Oral and Periodontal Health in Patients with Alzheimer's Disease and Other Forms of Dementia-A Cross-sectional Pilot Study

Purpose: Systemic inflammation is characteristic for the pathogenesis of Alzheimer's disease (AD) and is responsible for the accumulation of its disease-specific Tau-protein and B-amyloid plaques. Studies focusing on an association with periodontitis showed worse periodontal conditions in patients with dementia, but until now, no study has investigated the differences between AD and other forms of dementia (noAD/DEM). Expecting severe periodontal disease in AD, the aim of this pilot-study was to compare the periodontal and dental status in patients with either AD or noAD/DEM. Materials and Methods: Twenty patients recently diagnosed with AD and 20 with noAD/DEM between the ages of 50 and 70 years were recruited at the Department of Neurology, University Hospital, Munster, Germany and clinically examined at the Department of Periodontology, School of Dental Medicine, Munster, Germany. Neuropsychological testing, levels of Tau-protein and B-amyloid in serum and liquor were used to distinguish between both groups. Dental and periodontal parameters such as clinical attachment loss (CAL), probing pocket depth (PPD), bleeding-on-probing (BOP), radiographic bone loss, full-mouth plaque score (FMPS), and missing and restored teeth were recorded. Results: Periodontitis was diagnosed in all patients. Patients with AD presented mean BOP of 54.7 +/- 31.1% and radiographic bone loss of 42.5 +/- 25.3%; the mean BOP of those with noAD/DEM was 52.0 +/- 23.7% and radiographic bone loss was 40.9 +/- 32.3%. There was also no statistically significant difference regarding other periodontal and dental parameters. Conclusions: Both patients with AD and noAD/DEM had periodontal disease. Consequently, patients with all forms of dementia (AD/other) need special dental care to improve periodontal and oral health.