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Prevention and early treatment of periodontitis is important
The longitudinal SHIP study (Study of Health in Pomerania) has been researching the effect of oral diseases on people's general health since 1997. It has been shown that chronic periodontitis, which affects 15 to 45 percent of people depending on their age, increases the risk of cardiovascular diseases and dementia.
Now, scientists at the University Medicine Greifswald have published a new study in the American journal Alzheimer's & Dementia*, confirming previous findings regarding a link with Alzheimer's disease.
"It is very difficult to perform methodologically meaningful studies on the effects of periodontitis, a common severe form of gum disease. Only recently developed statistical models make it possible to emulate a controlled clinical trial by combining available data from treated patients and untreated subjects", explained Dr. Christian Schwahn of the Department of Prosthetic Dentistry, Gerodontology and Biomaterials. "For the first time, the relationship between treatment of chronic periodontitis and preclinical Alzheimer's disease could be analyzed in a quasi-experimental model of 177 periodontally treated patients from the Greifswald Approach to Individualized Medicine (GANI_MED) study and 409 untreated participants from the SHIP study."
Moderate to strong effect clearly detectable
Magnetic resonance imaging (MRI) data were used as an indicator of preclinical Alzheimer's disease. These were compared with MRI data from the U.S. Alzheimer's Disease Neuroimaging Initiative so that they could be used as an individual measure of Alzheimer's disease-related loss of brain matter.
Periodontitis treatment administered by a dentist specializing in gum disease showed a favorable effect on loss of brain matter, which could be estimated as moderate to severe.
"These results are remarkable in that the periodontitis patients were younger than 60 years at the time of the MRI examination, with a median observation period of 7.3 years between oral treatment and MRI examination," emphasized co-authors Prof. Thomas Kocher, director of the Department of Restorative Dentistry, Periodontology, Endodontology, and Pediatric and Preventive Dentistry, and Prof. Hans J. Grabe, director of the Department of Psychiatry and Psychotherapy at the University Medicine Greifswald.
"Our approach clearly lies in the prevention and early treatment of gum disease, which can be triggered by a variety of pathogens, in order to prevent such possible consequential damage in advance," Kocher said.
In contrast, a study underway in the USA (https://clinicaltrials.gov/ct2/show/study/NCT03823404) since spring 2019 is focusing on testing drugs. These are designed to achieve a treatment effect in subjects over 55 years of age already suffering from Alzheimer's disease by combating the harmful effects of the periodontal keystone pathogen (P. gingivalis) in the brain.
"We will have to continue to rely on observational studies that emulate a controlled clinical trial in this area," said Dr. Christian Schwahn. "A clinical trial with a placebo treatment in a patient group, i.e., with intentionally dentally untreated patients, is not feasible for ethical and medical reasons."
Background Periodontitis
Periodontitis, the inflammation of the periodontium, is one of the most common chronic diseases worldwide. In Germany, too, about 11.5 million people suffer from a severe form of this widespread disease. Periodontitis is thus the second most common disease of the oral cavity after caries.
If left untreated, periodontitis can lead to tooth loss as well as having an impact on general health and well-being. Like an iceberg, the disease progresses below the visible surface. And because it usually doesn't hurt either, it's often not detected until it's far advanced. It is therefore important to be aware of warning signs of possible periodontitis and to visit the dentist at the first signs. This is because early detection and systematic treatment can bring the disease process to a halt. Aesthetic or functional changes can thus be largely limited and the condition of the periodontium significantly improved.
*Originalpublikation
Alzheimers Dement. 2021 May 29.
Effect of periodontal treatment on preclinical Alzheimer’s disease—Results of a trial emulation approach
DOI: 10.1002/alz.12378
https://pubmed.ncbi.nlm.nih.gov/34050719/
Contact
Prof. Dr. Hans J. Grabe (Schwerpunkt Alzheimer), Tel. 03834 86 6915, 03834 86 5080
hans.grabe@med.uni-greifswald.de
Prof. Dr. Thomas Kocher (Schwerpunkt Parodontitis), Tel. 03834 86 7172, 03834 86 7127
kocher@uni-greifswald.de
Dr. Christian Schwahn (Schwerpunkt Methodik), Tel. 03834 867325
schwahn@uni-greifswald.de
Universitätsmedizin Greifswald
Leiter der Stabsstelle Kommunikation und Marketing
Pressesprecher: Christian Arns
T +49 3834 86-52 28
E christian.arns@med.uni-greifswald.de
www.medizin.uni-greifswald.de
www.facebook.com/UnimedizinGreifswald
Instagram/Twitter @UMGreifswald
Prof. Dr. Hans J. Grabe (Schwerpunkt Alzheimer), Tel. 03834 86 6915, 03834 86 5080
hans.grabe@med.uni-greifswald.de
Prof. Dr. Thomas Kocher (Schwerpunkt Parodontitis), Tel. 03834 86 7172, 03834 86 7127
kocher@uni-greifswald.de
Dr. Christian Schwahn (Schwerpunkt Methodik), Tel. 03834 867325
schwahn@uni-greifswald.de
*Originalpublikation
Alzheimers Dement. 2021 May 29.
Effect of periodontal treatment on preclinical Alzheimer’s disease—Results of a trial emulation approach
DOI: 10.1002/alz.12378
https://pubmed.ncbi.nlm.nih.gov/34050719/
Dr. Lukasz Jablonowski in the Greifswald dental clinic
Photo: Yvonne Breuhahn
Checking the gingival pockets with a special periodontal probe.
Photo: Yvonne Breuhahn
UMG
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