Periodontal (Gum) Disease

Periodontal Disease and Dementia

Periodontal Disease involves the gums and supporting bony tissue of the teeth.  Did you know that 80% of U.S. adults have it?  Periodontal disease is the leading cause of tooth loss among adults.  More adults lose their teeeth from gum disease than from cavities.  Certain conditions of the body, such as smoking and diabetes, can lead to severe periodontal disease and bone loss in the jaw.  Periodontal disease has been linked to heart attacks and stroke, and now dementia!

Periodontitis is associated with cognitive impairment among older adults: analysis of NHANES-III

J M Noble,1,2,3 L N Borrell,4 P N Papapanou,5 M S V Elkind,3,6 N Scarmeas,1,3 C B Wright7

ABSTRACT

Background: Periodontitis is ubiquitous and associated with serological evidence of exposure to periodontal organisms, systemic inflammation and vascular disease. Dementia is a major public health problem likely related to a complex interaction between genetics and diseases associated with systemic inflammation, including diabetes, smoking and stroke.

Methods: To assess relationships between systemic exposure to periodontal pathogens and cognitive test outcomes, data were analysed from the Third National Health and Nutrition Examination Survey (NHANES-III), a nationally representative cross sectional observational study among older adults. We included 2355 participants >60 years who completed measures of cognition and Poryphyromonas gingivalis IgG. Using SUDAAN, logistic regression models examined the association of P gingivalis IgG with cognitive test performance.

Results: Poor immediate verbal memory (,5/9 points) was prevalent in 5.7% of patients, and 6.5% overall had impaired delayed recall (,4/9); 22.1% had difficulty with serial subtractions (,5/5 trials correct). Individuals with the highest P gingivalis IgG (.119 ELISA Units (EU)) were more likely to have poor delayed verbal recall (OR 2.89, 95% CI 1.14 to 7.29) and impaired subtraction (OR 1.95, 95% CI 1.22 to 3.11) than those with the lowest ((57 EU), with dose–response relationships for both (p trend, delayed memory=0.045, subtraction=0.04). After adjusting for socioeconomic and vascular variables, these relationships remained robust for the highest P gingivalis IgG group (delayed verbal memory OR 3.01 (95% CI 1.06 to 8.53); subtraction OR 2.00 (95% CI 1.19 to 3.36)). In contrast, immediate verbal memory was not significantly associated with P gingivalis.

Conclusion: A serological marker of periodontitis is associated with impaired delayed memory and calculation. Further exploration of relationships between oral health and cognition is warranted.

The complete article can be found at J Neurol Neurosurg Psychiatry-2009-Noble-1206-11