheimer’s patients. We searched records in electronic databases such as PubMed, EBSCO, and Web of Science using the following keywords: Alzheimer’s Disease AND periodontal, Alzheimer’s Disease AND periodontitis, dementia AND (periodontitis OR periodontal) “Alzheimer’s Disease” AND “tooth” OR “dental loss,” “dementia” AND “edentulous,” “Alzheimer’s Disease” AND “edentulous,” “dementia” AND “tooth” OR “dental loss.” The records were screened, and after applying the eligibility and inclusion criteria, nine articles were left, six of which were analyzed for the primary outcome (loss of dental elements) and six for the secondary outcome (tooth loss). Results from this meta-analysis revealed that Alzheimer’s disease patients have an increased risk of dental loss (hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.00–2.30, p = 0.05) and edentulous condition (HR 2.26, 95% CI 1.70–3.01, p < 0.001). A quantitative analysis of the included studies indicated that patients suffering from Alzheimer’s disease are characterized by a greater number of lost dental elements and general edentulism compared to the control groups. View Full-Text
Keywords: Alzheimer’s disease; dementia; periodontitis; tooth loss Alzheimer’s disease; dementia; periodontitis; tooth loss
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Dioguardi, M.; Di Gioia, G.; Caloro, G.A.; Capocasale, G.; Zhurakivska, K.; Troiano, G.; Lo Russo, L.; Lo Muzio, L. The Association between Tooth Loss and Alzheimer’s Disease: a Systematic Review with Meta-Analysis of Case Control Studies. Dent. J. 2019, 7, 49.

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