{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:12:09Z","timestamp":1793751129677,"version":"4.6.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Dent. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alzheimer's Disease (AD) is the most common neurodegenerative disorder among the elderly, with a steadily rising prevalence that poses a significant global public health challenge. Recently, dentition defects (DD), such as tooth loss, have gained attention as potential risk factors influencing neurocognitive health. However, the relationship between DD and AD remains inconclusive, necessitating a systematic analysis to clarify this association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. We searched PubMed, Embase, Web of Science, and Cochrane Library databases to identify relevant studies published between 1996 and 2022. Eligible studies assessing the relationship between DD and AD were included. A random-effects model was applied to estimate the pooled odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity and publication bias were also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fourteen studies were included, with sample sizes ranging from 52 to 156,450 participants. The meta-analysis revealed a significant association between DD and an increased risk of AD (OR=1.38, 95% CI: 1.09\u20131.74,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Heterogeneity among the studies was substantial (I\u00b2\u2009=\u200997%), reflecting considerable variability in study designs, populations, and exposure definitions. Sensitivity analysis and publication bias assessments indicated the reliability of the results despite high heterogeneity. Mechanistic analyses suggested that DD may elevate AD risk through pathways such as chronic inflammation, nutritional deficiencies, alterations in the oral microbiome, and reduced cognitive reserve.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DD are significantly associated with an increased risk of AD. Improving oral health may represent a modifiable factor warranting. However, further high-quality prospective studies are needed to validate these findings and explore the underlying mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fdmed.2026.1783171","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T05:25:15Z","timestamp":1776662715000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between dentition defects and Alzheimer\u2019s disease risk: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"7","author":[{"given":"Qianxia","family":"Wang","sequence":"first","affiliation":[{"name":"College & Hospital of Stomatology, Anhui Medical University","place":["Hefei, Anhui Province, China"]},{"name":"Anhui Provincial Key Laboratory of Oral Diseases Research","place":["Hefei, Anhui Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaiyan","family":"Zhou","sequence":"additional","affiliation":[{"name":"College & Hospital of Stomatology, Anhui Medical University","place":["Hefei, Anhui Province, China"]},{"name":"Anhui Provincial Key Laboratory of Oral Diseases Research","place":["Hefei, Anhui Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miaomiao","family":"Zhang","sequence":"additional","affiliation":[{"name":"College & Hospital of Stomatology, Anhui Medical University","place":["Hefei, Anhui Province, China"]},{"name":"Anhui Provincial Key Laboratory of Oral Diseases Research","place":["Hefei, Anhui Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Dong","sequence":"additional","affiliation":[{"name":"College & Hospital of Stomatology, Anhui Medical University","place":["Hefei, Anhui Province, China"]},{"name":"Anhui Provincial Key Laboratory of Oral Diseases Research","place":["Hefei, Anhui Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Zhao","sequence":"additional","affiliation":[{"name":"College & Hospital of Stomatology, Anhui Medical University","place":["Hefei, Anhui Province, China"]},{"name":"Anhui Provincial Key Laboratory of Oral Diseases Research","place":["Hefei, Anhui Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1577","DOI":"10.1016\/S0140-6736(20)32205-4","article-title":"Alzheimer\u2019s disease","volume":"397","author":"Scheltens","year":"2021","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/S0140-6736(20)30367-6","article-title":"Dementia prevention, intervention, and care: 2020 report of the lancet commission","volume":"396","author":"Livingston","year":"2020","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.dadm.2017.08.004","article-title":"Further education improves cognitive