The Link Between Periodontitis and Alzheimer’s Disease: Reality or Yet Another Association

Abstract

Purpose of Review: To establish a link or causation between periodontitis and Alzheimer’s disease requires studies that first establish an association or correlation between these two diseases, followed by in vitro, animal model, and human studies to identify possible underlying biological mechanisms, and finally assessing the benefits of periodontal therapy in general and targeted therapies against the microbiota and inflammatory responses in periodontitis. This review presents an update on the current correlation and biological mechanisms that link these two diseases, with special emphasis on the keystone periodontal pathogen Porphyromonas gingivalis and its key family of gingipain enzymes. Recent Findings: Recent evidence for slowing the progression of Alzheimer’s disease through periodontal therapy in general, as well as focused therapies directed against Porphyromonas gingivalis and its gingipains, are presented. Summary: These intervention studies, together with the recent association and biological mechanism studies, strengthen the evidence for a direct link or causation between these two diseases. In addition, these recent studies support the special role of the dental practitioner in the management of patients with cognitive decline.