Poor Oral Health as a Chronic, Potentially Modifiable Dementia Risk Factor: Review of the Literature

  • James M. NobleEmail author
  • Nikolaos Scarmeas
  • Panos N. Papapanou
Dementia (KS Marder, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Dementia


Poor oral health, including caries, tooth loss, and periodontitis, is ubiquitous worldwide, and is potentially treatable and preventable. Like adverse oral health conditions, Alzheimer disease and related disorders are also very common among aging populations. Established risk factors for Alzheimer disease include cerebrovascular disease and its vascular risk factors, many of which share associations with evidence of systemic inflammation also identified in periodontitis and other poor oral health states. In this review, we present epidemiologic evidence of links between poor oral health and both prevalent and incident cognitive impairment, and review plausible mechanisms linking these conditions, including evidence from compelling animal models. Considering that a large etiologic fraction of dementia remains unexplained, these studies argue for further multidisciplinary research between oral health conditions, including translational, epidemiologic, and possibly clinical treatment studies.


Periodontitis Periodontal disease Tooth loss Oral health Caries Dentures Alzheimer disease Cerebrovascular disease Vascular dementia Dementia Epidemiology 



James M. Noble has received grant support from the Taub Institute (internal funding mechanism), and some of the prior research described was supported through this grant. He has also received grant support from the National Institute of Dental and Craniofacial Research. Nikolaos Scarmeas has received grant support from the National Institute on Aging (grant AG028506) and the Alzheimer’s Association (grant IIRG-04-1353).

Compliance with ethics Guidelines

Conflict of Interest

James M. Noble has received honoraria from Barclays for a single consulting event regarding intravenous immunoglobulin as an AD therapeutic (the trial has since been reported as a failure).

Nikolaos Scarmeas and Panos N. Papapanou declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Paper of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • James M. Noble
    • 1
    Email author
  • Nikolaos Scarmeas
    • 1
    • 2
  • Panos N. Papapanou
    • 3
  1. 1.Department of Neurology and Taub Institute for Research on Alzheimer’s Disease and the Aging BrainColumbia UniversityNew YorkUSA
  2. 2.Department of Social Medicine, Psychiatry and Neurology, Medical SchoolNational and Kapodistrian University of AthensAthensGreece
  3. 3.Division of Periodontics, School of Dental MedicineColumbia UniversityNew YorkUSA

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