1. Older patients presenting to the dentist with missing teeth were more likely to have Alzheimer’s Disease.
Evidence Rating Level: 2 (Good)
The association between cognitive impairment and worse oral health is well-established: In particular, individuals with cognitive impairment are at greater risk for having missing teeth, cavities, plaque accumulation, and periodontal disease. As aging populations are beginning to prevail in countries like Japan, identifying early signs for dementia are becoming increasingly important. The current cross-sectional study investigated the association between the number of teeth and presence of Alzheimer’s Disease. The data was taken from a national database of dental and medical care claims in Japan, identifying patients 60 years and older diagnosed with periodontitis, missing teeth, or Alzheimer’s Disease. The study found that the prevalence of Alzheimer’s was 3.0% and 3.7% in patients with periodontitis and missing teeth respectively. In patients diagnosed with periodontitis, those with fewer teeth had higher prevalence of Alzheimer’s (p < 0.001): 1.95% of Alzheimer’s patients had 20-28 teeth present, 3.87% had 10-19 teeth, and 6.86% had 1-9 teeth. The odds ratios were 1.11 (95% CI 1.10-1.13) and 1.34 (95% CI 1.32-1.37) for patients with 10-19 teeth and 1-9 teeth respectively (p < 0.001). For patients diagnosed with missing teeth, the same association was present (p < 0.001): 2.67% of Alzheimer’s patients had 20-28 teeth present, 5.51% had 10-19 teeth, and 8.70% had 1-9 teeth. The odds ratios were 1.40 (95% CI 1.36-1.44) and 1.81 (95% CI 1.74-1.89) for patients with 14-27 missing teeth and 28 missing teeth respectively (p < 0.001). In summary, this study demonstrated that older individuals with fewer teeth are at a greater likelihood of having Alzheimer’s Disease, providing a potentially novel risk factor associated with the disease.
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