The Potential Link between Removable Dentures and Alzheimer's Disease

REVIEW
Enis Veseli, Dinesh Rokaya, ArunSundar MohanaSundaram, Hina Memon, Jaiprakash Suresh Gurav, Swathy Krishna, Kaltrina Veseli

 
For citation: Veseli E, Rokaya D, MohanaSundaram A, Memon H, Gurav JS, Krishna S, Veseli K. The Potential Link between Removable Dentures and Alzheimer's Disease. International Journal of Biomedicine. 2025;15(1):17-23. doi:10.21103/Article15(1)_RA2
 
Originally published March 5, 2025

Abstract: 

Alzheimer's disease (AD) is a common neurocognitive disorder that impacts millions of people globally. The last few decades have seen considerable progress in AD research, while much of the pathophysiology and associated risk factors are still up for debate. Recent studies suggested the association between oral health and the development of AD, especially periodontal pathogens. Edentulism and partial edentulism are common in older people and are frequently addressed with the use of removable dentures. However, RDs can disturb the homeostasis of oral microflora over time. This study aims to explore the possible connections between the use of removable dentures and AD by reviewing existing literature. The findings indicate that the use of removable dentures in individuals with edentulism and partial edentulism is associated with an increased prevalence of periodontal pathogens. Considering that AD primarily affects older individuals, who frequently require rehabilitation with removable dentures, these findings highlight the potential relationship between these factors. However, further detailed research is necessary to clarify this association.

Keywords: 
removable dentures • Alzheimer's disease • periodontal pathogens
References: 
  1. Gustavsson A, Norton N, Fast T, Frölich L, Georges J, Holzapfel D, Kirabali T, Krolak-Salmon P, Rossini PM, Ferretti MT, Lanman L, Chadha AS, van der Flier WM. Global estimates on the number of persons across the Alzheimer's disease continuum. Alzheimers Dement. 2023 Feb;19(2):658-670. doi: 10.1002/alz.12694. Epub 2022 Jun 2. PMID: 35652476.
  2. 2024 Alzheimer's disease facts and figures. Alzheimers Dement. 2024 May;20(5):3708-3821. doi: 10.1002/alz.13809. Epub 2024 Apr 30. PMID: 38689398; PMCID: PMC11095490.
  3. Plachokova AS, Gjaltema J, Hagens ERC, Hashemi Z, Knüppe TBA, Kootstra TJM, Visser A, Bloem BR. Periodontitis: A Plausible Modifiable Risk Factor for Neurodegenerative Diseases? A Comprehensive Review. Int J Mol Sci. 2024 Apr 19;25(8):4504. doi: 10.3390/ijms25084504. PMID: 38674088; PMCID: PMC11050498.
  4. Li R, Wang J, Xiong W, Luo Y, Feng H, Zhou H, Peng Y, He Y, Ye Q. The oral-brain axis: can periodontal pathogens trigger the onset and progression of Alzheimer's disease? Front Microbiol. 2024 Feb 1;15:1358179. doi: 10.3389/fmicb.2024.1358179. PMID: 38362505; PMCID: PMC10868393.
  5. Danser MM, van Winkelhoff AJ, de Graaff J, Loos BG, van der Velden U. Short-term effect of full-mouth extraction on periodontal pathogens colonizing the oral mucous membranes. J Clin Periodontol. 1994 Aug;21(7):484-9. doi: 10.1111/j.1600-051x.1994.tb00412.x. PMID: 7929861.
  6. Cortelli JR, Aquino DR, Cortelli SC, Nobre Franco GC, Fernandes CB, Roman-Torres CV, Costa FO. Detection of periodontal pathogens in oral mucous membranes of edentulous individuals. J Periodontol. 2008 Oct;79(10):1962-5. doi: 10.1902/jop.2008.080092. PMID: 18834252.
  7. Oral health for an ageing population | FDI [Internet]. [cited 2024 Dec 10]. Available from: https://www.fdiworlddental.org/oral-health-ageing-population
  8. Andjelkovic M, Sojic LT, Lemic AM, Nikolic N, Kannosh IY, Milasin J. Does the Prevalence of Periodontal Pathogens Change in Elderly Edentulous Patients after Complete Denture Treatment? J Prosthodont. 2017 Jul;26(5):364-369. doi: 10.1111/jopr.12402. Epub 2015 Nov 30. PMID: 26619204.
