Bidirectional Interplay Between Periodontitis and Alzheimer's Disease: Mechanisms, Clinical Management, and Preventive Strategies.

Authors

Naif A Alwithanani

Published in

Cureus. Volume 18. Issue 9. Pages e117264. Epub Sep 30, 2026.

Abstract

Alzheimer's disease (AD) is a major neurodegenerative disorder, whereas periodontitis is a highly prevalent chronic inflammatory disease that may have important systemic consequences. Increasing evidence suggests a bidirectional relationship between periodontitis and AD, with periodontal inflammation potentially contributing to cognitive decline and neurodegeneration, while cognitive and motor impairment may simultaneously worsen oral hygiene and periodontal health. This narrative review synthesizes current evidence regarding the epidemiological association, potential biological mechanisms, clinical implications, and emerging preventive and therapeutic strategies linking the two conditions. Evidence indicates that periodontitis is associated with an increased risk of cognitive impairment and AD, although causality remains unproven. Proposed mechanisms include translocation of periodontal pathogens, particularly Porphyromonas gingivalis, systemic inflammation and neuroinflammation, blood-brain barrier disruption, oxidative stress, microbiome alterations, and effects on amyloid-β and tau pathology. In patients with AD, progressive cognitive impairment can compromise oral self-care and increase dependence on caregivers, contributing to periodontal deterioration. Early periodontal assessment, individualized treatment, caregiver-supported oral hygiene, regular maintenance, and interdisciplinary care may therefore be clinically beneficial. Emerging approaches targeting periodontal pathogens, gingipains, and the oral microbiome are promising but require stronger clinical validation. Overall, maintaining periodontal health represents a potentially modifiable component of comprehensive strategies for reducing the oral and systemic burden associated with AD.

PMID:
42966961
Bibliographic data and abstract were imported from PubMed on 01 Nov 2026.

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