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Current Oral Health Reports

, Volume 6, Issue 2, pp 82–88 | Cite as

Tooth Loss and Alzheimer’s Disease

  • Tetsuya GotoEmail author
  • W. Keung Leung
Oral Disease and Nutrition (F Nishimura, Section Editor)
  • 19 Downloads
Part of the following topical collections:
  1. Topical Collection on Oral Disease and Nutrition

Abstract

Purpose of Review

Alzheimer’s disease (AD) is a major subtype of dementia. Recent cohort studies have demonstrated that loss of masticatory function, periodontitis, and/or tooth loss are risk factors for AD. The present review provides an overview of the existing literature as well as recent evidence regarding the relationship between tooth loss and the onset of AD.

Recent Findings

In the dental field, tooth loss is one of the most relevant factors related to the prevalence of AD. This is important in a progressively elderly population because tooth loss is associated with the risk of mild cognitive impairment (MCI) developing into dementia due to a cascade of neurodegeneration caused by damage to periodontal tissues via the trigeminal nerve, locus coeruleus (LC), and hippocampus. Additionally, periodontal disease and/or the loss of masticatory function are likely to exacerbate factors associated with AD.

Summary

Tooth loss in the elderly may cause neurodegeneration and act as a trigger for the progression from MCI to dementia. Moreover, neurodegeneration due to tooth loss is thought to exacerbate the accumulation of AD-specific amyloid-β and phosphorylated tau proteins, which worsen the pathological condition of AD. Although further evidence is needed, novel strategies for avoiding the progression to AD due to tooth loss in the elderly are required.

Keywords

Tooth loss Alzheimer’s disease Periodontitis Neurodegeneration 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors 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 the author.

