Integrative literature review on the association between periodontal disease and Alzheimer's disease.
DOI:
https://doi.org/10.36557/2674-8169.2026v8n9p355-371Keywords:
Periodontal disease; Alzheimer's disease; Inflammation; Porphyromonas gingivalis; Systemic health.Abstract
Periodontal disease is a chronic inflammatory condition that affects the supporting tissues of the teeth, while Alzheimer's disease is a progressive neurodegenerative disease associated with cognitive decline. This integrative review addresses evidence on the possible relationship between the two diseases and their pathophysiological mechanisms. This article aims to analyze, through an integrative literature review, the relationship between periodontal disease and Alzheimer's disease, gathering evidence on pathophysiological mechanisms, clinical association, and possible bidirectional relationship. Nineteen studies were included in the review. Of these, 9 studies were used in the analysis presented in Table 1, regarding the association between periodontal disease and Alzheimer's disease, while 10 studies were used in the analysis of the proposed pathophysiological mechanisms, presented in Table 2. It is concluded that the most recent studies point to a possible association between periodontal disease and Alzheimer's disease, mainly in cases of more severe periodontitis. However, more robust studies with long-term follow-up are needed to accurately determine the nature of this association and the exact influence of periodontal disease on the development and progression of Alzheimer's disease.
Downloads
References
ABDULKAREEM, A. A. et al. Current concepts in the pathogenesis of periodontitis: from symbiosis to dysbiosis. Journal of Oral Microbiology, v. 15, n. 1, 2197779, 2023. DOI: 10.1080/20002297.2023.2197779.
ARAGÓN, F. et al. Oral health in Alzheimer's disease: a multicenter case-control study. Clinical Oral Investigations, v. 22, n. 9, p. 3061-3070, 2018. DOI: 10.1007/s00784-018-2396-z.
ARBILDO-VEGA, H. I. et al. Association between periodontal disease and Alzheimer's disease: umbrella review. Frontiers in Dental Medicine, v. 6, 1635200, 2025. DOI: 10.3389/fdmed.2025.1635200.
BOUZIANE, A.; LATTAF, S.; ABDALLAOUI MAAN, L. Effect of periodontal disease on Alzheimer's disease: a systematic review. Cureus, v. 15, n. 10, e46311, 2023. DOI: 10.7759/cureus.46311.
BUI, F. Q. et al. Association between periodontal pathogens and systemic disease. Biomedical Journal, v. 42, n. 1, p. 27-35, 2019. DOI: 10.1016/j.bj.2018.12.001.
CHEN, C. K.; WU, Y. T.; CHANG, Y. C. Association between chronic periodontitis and the risk of Alzheimer's disease: a retrospective, population-based, matched-cohort study. Alzheimer's Research & Therapy, v. 9, n. 1, p. 56, 2017. DOI: 10.1186/s13195-017-0282-6.
DIBELLO, V. et al. Impact of periodontal disease on cognitive disorders, dementia, and depression: a systematic review and meta-analysis. GeroScience, v. 46, n. 5, p. 5133-5169, 2024. DOI: 10.1007/s11357-024-01243-8.
DUKKA, H. D. et al. Prognostic performance of the 2017 World Workshop classification on staging and grading of periodontitis compared with the British Society of Periodontology's implementation. Journal of Periodontology, v. 93, n. 4, p. 537-547, 2022. DOI: 10.1002/JPER.21-0296.
JUNGBAUER, G. et al. Periodontal microorganisms and Alzheimer disease – a causative relationship? Periodontology 2000, v. 89, n. 1, p. 59-82, 2022. DOI: 10.1111/prd.12429.
KIM, D. H.; HAN, G. S. Periodontitis as a risk factor for dementia: a systematic review and meta-analysis. Journal of Evidence-Based Dental Practice, v. 25, n. 2, 102094, 2025. DOI: 10.1016/j.jebdp.2025.102094.
LEIRA, Y. et al. Association of Alzheimer's disease and periodontitis: a systematic review and meta-analysis of evidence from observational studies. Neuroepidemiology, 2022.