reserve and triggers improvement in selective cognitive functions in older adults: the tasmanian healthy brain project","volume":"10","author":"Thow","year":"2018","journal-title":"Alzheimers Dementia"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1177\/0022034514552491","article-title":"Global burden of severe periodontitis in 1990\u20132010: a systematic review and meta-regression","volume":"93","author":"Kassebaum","year":"2014","journal-title":"J Dent Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.3390\/nu13041111","article-title":"Milk fatty acid profiles in different animal species: focus on the potential effect of selected PUFAs on metabolism and brain functions","volume":"13","author":"Mollica","year":"2021","journal-title":"Nutrients"},{"key":"B6","doi-asserted-by":"publisher","first-page":"eaau3333","DOI":"10.1126\/sciadv.aau3333","article-title":"Porphyromonas gingivalis in Alzheimer\u2019s disease brains: evidence for disease causation and treatment with small-molecule inhibitors","volume":"5","author":"Dominy","year":"2019","journal-title":"Sci Adv"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1037842","DOI":"10.3389\/fnut.2022.1037842","article-title":"Effect of the Mediterranean diet and probiotic supplementation in the management of mild cognitive impairment: rationale, methods, and baseline characteristics","volume":"9","author":"Cardelo","year":"2022","journal-title":"Front Nutr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1423322","DOI":"10.3389\/fnagi.2024.1423322","article-title":"Occlusion dysfunction and Alzheimer\u2019s disease: mendelian randomization study","volume":"16","author":"Wang","year":"2024","journal-title":"Front Aging Neurosci"},{"key":"B9","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.jamda.2019.06.001","article-title":"Interventions to reduce anticholinergic burden in adults aged 65 and older: a systematic review","volume":"21","author":"Nakham","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"B10","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1007\/978-1-0716-1566-9_4","article-title":"Assessing heterogeneity in random-effects meta-analysis","volume":"2345","author":"Langan","year":"2022","journal-title":"Methods Mol Biol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","article-title":"GRADE Guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"3061","DOI":"10.1007\/s00784-018-2396-z","article-title":"Oral health in Alzheimer\u2019s disease: a multicenter case-control study","volume":"22","author":"Arag\u00f3n","year":"2018","journal-title":"Clin Oral Investig"},{"key":"B13","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1111\/j.1600-0528.2011.00650.x","article-title":"Oral health condition of French elderly and risk of dementia: a longitudinal cohort study","volume":"40","author":"Arriv\u00e9","year":"2012","journal-title":"Community Dent Oral Epidemiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e200","DOI":"10.1111\/j.1741-2358.2010.00441.x","article-title":"Possible relationship between periodontitis and dementia in a north Indian old age population: a pilot study","volume":"29","author":"Rai","year":"2012","journal-title":"Gerodontology"},{"key":"B15","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1186\/s12877-022-02985-w","article-title":"Cognitive impairment and edentulism among older adults: an observational study using claims data","volume":"22","author":"Choi","year":"2022","journal-title":"BMC Geriatr"},{"key":"B16","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1002\/bjs.11433","article-title":"Impact of bariatric surgery on cardiovascular outcomes and mortality: a population-based cohort study","volume":"107","author":"Singh","year":"2020","journal-title":"Br J Surg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1111\/j.1741-2358.2010.00396.x","article-title":"Dementia and oral health among subjects aged 75 years or older","volume":"29","author":"Syrj\u00e4l\u00e4","year":"2012","journal-title":"Gerodontology"},{"key":"B18","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1902\/jop.2014.140340","article-title":"Is periodontitis a risk factor for cognitive impairment and dementia? A case-control study","volume":"86","author":"Gil-Montoya","year":"2015","journal-title":"J Periodontol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1111\/jgs.14697","article-title":"Oral hygiene in the elderly with different degrees of cognitive impairment and dementia","volume":"65","author":"Gil-Montoya","year":"2017","journal-title":"J Am Geriatr