  9. Sachdeo A, Haffajee AD, Socransky SS. Biofilms in the edentulous oral cavity. J Prosthodont. 2008 Jul;17(5):348-56. doi: 10.1111/j.1532-849X.2008.00301.x. PMID: 18355168.
  10. Veseli E, Staka G. Detection of Actinobacillus actinomycetemcomitans DNA in Patients with Partial and Complete Dentures by Real-Time PCR. International Journal of Biomedicine. 2023 Mar 10;13(1):141–5.
  11. Veseli E, Staka G, Tovani-Palone MR. Evaluation of red-complex bacteria loads in complete denture patients: a pilot study. BDJ Open. 2023 Feb 18;9(1):7. doi: 10.1038/s41405-023-00133-z. PMID: 36801907; PMCID: PMC9938684.
  12. Wong HH, Hung CH, Yip J, Lim TW. Metagenomic Characterization and Comparative Analysis of Removable Denture-Wearing and Non-Denture-Wearing Individuals in Healthy and Diseased Periodontal Conditions. Microorganisms. 2024 Jun 13;12(6):1197. doi: 10.3390/microorganisms12061197. PMID: 38930579; PMCID: PMC11205920.
  13. Yasui M, Ryu M, Sakurai K, Ishihara K. Colonisation of the oral cavity by periodontopathic bacteria in complete denture wearers. Gerodontology. 2012 Jun;29(2):e494-502. doi: 10.1111/j.1741-2358.2011.00506.x. Epub 2011 Sep 19. PMID: 21929616.
  14. Veseli E. Removable dentures and Alzheimer's disease. Br Dent J. 2024 Jul;237(1):11. doi: 10.1038/s41415-024-7633-z. Epub 2024 Jul 12. PMID: 38997346.
  15. Eslami S, Hosseinzadeh Shakib N, Fooladfar Z, Nasrollahian S, Baghaei S, Mosaddad SA, Motamedifar M. The role of periodontitis-associated bacteria in Alzheimer's disease: A narrative review. J Basic Microbiol. 2023 Oct;63(10):1059-1072. doi: 10.1002/jobm.202300250. Epub 2023 Jun 13. PMID: 37311215.
  16. Yates D, McLoughlin DM. The molecular pathology of Alzheimer’s disease. Psychiatry. 2008 Jan;7(1):1–5.
  17. Preethi B, Moorthi V. A REVIEW ON ALZHIMER’S DISEASE: PATHOLOGY, MOLECULAR CONDITIONS, MANAGEMNT AND CAUSES. Asian Journal of Pharmaceutical and Clinical Research. 2017 May 1;10(5):27.
  18. Thakur AK, Kamboj P, Goswami K. Pathophysiology and management of Alzheimer’s disease: an overview. J Anal Pharm Res. 2018;9(2):226-235. doi: 10.15406/japlr.2018.07.00230
  19. Martins CC, Lockhart PB, Firmino RT, Kilmartin C, Cahill TJ, Dayer M, Occhi-Alexandre IGP, Lai H, Ge L, Thornhill MH. Bacteremia following different oral procedures: Systematic review and meta-analysis. Oral Dis. 2024 Apr;30(3):846-854. doi: 10.1111/odi.14531. Epub 2023 Mar 29. PMID: 36750413.
  20. Noble JM, Scarmeas N, Celenti RS, Elkind MS, Wright CB, Schupf N, Papapanou PN. Serum IgG antibody levels to periodontal microbiota are associated with incident Alzheimer disease. PLoS One. 2014 Dec 18;9(12):e114959. doi: 10.1371/journal.pone.0114959. PMID: 25522313; PMCID: PMC4270775.
  21. Fogelholm N, Leskelä J, Manzoor M, Holmer J, Paju S, Hiltunen K, Roitto HM, Saarela RK, Pitkälä K, Eriksdotter M, Buhlin K, Pussinen PJ, Mäntylä P. Subgingival microbiome at different levels of cognition. J Oral Microbiol. 2023 Feb 19;15(1):2178765. doi: 10.1080/20002297.2023.2178765. PMID: 36844899; PMCID: PMC9946326.
  22. Wan J, Fan H. Oral Microbiome and Alzheimer's Disease. Microorganisms. 2023 Oct 13;11(10):2550. doi: 10.3390/microorganisms11102550. PMID: 37894208; PMCID: PMC10609607.