References

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

  1. 1.
    Ali GC, Guerchet MM, Wu Y-T, Prince MJ, Prina M. The global prevalence of dementia. World Alzheimer Report 2015—the global impact of dementia: an analysis of prevalence, incidence, cost and trends. London: Alzheimer’s Disease International; 2015. p. 10–29.Google Scholar
  2. 2.
    Prince MJ, Albanese E, Guerchet MM, Prina M. Key message. World Alzheimer Report 2014—an analysis of protective and modifiable factors. London: Alzheimer’s Disease International; 2014. p. p5.Google Scholar
  3. 3.
    • Scheltens P, Blennow K, Breteler MM, de Strooper B, Frisoni GB, Salloway S, et al. Alzheimer’s disease. Lancet. 2016;388(10043):505–17 This manuscript well summarized recent knowledge about Alzheimer’s disease.CrossRefPubMedGoogle Scholar
  4. 4.
    Sperling RA, Aisen PS, Beckett LA, Bennett DA, Craft S, Fagan AM, et al. Toward defining the preclinical stages of Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnosticguidelines for Alzheimer’s disease. Alzheimers Dement. 2011;7(3):280–92.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Rapp MA, Schnaider-Beeri M, Purohit DP, Reichenberg A, McGurk SR, Haroutunian V, et al. Cortical neuritic plaques and hippocampal neurofibrillary tangles are related to dementia severity in elderly schizophrenia patients. Schizophr Res. 2010;116(1):90–6.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Jack CR Jr, Knopman DS, Jagust WJ, Shaw LM, Aisen PS, Weiner MW, et al. Hypothetical model of dynamic biomarkers of the Alzheimer’s pathological cascade. Lancet Neurol. 2010;9(1):119–28.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Braak H, Thal DR, Ghebremedhin E, Del Tredici K. Stages of the pathologic process in Alzheimer disease: age categories from 1 to 100 years. J Neuropathol Exp Neurol. 2011;70(11):960–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Kocaelli H, Yaltirik M, Yargic LI, Ozbas H. Alzheimer’s disease and dental management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(5):521–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Ghezzi EM, Ship JA. Systemic diseases and their treatments in the elderly: impact on oral health. J Public Health Dent. 2000;60(4):289–96.CrossRefPubMedGoogle Scholar
  10. 10.
    Chalmers JM. Behavior management and communication strategies for dental professionals when caring for patients with dementia. Spec Care Dentist. 2000;20(4):147–54.CrossRefPubMedGoogle Scholar
  11. 11.
    Chalmers J, Pearson A. Oral hygiene care for residents with dementia: a literature review. J Adv Nurs. 2005;52(4):410–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Rejnefelt I, Andersson P, Renvert S. Oral health status in individuals with dementia living in special facilities. Int J Dent Hyg. 2006;4(2):67–71.CrossRefPubMedGoogle Scholar
  13. 13.
    Gatz M, Mortimer JA, Fratiglioni L, Johansson B, Berg S, Reynolds CA, et al. Potentially modifiable risk factors for dementia in identical twins. Alzheimers Dement. 2006;2(2):110–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Delwel S, Binnekade TT, Perez RSGM, Hertogh CMPM, Scherder EJA, Lobbezoo F. Oral hygiene and oral health in older people with dementia: a comprehensive review with focus on oral soft tissues. Clin Oral Investig. 2018;22(1):93–108.CrossRefPubMedGoogle Scholar
  15. 15.
    Fereshtehnejad SM, Garcia-Ptacek S, Religa D, Holmer J, Buhlin K, Eriksdotter M, et al. Dental care utilization in patients with different types of dementia: a longitudinal nationwide study of 58,037 individuals. Alzheimers Dement. 2018;14(1):10–9.CrossRefPubMedGoogle Scholar
  16. 16.
    D’Alessandro G, Costi T, Alkhamis N, Bagattoni S, Sadotti A, Piana G. Oral health status in Alzheimer’s disease patients: a descriptive study in an Italian population. J Contemp Dent Pract. 2018;19(5):483–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Grabe HJ, Schwahn C, Völzke H, Spitzer C, Freyberger HJ, John U, et al. Tooth loss and cognitive impairment. J Clin Periodontol. 2009;36(7):550–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Luo J, Wu B, Zhao Q, Guo Q, Meng H, Yu L, et al. Association between tooth loss and cognitive function among 3063 Chinese older adults: a community-based study. PLoS One. 2015;10(3):e0120986.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Okamoto N, Morikawa M, Okamoto K, Habu N, Hazaki K, Harano A, et al. Tooth loss is associated with mild memory impairment in the elderly: the Fujiwara-kyo study. Brain Res. 2010;1349:68–75.CrossRefPubMedGoogle Scholar
  20. 20.
    • Takeuchi K, Ohara T, Furuta M, Takeshita T, Shibata Y, Hata J, et al. Tooth loss and risk of dementia in the community: the Hisayama study. J Am Geriatr Soc. 2017;65(5):e95–e100 This cohort study clearly shows the association of the number of remaining teeth and the risk of dementia. CrossRefPubMedGoogle Scholar
