The association between periodontal disease, dementia, and mild cognitive Impairment: Assessing the contribution of sleep disturbances and sleep disorders

Abstract

This review explores the potential role of sleep disturbances in the interaction between periodontal disease—a microbially driven, inflammatory condition causing bone loss and dentition damage—and the risk of cognitive impairment and dementia. Both periodontal disease and sleep disturbances, rise in parallel with aging, a period marked by cognitive changes. Our aims were to assess the strength and certainty of the proposed association to guide clinicians in addressing this question and advising patients. Sleep disturbances and periodontal disease are age-related, modifiable conditions that impact systemic health, yet their combined effect on cognition and dementia risk remains uncertain due to varying risk factors. Both conditions share inflammatory and oxidative stress pathways, which may contribute to periodontal disease and possibly cognitive decline, though causality remains unproven. Periodontal disease is also linked to other systemic conditions, such as diabetes and cardiovascular disease, through inflammation or bacterial spread. We discuss how chronic sleep disruptions may exacerbate periodontal inflammation and cognitive decline, with systemic inflammation potentially accelerating neurodegenerative processes. Integrating evidence from sleep medicine, neuroinflammation, and dentistry can help identify mechanisms to protect brain health. We emphasize the consideration of periodontal health and sleep assessments in individuals at risk for cognitive decline or dementia.