Relationship between periodontal disease and dementia: A Population-Based Cohort Study

Background: The prevalence of periodontal disease (PD) is high, but varies widely. Approximately 90% or more of the world population has mild to advanced PD. At the same time, the prevalence of dementia is also noted to increase rapidly the world. Poor dental health and PD may be linked to dementia. However, the magnitude and the temporal relationship remain unclear.

Methods: This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database (NHIRD). Between 2000 and 2010, we identified 344278 newly-diagnosed PD cases, 14085 PD with intensive treatment, 107839 PD with tooth extraction, and 45530 PD without treatment as the study cohort and 208703 non-PD subjects. We used Cox proportional hazard regression analysis to measure the association between PD and dementia.

Results: The incidence rate (IR) of dementia were significantly higher in the PD with tooth extraction (0.33%/y), and PD without treatment patients (0.39%/y) than that in non-PD subjects (0.27%/y). After adjusted for age, sex, hypertension, diabetes, and hyperlipidemia, the multivariate Cox proportional hazards model revealed that PD with tooth extraction (HR: 1.39, 95% CI: 1.33-1.47) and PD without treatment (HR: 1.41, 95% CI: 1.30-1.53) had higher risk of dementia than subjects without PD.

Conclusion: Patients with PD and tooth extraction are associated with an increased risk of dementia.