  23. Mao S, Huang CP, Lan H, Lau HG, Chiang CP, Chen YW. Association of periodontitis and oral microbiomes with Alzheimer's disease: A narrative systematic review. J Dent Sci. 2022 Oct;17(4):1762-1779. doi: 10.1016/j.jds.2022.07.001. Epub 2022 Jul 21. PMID: 36299333; PMCID: PMC9588805.
  24. Hosseininasab SSM, Ebrahimi R, Yaghoobpoor S, Kazemi K, Khakpour Y, Hajibeygi R, Mohamadkhani A, Fathi M, Vakili K, Tavasol A, Tutunchian Z, Fazel T, Fathi M, Hajiesmaeili M. Alzheimer's disease and infectious agents: a comprehensive review of pathogenic mechanisms and microRNA roles. Front Neurosci. 2025 Jan 7;18:1513095. doi: 10.3389/fnins.2024.1513095. PMID: 39840010; PMCID: PMC11747386.
  25. Kumar R, Sharma M, Singh P. Oral pathogens and neurodegenerative diseases: A link between oral health and cognitive functions. J Oral Microbiol. 2020;12(1):1813702.
  26. Riviere GR, O’Brien MM, Ebersole JL. The role of oral bacteria in the development of Alzheimer’s disease. Alzheimer’s Res Ther. 2016;8(1):8.
  27. Guan X, Huang M, Wu Y. The impact of periodontal disease on gut microbiota and its implications for Alzheimer’s disease. Front Aging Neurosci. 2021;13:1–10.
  28. Costerton JW, Lewandowski Z, Caldwell DE, Korber DR, Lappin-Scott HM. Microbial biofilms. Annu Rev Microbiol. 1995;49:711-45. doi: 10.1146/annurev.mi.49.100195.003431. PMID: 8561477.
  29. Vulović S, Nikolić-Jakoba N, Radunović M, Petrović S, Popovac A, Todorović M, Milić-Lemić A. Biofilm Formation on the Surfaces of CAD/CAM Dental Polymers. Polymers (Basel). 2023 Apr 29;15(9):2140. doi: 10.3390/polym15092140. PMID: 37177285; PMCID: PMC10181064.
  30. Teles FR, Teles RP, Sachdeo A, Uzel NG, Song XQ, Torresyap G, Singh M, Papas A, Haffajee AD, Socransky SS. Comparison of microbial changes in early redeveloping biofilms on natural teeth and dentures. J Periodontol. 2012 Sep;83(9):1139-48. doi: 10.1902/jop.2012.110506. Epub 2012 Mar 23. PMID: 22443543; PMCID: PMC4041159.
  31. Mengatto CM, Marchini L, Bernardes LA, Gomes SC, Silva AM, Rizzatti-Barbosa CM. Partial denture metal framework may harbor potentially pathogenic bacteria. J Adv Prosthodont. 2015 Dec;7(6):468-74. doi: 10.4047/jap.2015.7.6.468. Epub 2015 Dec 30. PMID: 26816577; PMCID: PMC4722151.
  32. Zitzmann NU, Hagmann E, Weiger R. What is the prevalence of various types of prosthetic dental restorations in Europe? Clin Oral Implants Res. 2007 Jun;18 Suppl 3:20-33. doi: 10.1111/j.1600-0501.2007.01435.x. Erratum in: Clin Oral Implants Res. 2008 Mar;19(3):326-8. PMID: 17594367.
  33. Hirotomi T, Yoshihara A, Ogawa H, Miyazaki H. Tooth-related risk factors for periodontal disease in community-dwelling elderly people. J Clin Periodontol. 2010 Jun;37(6):494-500. doi: 10.1111/j.1600-051X.2010.01565.x. PMID: 20507372.
  34. Carlsson GE, Hedegård B, Koivumaa KK. Late results of treatment with partial dentures. An investigation by questionnaire and clinical examination 13 years after treatment. J Oral Rehabil. 1976 Jul;3(3):267-72. doi: 10.1111/j.1365-2842.1976.tb00951.x. PMID: 1068237.
  35. Addy M, Bates JF. Plaque accumulation following the wearing of different types of removable partial dentures. J Oral Rehabil. 1979 Apr;6(2):111-7. doi: 10.1111/j.1365-2842.1979.tb01271.x. PMID: 374695.
  36. Ghamrawy EE. Qualitative changes in dental plaque formation related to removable partial dentures. J Oral Rehabil. 1979 Apr;6(2):183-8. doi: 10.1111/j.1365-2842.1979.tb01279.x. PMID: 286025.
