Bidirectional Interplay Between Periodontitis and Alzheimer’s Disease: Mechanisms, Clinical Management, and Preventive Strategies
- 1Oral and Maxillofacial Surgery and Diagnostic Sciences Department, Taif University, Taif, SAU
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.
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BibTeX
@article{alwithanani2026bidirectional,
title = {{Bidirectional Interplay Between Periodontitis and Alzheimer’s Disease: Mechanisms, Clinical Management, and Preventive Strategies}},
author = {Naif A Alwithanani},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117264},
url = {https://europepmc.org/article/PMC/PMC13722825},
note = {CC BY},
}
RIS
TY - JOUR
TI - Bidirectional Interplay Between Periodontitis and Alzheimer’s Disease: Mechanisms, Clinical Management, and Preventive Strategies
AU - Naif A Alwithanani
PY - 2026
DA - 2026/09/30
JO - Cureus
DO - 10.7759/cureus.117264
UR - https://europepmc.org/article/PMC/PMC13722825
AB - 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.
SN - 2168-8184
ER -