  21. 21.
    Weijenberg RA, Scherder EJ, Lobbezoo F. Mastication for the mind—the relationship between mastication and cognition in ageing and dementia. Neurosci Biobehav Rev. 2011;35(3):483–97.CrossRefPubMedGoogle Scholar
  22. 22.
    Lexomboon D, Trulsson M, Wårdh I, Parker MG. Chewing ability and tooth loss: association with cognitive impairment in an elderly population study. J Am Geriatr Soc. 2012;60(10):1951–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Kamer AR, Craig RG, Dasanayake AP, Brys M, Glodzik-Sobanska L, de Leon MJ. Inflammation and Alzheimer’s disease: possible role of periodontal diseases. Alzheimers Dement. 2008;4(4):242–50.CrossRefPubMedGoogle Scholar
  24. 24.
    Noble JM, Scarmeas N, Papapanou PN. Poor oral health as a chronic, potentially modifiable dementia risk factor: review of the literature. Curr Neurol Neurosci Rep. 2013;13(10):384.CrossRefPubMedGoogle Scholar
  25. 25.
    Oue H, Miyamoto Y, Okada S, Koretake K, Jung CG, Michikawa M, et al. Tooth loss induces memory impairment and neuronal cell loss in APP transgenic mice. Behav Brain Res. 2013;252:318–25.CrossRefPubMedGoogle Scholar
  26. 26.
    Miura H, Yamasaki K, Kariyasu M, Miura K, Sumi Y. Relationship between cognitive function and mastication in elderly females. J Oral Rehabil. 2003;30(8):808–11.CrossRefPubMedGoogle Scholar
  27. 27.
    Weyant RJ, Pandav RS, Plowman JL, Ganguli M. Medical and cognitive correlates of denture wearing in older community-dwelling adults. J Am Geriatr Soc. 2004;52(4):596–600.CrossRefPubMedGoogle Scholar
  28. 28.
    Kieser J, Jones G, Borlase G, MacFadyen E. Dental treatment of patients with neurodegenerative disease. N Z Dent J. 1999;95(422):130–4.PubMedGoogle Scholar
  29. 29.
    D’Hooge R, De Deyn PP. Applications of the Morris water maze in the study of learning and memory. Brain Res Brain Res Rev. 2001;36(1):60–90.CrossRefPubMedGoogle Scholar
  30. 30.
    Watanabe K, Ozono S, Nishiyama K, Saito S, Tonosaki K, Fujita M, et al. The molarless condition in aged SAMP8 mice attenuates hippocampal Fos induction linked to water maze performance. Behav Brain Res. 2002;128(1):19–25.CrossRefPubMedGoogle Scholar
  31. 31.
    Onozuka M, Watanabe K, Nagasaki S, Jiang Y, Ozono S, Nishiyama K, et al. Impairment of spatial memory and changes in astroglial responsiveness following loss of molar teeth in aged SAMP8 mice. Behav Brain Res. 2000;108(2):145–55.CrossRefPubMedGoogle Scholar
  32. 32.
    Onozuka M, Watanabe K, Fujita M, Tomida M, Ozono S. Changes in the septohippocampal cholinergic system following removal of molar teeth in the aged SAMP8 mouse. Behav Brain Res. 2002;133(2):197–204.CrossRefPubMedGoogle Scholar
  33. 33.
    Ono Y, Kataoka T, Miyake S, Cheng SJ, Tachibana A, Sasaguri KI, et al. Chewing ameliorates stress-induced suppression of hippocampal long-term potentiation. Neuroscience. 2008;154(4):1352–9.CrossRefPubMedGoogle Scholar
  34. 34.
    Kordass B, Lucas C, Huetzen D, Zimmermann C, Gedrange T, Langner S, et al. Functional magnetic resonance imaging of brain activity during chewing and occlusion by natural teeth and occlusal splints. Ann Anat. 2007;189(4):371–6.CrossRefPubMedGoogle Scholar
  35. 35.
    Ono T, Hasegawa Y, Hori K, Nokubi T, Hamasaki T. Task-induced activation and hemispheric dominance in cerebral circulation during gum chewing. J Neurol. 2007;254(10):1427–32.CrossRefPubMedGoogle Scholar
  36. 36.
    Hasegawa Y, Ono T, Hori K, Nokubi T. Influence of human jaw movement oncerebral blood flow. J Dent Res. 2007;86(1):64–8.CrossRefPubMedGoogle Scholar
  37. 37.
    Onozuka M, Fujita M, Watanabe K, Hirano Y, Niwa M, Nishiyama K, et al. Age-related changes in brain regional activity during chewing: a functional magnetic resonance imaging study. J Dent Res. 2003;82(8):657–60.CrossRefPubMedGoogle Scholar
  38. 38.
    Grady C. The cognitive neuroscience of ageing. Nat Rev Neurosci. 2012;13(7):491–505.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Globalepidemiology of dental caries and severe periodontitis—a comprehensive review. J Clin Periodontol. 2017;44(Suppl 18):S94–S105.CrossRefPubMedGoogle Scholar
  40. 40.
    Kaye EK, Valencia A, Baba N, Spiro A, Dietrich T, Garcia R. Tooth loss and periodontal disease predict poor cognitive function in older men. J Am Geriatr Soc. 2010;58:713–8.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Kim J-M, Stewart R, Prince M, Kim SW, Yang SJ, Shin IS, et al. Dental health, nutritional status and recent-onset dementia in a Korean community population. Int J Geriatr Psychiatry. 2007;22:850–5.CrossRefPubMedGoogle Scholar
  42. 42.
    Stein PS, Kryscio RJ, Desrosiers M, Donegan SJ, Gibbs MB. Tooth loss, apolipoprotein E, and decline in delayed word recall. J Dent Res. 2010;89:473–7.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Chen JH, Lin LH, Chen YC. Risk factors for dementia. J Formos Med Assoc. 2009;108:754–64.CrossRefPubMedGoogle Scholar