  37. Stipho HD, Murphy WM, Adams D. Effect of oral prostheses on plaque accumulation. Br Dent J. 1978 Jul 18;145(2):47-50. doi: 10.1038/sj.bdj.4804114. PMID: 278621.
  38. Dula LJ, Ahmedi EF, Lila-Krasniqi ZD, Shala KSh. Clinical evaluation of removable partial dentures on the periodontal health of abutment teeth: a retrospective study. Open Dent J. 2015 Mar 31;9:132-9. doi: 10.2174/1874210601509010132. PMID: 25926896; PMCID: PMC4406999.
  39. Isidor F, Budtz-Jørgensen E. Periodontal conditions following treatment with distally extending cantilever bridges or removable partial dentures in elderly patients. A 5-year study. J Periodontol. 1990 Jan;61(1):21-6. doi: 10.1902/jop.1990.61.1.21. PMID: 2313518.
  40. Kern M, Wagner B. Periodontal findings in patients 10 years after insertion of removable partial dentures. J Oral Rehabil. 2001 Nov;28(11):991-7. doi: 10.1046/j.1365-2842.2001.00788.x. PMID: 11722713.
  41. Elmahdi AA, Elagib MFA, Mohamed Ali AB, Abouzeid HL, Atta AS, Abullais SS, Dhadse PV. Assessment of Periodontal Health Among Removable and Fixed Partial Denture Wearers in Aseer Region of Saudi Arabia. Med Sci Monit. 2023 May 4;29:e940322. doi: 10.12659/MSM.940322. PMID: 37138499; PMCID: PMC10167865.
  42. Fueki K, Inamochi Y, Yoshida-Kohno E, Wakabayashi N. Short-term effect of thermoplastic resin removable partial dentures on periodontal health: A randomized cross-over trial. J Prosthodont Res. 2022 Jan 11;66(1):167-175. doi: 10.2186/jpr.JPR_D_20_00317. Epub 2021 Jun 25. PMID: 34176847.
  43. Akaltan F, Kaynak D. An evaluation of the effects of two distal extension removable partial denture designs on tooth stabilization and periodontal health. J Oral Rehabil. 2005 Nov;32(11):823-9. doi: 10.1111/j.1365-2842.2005.01511.x. PMID: 16202046.
  44. Zlatarić DK, Celebić A, Valentić-Peruzović M. The effect of removable partial dentures on periodontal health of abutment and non-abutment teeth. J Periodontol. 2002 Feb;73(2):137-44. doi: 10.1902/jop.2002.73.2.137. PMID: 11895277.
  45. Mine K, Fueki K, Igarashi Y. Microbiological risk for periodontitis of abutment teeth in patients with removable partial dentures. J Oral Rehabil. 2009 Sep;36(9):696-702. doi: 10.1111/j.1365-2842.2009.01982.x. Epub 2009 Jul 23. PMID: 19650858.
  46. Vanzeveren C, D'Hoore W, Bercy P. Influence of removable partial denture on periodontal indices and microbiological status. J Oral Rehabil. 2002 Mar;29(3):232-9. doi: 10.1046/j.1365-2842.2002.00854.x. PMID: 11896839.
  47. Zhu X, Wang S, Gu Y, Li X, Yan H, Yan H, Miyoshi S, Shi L. Possible variation of the human oral bacterial community after wearing removable partial dentures by DGGE. World J Microbiol Biotechnol. 2012 May;28(5):2229-36. doi: 10.1007/s11274-012-1030-5. Epub 2012 Mar 6. PMID: 22806046.
  48. Urushibara Y, Ohshima T, Sato M, Hayashi Y, Hayakawa T, Maeda N, Ohkubo C. An analysis of the biofilms adhered to framework alloys using in vitro denture plaque models. Dent Mater J. 2014;33(3):402-14. doi: 10.4012/dmj.2013-325. PMID: 24882112.
  49. Mantzourani M, Gilbert SC, Fenlon M, Beighton D. Non-oral bifidobacteria and the aciduric microbiota of the denture plaque biofilm. Mol Oral Microbiol. 2010 Jun;25(3):190-9. doi: 10.1111/j.2041-1014.2009.00565.x. PMID: 20536746.
  50. Marsh PD, Percival RS, Challacombe SJ. The influence of denture-wearing and age on the oral microflora. J Dent Res. 1992 Jul;71(7):1374-81. doi: 10.1177/00220345920710070501. PMID: 1629453.
