Periodontitis and Tooth Loss Are Associated With Higher Risks of Cognitive Disorders: A Systematic Umbrella Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and umbrella meta-analysis of meta-analyses
PubMed 41220116 · doi:10.1002/cre2.70240
What was done
An umbrella systematic review and meta-analysis searched PubMed and MEDLINE through June 2025 to evaluate the association between periodontal disease, tooth loss, and cognitive disorders. Associations were evaluated using odds ratios (OR) and relative risks (RR), and evidence quality was assessed using GRADE.
What was found
A total of 20 meta-analyses were included. Periodontal disease and tooth loss were significantly associated with cognitive disorders: - Periodontitis: OR = 1.65 (95% CI: 1.37–1.97, p < 0.0001) - Tooth loss: OR = 1.51 (95% CI: 1.32–1.71, p < 0.0001) - Severe periodontitis: OR = 2.69 (95% CI: 2.26–3.20, p < 0.0001) - Cohort studies pooled analysis: RR = 1.26 (95% CI: 1.20–1.32, p < 0.0001) Certainty of evidence measured by GRADE was low to moderate.
Why it matters
This review synthesizes secondary evidence linking oral health pathology to cognitive decline, highlighting periodontal disease as a consistent observational risk marker for cognitive disorders.
Limits
The primary studies synthesized are observational, precluding causal inference and leaving open possibilities of reverse causality or residual confounding (such as socioeconomic status, diet, and shared inflammatory pathways). The abstract does not provide total participant sample size, the extent of primary study overlap among the 20 meta-analyses, or subtype-specific cognitive outcomes.
Cited by
- supports Oral health is significantly linked to cognitive function.