Oral health as a modifiable risk factor for neurodegeneration: Prudent optimism and interdisciplinary action

Abstract

Neurodegenerative diseases, including Alzheimer’s disease (AD) and Parkinson’s disease (PD), represent a growing public health burden, necessitating exploration of modifiable risk factors. Emerging evidence suggests a link between poor oral health, particularly chronic periodontitis, and neurodegeneration, mediated by systemic inflammation, direct bacterial invasion, and disruptions in the microbiota-gut-brain axis. Periodontal pathogens, such as Porphyromonas gingivalis, have been suggested to contribute to neuroinflammation, blood–brain barrier dysfunction, and amyloid-beta aggregation, all of which are implicated in AD pathology. Additionally, tooth loss and masticatory dysfunction could further exacerbate cognitive decline through reduced cerebral stimulation and impaired nutrient absorption. While the association between periodontitis and neurodegeneration is compelling, causality remains uncertain, warranting further longitudinal and interventional studies. Interdisciplinary collaboration between neurologists and dental professionals is essential to establish oral health as a potential preventive strategy for neurodegenerative diseases. Routine periodontal screenings, improved oral hygiene awareness, and early intervention could help mitigate cognitive decline. Moreover, salivary biomarkers show promise as non-invasive tools for early detection of neurodegeneration. Addressing socioeconomic and healthcare disparities in access to both dental and neurological care is crucial in minimizing disease burden. Future research should focus on mechanistic studies and randomized trials to determine whether and how periodontal interventions can influence neurodegenerative disease progression.