Soc"},{"key":"B20","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1002\/gps.1750","article-title":"Dental health, nutritional status and recent-onset dementia in a Korean community population","volume":"22","author":"Kim","year":"2007","journal-title":"Int J Geriatr Psychiatry"},{"key":"B21","doi-asserted-by":"publisher","first-page":"3763","DOI":"10.3390\/jcm1017376310.3390\/jcm10173763","article-title":"Association between tooth loss and Alzheimer\u2019s disease in a nested case-control study based on a national health screening cohort","volume":"10","author":"Kim","year":"2021","journal-title":"J Clin Med"},{"key":"B22","doi-asserted-by":"publisher","first-page":"51","DOI":"10.3290\/j.ogpd.a32343","article-title":"Oral health status of elderly chinese with dementia in Hong Kong","volume":"13","author":"Chu","year":"2015","journal-title":"Oral Health Prev Dent"},{"key":"B23","doi-asserted-by":"publisher","first-page":"823","DOI":"10.3233\/JAD-131283","article-title":"Oral infections and orofacial pain in Alzheimer\u2019s disease: a case-control study","volume":"38","author":"de Souza Rolim","year":"2013","journal-title":"J Alzheimers Dis"},{"key":"B24","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1111\/j.1754-4505.1997.tb00866.x","article-title":"Oral health of persons with and without dementia attending a geriatric clinic","volume":"17","author":"Warren","year":"1997","journal-title":"Spec Care Dentist"},{"key":"B25","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1080\/13607863.2015.1008986","article-title":"Improving oral health of institutionalized older people with diagnosed dementia","volume":"20","author":"Zenth\u00f6fer","year":"2016","journal-title":"Aging Ment Health"},{"key":"B26","doi-asserted-by":"publisher","first-page":"d4002","DOI":"10.1136\/bmj.d4002","article-title":"Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials","volume":"343","author":"Sterne","year":"2011","journal-title":"Br Med J"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1136\/bmj.328.7454.1490","article-title":"Grading quality of evidence and strength of recommendations","volume":"328","author":"Atkins","year":"2004","journal-title":"Br Med J"},{"key":"B28","doi-asserted-by":"publisher","first-page":"974694","DOI":"10.3389\/fnut.2022.974694","article-title":"Different oral and gut microbial profiles in those with Alzheimer\u2019s disease consuming anti-inflammatory diets","volume":"9","author":"Chen","year":"2022","journal-title":"Front Nutr"},{"key":"B29","doi-asserted-by":"publisher","first-page":"723","DOI":"10.3233\/JAD-140387","article-title":"Oral inflammation, tooth loss, risk factors, and association with progression of Alzheimer\u2019s disease","volume":"42","author":"Singhrao","year":"2014","journal-title":"J Alzheimers Dis"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1111\/jcpe.13016","article-title":"Association between periodontitis and risk of Alzheimer\u2032s disease, mild cognitive impairment and subjective cognitive decline: a case-control study","volume":"45","author":"Holmer","year":"2018","journal-title":"J Clin Periodontol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"5023","DOI":"10.1007\/s10787-025-01888-7","article-title":"The link between oral health and neurodegeneration: a review of periodontitis in Alzheimer\u2019s and Parkinson\u2019s disease and dementia","volume":"33","author":"Wagaskar","year":"2025","journal-title":"Inflammopharmacology"},{"key":"B32","doi-asserted-by":"publisher","first-page":"797","DOI":"10.3233\/JAD-191283","article-title":"Apolipoprotein \u025b4 allele and dental occlusion deficiency as risk factors for Alzheimer\u2019s disease","volume":"74","author":"Popovac","year":"2020","journal-title":"J Alzheimers Dis"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1016\/S0140-6736(05)66379-9","article-title":"Compared to what? Finding controls for case-control studies","volume":"365","author":"Grimes","year":"2005","journal-title":"Lancet"}],"container-title":["Frontiers in Dental Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdmed.2026.1783171\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T05:25:16Z","timestamp":1776662716000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdmed.2026.1783171\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,20]]},"references-count":33,"alternative-id":["10.3389\/fdmed.2026.1783171"],"URL":"https:\/\/doi.org\/10.3389\/fdmed.2026.1783171","relation":{},"ISSN":["2673-4915"],"issn-type":[{"value":"2673-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,20]]},"article-number":"1783171"}}