  51. Rocha EP, Francisco SB, Del Bel Cury AA, Cury JA. Longitudinal study of the influence of removable partial denture and chemical control on the levels of Streptococcus mutans in saliva. J Oral Rehabil. 2003 Feb;30(2):131-8. doi: 10.1046/j.1365-2842.2003.01015.x. PMID: 12535138.
  52. Nyvad B, Kilian M. Microbiology of the early colonization of human enamel and root surfaces in vivo. Scand J Dent Res. 1987 Oct;95(5):369-80. doi: 10.1111/j.1600-0722.1987.tb01627.x. PMID: 3477852.
  53. Fernandes CB, Aquino DR, Franco GC, Cortelli SC, Costa FO, Cortelli JR. Do elderly edentulous patients with a history of periodontitis harbor periodontal pathogens? Clin Oral Implants Res. 2010 Jun;21(6):618-23. doi: 10.1111/j.1600-0501.2009.01892.x. Epub 2010 Mar 11. PMID: 20337663.
  54. Gordon JH, LaMonte MJ, Zhao J, Genco RJ, Cimato TR, Hovey KM, Allison MA, Mouton CP, Wactawski-Wende J. Association of Periodontal Disease and Edentulism With Hypertension Risk in Postmenopausal Women. Am J Hypertens. 2019 Jan 15;32(2):193-201. doi: 10.1093/ajh/hpy164. PMID: 30517596; PMCID: PMC6331709.
  55. Brown JL, Young T, McKloud E, Butcher MC, Bradshaw D, Pratten JR, Ramage G. An In Vitro Evaluation of Denture Cleansing Regimens against a Polymicrobial Denture Biofilm Model. Antibiotics (Basel). 2022 Jan 16;11(1):113. doi: 10.3390/antibiotics11010113. PMID: 35052990; PMCID: PMC8772836.
  56. Mager DL, Ximenez-Fyvie LA, Haffajee AD, Socransky SS. Distribution of selected bacterial species on intraoral surfaces. J Clin Periodontol. 2003 Jul;30(7):644-54. doi: 10.1034/j.1600-051x.2003.00376.x. PMID: 12834503.
  57. Li J, Helmerhorst EJ, Leone CW, Troxler RF, Yaskell T, Haffajee AD, Socransky SS, Oppenheim FG. Identification of early microbial colonizers in human dental biofilm. J Appl Microbiol. 2004;97(6):1311-8. doi: 10.1111/j.1365-2672.2004.02420.x. PMID: 15546422.
  58. Könönen E, Asikainen S, Jousimies-Somer H. The early colonization of gram-negative anaerobic bacteria in edentulous infants. Oral Microbiol Immunol. 1992 Feb;7(1):28-31. doi: 10.1111/j.1399-302x.1992.tb00016.x. PMID: 1528621.
  59. Könönen E, Asikainen S, Alaluusua S, Könönen M, Summanen P, Kanervo A, Jousimies-Somer H. Are certain oral pathogens part of normal oral flora in denture-wearing edentulous subjects? Oral Microbiol Immunol. 1991 Apr;6(2):119-22. doi: 10.1111/j.1399-302x.1991.tb00463.x. PMID: 1945487.
  60. Carlsson J, Söderholm G, Almfeldt I. Prevalence of Streptococcus sanguis and Streptococcus mutans in the mouth of persons wearing full-dentures. Arch Oral Biol. 1969 Mar;14(3):243-9. doi: 10.1016/0003-9969(69)90226-x. PMID: 5255438.
  61. Theilade E, Budtz-Jørgensen E, Theilade J. Predominant cultivable microflora of plaque on removable dentures in patients with healthy oral mucosa. Arch Oral Biol. 1983;28(8):675-80. doi: 10.1016/0003-9969(83)90101-2. PMID: 6579900.
  62. Danser MM, van Winkelhoff AJ, de Graaff J, van der Velden U. Putative periodontal pathogens colonizing oral mucous membranes in denture-wearing subjects with a past history of periodontitis. J Clin Periodontol. 1995 Nov;22(11):854-9. doi: 10.1111/j.1600-051x.1995.tb01784.x. PMID: 8550862.
  63. Zhou X, Kattadiyil MT, Aprecio RM, Liu X, Zhang W, Li Y. Effect of opposing implant prostheses on periodontal pathogens in dentures: A pilot study. J Prosthet Dent. 2017 Aug;118(2):153-158. doi: 10.1016/j.prosdent.2016.10.011. Epub 2017 Jan 23. PMID: 28126355.

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Received January 16, 2025.
Accepted February 23, 2025.
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