  44. 44.
    Arrivé E, Letenneur L, Matharan F, Laporte C, Helmer C, Barberger-Gateau P, et al. Oral health condition of French elderly and risk of dementia: a longitudinal cohort study. Community Dent Oral Epidemiol. 2012;40:230–8.CrossRefPubMedGoogle Scholar
  45. 45.
    Stewart R, Stenman U, Hakeberg M, Hagglin C, Gustafson D, Skoog I. Associations between oral health and risk of dementia in a 37-year follow-up study: the prospective population study of women in Gothenburg. J Am Geriatr Soc. 2015;15:100–5.CrossRefGoogle Scholar
  46. 46.
    Naorungroj S, Schoenbach VJ, Wruck L, Mosley TH, Gottesman RF, Alonso A, et al. Tooth loss, periodontal disease, and cognitive decline in the Atherosclerosis Risk in Communities (ARIC) study. Community Dent Oral Epidemiol. 2015;43:47–57.CrossRefPubMedGoogle Scholar
  47. 47.
    Tonetti MS, Van Dyke TE. Working group 1 of the joint EFP/AAP workshop—periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Periodontol. 2013;84(4 Suppl):S24–9.PubMedGoogle Scholar
  48. 48.
    Cotti E, Mercuro G. Apical periodontitis and cardiovascular diseases: previous findings and ongoing research. Int Endod J. 2015;48(10):926–32.CrossRefPubMedGoogle Scholar
  49. 49.
    Poole S, Singhrao SK, Kesavalu L, Curtis MA, Crean S. Determining the presence of periodontopathic virulence factors in short-term postmortem Alzheimer’s disease brain tissue. J Alzheimers Dis. 2013;36(4):665–77.CrossRefPubMedGoogle Scholar
  50. 50.
    Liu Y, Wu Z, Zhang X, Ni J, Yu W, Zhou Y, et al. Leptomeningeal cells transduce peripheral macrophages inflammatory signal to microglia in reponse to Porphyromonas gingivalis LPS. Mediat Inflamm. 2013;2013:407562.Google Scholar
  51. 51.
    Wu Z, Nakanishi H. Lessons from microglia aging for the link between inflammatory bone disorders and Alzheimer’s disease. J Immunol Res. 2015;2015:471342.PubMedPubMedCentralGoogle Scholar
  52. 52.
    • Dominy SS, Lynch C, Ermini F, Benedyk M, Marczyk A, Konradi A, et al. Piotr Mydel2,6, Annelie Hellvard3,6, Karina Adamowicz2, Hatice Hasturk7,8, Walker GD, Reynolds EC, Faull RIM, Curtis MA, Dragunow M, Potempa J., 2019. Porphyromonas gingivalis in Alzheimer’s disease brains: evidence for disease causation and treatment with small-molecule inhibitors. Sci Adv. 2019;5:eaau3333 Most recent evidence is shown in terms of the association of Pg to AD.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Arendt T, Brückner MK, Morawski M, Jäger C, Gertz HJ. Early neurone loss in Alzheimer’s disease: cortical or subcortical? Acta Neuropathol Commun. 2015;10(3):10.CrossRefGoogle Scholar
  54. 54.
    Foote SL, Bloom FE, Aston-Jones G. Nucleus locus ceruleus: new evidence of anatomical and physiological specificity. Physiol Rev. 1983;63(3):844–914.CrossRefPubMedGoogle Scholar
  55. 55.
    Takahashi T, Shirasu M, Shirasu M, Kubo KY, Onozuka M, Sato S, et al. The locus coeruleus projects to the mesencephalic trigeminal nucleus in rats. Neurosci Res. 2010;68(2):103–6.CrossRefPubMedGoogle Scholar
  56. 56.
    Maeda T, Byers MR. Different localizations of growth-associated protein (GAP-43) in mechanoreceptors and free nerve endings of adult rat periodontalligament, dental pulp and skin. Arch Histol Cytol. 1996;59(3):291–304.CrossRefPubMedGoogle Scholar
  57. 57.
    Dandov AD, Atanasova DY, Lazarov NE. Morphological changes in the rat mesencephalic trigeminal nucleus following peripheral axotomy. Compt Rend Acad BulgSci. 2016;69(6):801–6.Google Scholar
  58. 58.
    • Jou YT. Dental deafferentation and brain damage: a review and a hypothesis. Kaohsiung J Med Sci. 2018;34(4):231–7 Possible explanation about the relationship between trigeminal neurodegeneration and the progress of dementia is shown. CrossRefPubMedGoogle Scholar
  59. 59.
    Xu X, Cao B, Wang J, Yu T, Li Y. Decision-making deficits associated with disrupted synchronization between basolateral amygdala and anterior cingulate cortex in rats after tooth loss. Prog Neuro-Psychopharmacol Biol Psychiatry. 2015;60:26–35.CrossRefGoogle Scholar
  60. 60.
    Takeda Y, Oue H, Okada S, Kawano A, Koretake K, Michikawa M, et al. Molar loss and powder diet leads to memory deficit and modifies the mRNAvexpression of brain-derived neurotrophic factor in the hippocampus of adult mice. BMC Neurosci. 2016;17(1):81.CrossRefPubMedPubMedCentralGoogle Scholar
  61. 61.
    Oue H, Miyamoto Y, Koretake K, Okada S, Doi K, Jung CG, et al. Tooth loss might not alter molecular pathogenesis in an aged transgenic Alzheimer’s disease model mouse. Gerodontology. 2016;33(3):308–14.CrossRefPubMedGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Oral Anatomy and Cell Biology, Graduate School of Medical and Dental SciencesKagoshima UniversityKagoshimaJapan
  2. 2.Periodontology, Faculty of DentistryThe University of Hong KongHong KongChina

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