LI, X. et al. Neuroinflammation: a distal consequence of periodontitis. Journal of Dental Research, v. 101, n. 12, p. 1441-1449, 2022. DOI: 10.1177/00220345221102084.
LIN, J. et al. Association between periodontitis and mild cognitive impairment: a systematic review and meta-analysis. Gerodontology, v. 53, n. 1, p. 37-46, 2024. DOI: 10.1159/000535776.
MAO, S. et al. Association of periodontitis and oral microbiomes with Alzheimer's disease: a narrative systematic review. Journal of Dental Sciences, v. 17, n. 4, p. 1762-1774, 2022. DOI: 10.1016/j.jds.2022.07.001.
MELO, A. et al. Association between Alzheimer's disease and periodontal inflammatory parameters: a systematic review. Journal of Clinical and Experimental Dentistry, v. 17, n. 3, p. e310-e323, 2025. DOI: 10.4317/jced.62519.
NEWMAN, M. G. et al. Newman and Carranza's clinical periodontology and implantology. 14. ed. St. Louis: Elsevier, 2023.
PARRA-TORRES, V. et al. Periodontal bacteria in the brain – implication for Alzheimer's disease: a systematic review. Oral Diseases, v. 29, n. 1, p. 21-28, 2023. DOI: 10.1111/odi.14054.
PAZOS, P. et al. Association between periodontal disease and dementia: a literature review. Neurología, v. 33, n. 9, p. 602-613, 2018. DOI: 10.1016/j.nrl.2016.07.013.
PRITCHARD, A. B. et al. Periodontitis, microbiomes and their role in Alzheimer's disease. Frontiers in Aging Neuroscience, v. 9, 336, 2017. DOI: 10.3389/fnagi.2017.00336.
RIDHO, F. M. et al. Alzheimer's disease and periodontal disease: uncovering the association through systematic review and meta-analysis. Revista Clínica Española, v. 226, n. 6, 502545, 2026. DOI: 10.1016/j.rce.2026.502545.
ROPPER, A. H. et al. Adams and Victor's principles of neurology. 12. ed. New York: McGraw Hill, 2023.
SALHI, L. et al. How periodontitis or periodontal bacteria can influence Alzheimer's disease features? A systematic review of pre-clinical studies. Journal of Alzheimer's Disease, v. 96, n. 3, p. 979-1010, 2023. DOI: 10.3233/JAD-230478.
SPARKS STEIN, P. et al. Serum antibodies to periodontal pathogens are a risk factor for Alzheimer's disease. Alzheimer's & Dementia, v. 8, n. 3, p. 196-203, 2012. DOI: 10.1016/j.jalz.2011.04.006.
WEBER, C.; DILTHEY, A.; FINZER, P. The role of microbiome-host interactions in the development of Alzheimer's disease. Frontiers in Cellular and Infection Microbiology, v. 13, 1151021, 2023. DOI: 10.3389/fcimb.2023.1151021.
WERESZCZYŃSKI, M. et al. Investigating the relationship between periodontitis and specific memory processes in the search for cognitive markers of Alzheimer's disease risk. Scientific Reports, v. 13, n. 1, 11555, 2023. DOI: 10.1038/s41598-023-38674-w.
ZHAO, C. et al. Nisin, a probiotic bacteriocin, mitigates brain microbiome dysbiosis and Alzheimer's disease-like neuroinflammation triggered by periodontal disease. Journal of Neuroinflammation, v. 20, n. 1, 228, 2023. DOI: 10.1186/s12974-023-02915-6.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 José Cássio de Almeida Magalhaes, Fernando Martins Baeder, José Sani Netto, Tatiane Barbosa Gonzalez, Giovanna de Oliveira Motta, Elaine Marcílio Santos, Gustavo Duarte Mendes, Ana Paula Taboada Sobral, Marcela Letícia Leal Gonçalves, Elza Ferri, Paola Fernanda Leal Corazza, Gabriela Traldi Zaffalon
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors are copyright holders under a CCBY 4.0 license.
