Oral Infections and Orofacial Pain in Alzheimer's Disease: A Case-Control Study

Article type: Research Article

Authors: de Souza Rolim, Thaís^a | Fabri, Gisele Maria Campos^b | Nitrini, Ricardo^c | Anghinah, Renato^d | Teixeira, Manoel Jacobsen^e | de Siqueira, José Tadeu T.^f | Cestari, José Augusto Ferrari^g | de Siqueira, Silvia Regina Dowgan T.^{h; *}

Affiliations: [a] Orofacial Team, Hospital das Clínicas, and Neurology Department, School of Medicine, University of São Paulo, Brazil | [b] Dentistry Division, Central Institute, Hospital das Clinicas, School of Medicine, University of São Paulo, Brazil | [c] Cognitive Neurology and Behavior Group, Hospital das Clínicas, and Neurology Department, School of Medicine, University of São Paulo, Brazil | [d] Cognitive Neurology and Behavior Group, Neurology Division, Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil | [e] Functional Neurosurgery Division, Psychiatry Institute of Hospital das Clinicas and Neurology Department, School of Medicine, University of São Paulo, Brazil | [f] Orofacial Pain Team of Dentistry Division and Group of Oral Medicine and Neuroscience of the Dentistry Division of the Psychiatry Institute, Hospital das Clinicas, School of Medicine, University of São Paulo, Brazil | [g] Group of Oral Medicine and Neuroscience of the Dentistry Division of the Psychiatry Institute, Hospital das Clinicas, School of Medicine, University of São Paulo, Brazil | [h] Gerontology, School of Arts, Sciences and Humanities of the University of Sao Paulo, and Group of Oral Medicine and Neuroscience of the Dentistry Division of the Psychiatry Institute, Hospital das Clinicas, School of Medicine, University of São Paulo, Brazil

Correspondence: [*] Correspondence to: Silvia R D T de Siqueira, Rua Maria Candida 135 São Paulo, CEP. 02071-010; Brazil. Tel.: +55 11 991842878; E-mail: [email protected].

Abstract: Background:Dental infections are frequent and have recently been implicated as a possible risk factor for Alzheimer’s disease (AD). Despite a lack of studies investigating orofacial pain in this patient group, dental conditions are known to be a potential cause of pain and to affect quality of life and disease progression. Objectives:To evaluate oral status, mandibular function and orofacial pain in patients with mild AD versus healthy subjects matched for age and gender. Methods:Twenty-nine patients and 30 control subjects were evaluated. The protocol comprised a clinical questionnaire and dental exam, research diagnostic criteria for temporomandibular disorders, the McGill Pain Questionnaire, the decayed, missing, and filled teeth index, and included a full periodontal evaluation. AD signs and symptoms as well as associated factors were evaluated by a trained neurologist. Results:A higher prevalence of orofacial pain (20.7%, p < 0.001), articular abnormalities in temporomandibular joints (p < 0.05), and periodontal infections (p = 0.002) was observed in the study group compared to the control group. Conclusion:Orofacial pain and periodontal infections were more frequent in patients with mild AD than in healthy subjects. Orofacial pain screening and dental and oral exams should be routinely performed in AD patients in order to identify pathological conditions that need treatment thus improving quality of life compromised due to dementia.

Keywords: Alzheimer's disease, oral infections, orofacial pain, periodontitis, TMD

DOI: 10.3233/JAD-131283

Journal: Journal of Alzheimer's Disease, vol. 38, no. 4, pp. 823-829, 2014