Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, Campus Miguel de Unamuno, Calle Alfonso X El Sabio s/n, 37007, Salamanca, Spain.
Alzheimer Disease Research Unit, CIEN Foundation, Alzheimer Center Reina Sofia Foundation, Carlos III Institute of Health, Calle de Valderrebollo, 5, PC 28031, Madrid, Spain.
Clin Oral Investig. 2018 Dec;22(9):3061-3070. doi: 10.1007/s00784-018-2396-z. Epub 2018 Feb 23.
The aim of this case-control study was to carry out an oral health assessment on a group of Alzheimer's patients and to establish a hypothesis regarding the implication of the characteristics of the disease and the treatment of oral health.
A total of 70 Alzheimer's patients, residents at the Alzheimer Center Reina Sofia Foundation (Madrid, Spain) and at the Alzheimer State Reference Center (Salamanca, Spain), and 36 controls (companions/acquaintances), were studied by oral examination and saliva sampling. The oral health indices DMFT/DMFS, CPI, the prosthetic condition, oral hygiene, saliva volume, and pH, as well as the specific microbiological parameters governing the risk of developing caries were assessed.
Alzheimer's patients exhibited, as compared to the control group, (1) fewer teeth (10.9 ± 10.5 vs 23.7 ± 6.5), (2) fewer obturations (2.2 ± 3.4 vs 6.6 ± 5.6), (3) fewer periodontally healthy sextants (0.1 ± 0.4 vs 1.4 ± 2.2), (4) worse oral hygiene (43.1 vs 72.2% brushed), (5) greater use of removable prostheses (47.8 vs 8.4%), (6) higher incidence of candida infection (11.8 vs 0.0%) and cheilitis (15.9 vs 0.0%), (7) lower salivary flow (0.6 ± 0.6 vs 1.1 ± 0.6), and (8) lower buffering capacity (46 vs 80%).
After taking into account the influence of age, Alzheimer's patients had worse oral health (caries and periodontal disease), more mucosal lesions (cheilitis and candidiasis), and worse saliva quantity and quality.
Clinicians should be aware of the implications of Alzheimer's disease in oral health, in order to stablish the effective preventive measures and the optimal treatment plan.
本病例对照研究旨在对一组阿尔茨海默病患者进行口腔健康评估，并提出关于疾病特征和口腔健康治疗的假设。
共对 70 名阿尔茨海默病患者（西班牙雷纳索菲亚基金会阿尔茨海默病中心和萨拉曼卡州阿尔茨海默病参考中心的居民）和 36 名对照者（同伴/熟人）进行了口腔检查和唾液采样。评估了口腔健康指标 DMFT/DMFS、CPI、修复状况、口腔卫生、唾液量和 pH 值，以及控制龋病风险的特定微生物学参数。
与对照组相比，阿尔茨海默病患者表现出（1）更少的牙齿（10.9±10.5 颗 vs. 23.7±6.5 颗），（2）更少的补牙（2.2±3.4 颗 vs. 6.6±5.6 颗），（3）更少牙周健康六区（0.1±0.4 个 vs. 1.4±2.2 个），（4）较差的口腔卫生（43.1% vs. 72.2%刷牙），（5）更多使用可摘义齿（47.8% vs. 8.4%），（6）更高的念珠菌感染发生率（11.8% vs. 0.0%）和唇炎（15.9% vs. 0.0%），（7）更低的唾液流量（0.6±0.6 毫升/分钟 vs. 1.1±0.6 毫升/分钟）和（8）更低的缓冲能力（46 毫摩尔/升 vs. 80 毫摩尔/升）。
在考虑到年龄影响后，阿尔茨海默病患者的口腔健康状况更差（龋齿和牙周病），粘膜病变更多（唇炎和念珠菌病），唾液量和质量更差。
临床医生应意识到阿尔茨海默病对口腔健康的影响，以便制定有效的预防措施和最佳治疗计划。
