Researchers at the University Medical Center Greifswald have confirmed the results of a previous study that found an association between inflammatory gum disease due to periodontitis and Alzheimer’s disease.
“It is very difficult to conduct meaningful methodological studies of the effects of periodontal disease, a common severe form of gum disease,” said Dr. Christian Schwahn of the university’s Polyclinic for Dental Prosthetics, Geriatric Dentistry, and Medical Materials Science.
“Statistical models that have only recently been developed make it possible to simulate a controlled clinical study by combining available data from treated patients and untreated patients,” said Schwahn.
The long-term Study of Health in Pomerania/Life and Health in Western Pomerania (SHIP) has been examining the influence of dental diseases on the general health of people since 1997, finding that inflammatory gum disease affects 15% to 45% of people depending on age.
“For the first time, the connection between the treatment of gum disease and the onset of Alzheimer’s disease in a quasi-experimental model of 177 patients treated periodontally in the Greifswald GANI-MED study and 409 untreated participants from the SHIP study will be analyzed,” said Schwahn.
The researchers used magnetic resonance imaging (MRI) data as an indicator for the onset of Alzheimer’s disease and compared it with MRI data from the US Alzheimer’s Disease Neuroimaging Initiative so they it be used as an individual measure of the loss of brain substance typical of Alzheimer’s disease.
Periodontitis treatment carried out by a dentist specializing in gum disease showed a positive effect on the loss of brain matter, which could be assessed as moderate to severe.
The researchers said that the results were remarkable because the periodontitis patients were younger than the age of 60 at the time of the MRI examination, and the observation time between the dental treatment and the MRI exam was 7.3 years on average for the patients.
“Our approach clearly lies in the prevention and timely treatment of gum disease, which can be triggered by a large number of germs, in order to prevent such possible consequential damage in advance,” said Thomas Kocher, director of the Polyclinic for Dental Conservation, Periodontology, Endodontology, Pediatric Dentistry, and Preventive Dentistry.
“We will continue to have to rely on observational studies that simulate a controlled clinical study in this area,” said Schwahn. “A clinical study with a placebo treatment in a patient group, i.e., with patients who have intentionally not been treated by the dentist, is not feasible for ethical and medical reasons.”
The study, “Effect of Periodontal Treatment on Preclinical Alzheimer’s Disease—Results of a Trial Emulation Approach,” was published by Alzheimer’s & Dementia.