Association of Tooth Loss with Alzheimer’s Disease Tau Pathologies Assessed by Positron Emission Tomography

Background: Deterioration of the oral environment is one of the risk factors for dementia. A previous study of an Alzheimer’s disease (AD) model mouse suggests that tooth loss induces denervation of the mesencephalic trigeminal nucleus and neuroinflammation, possibly leading to accelerated tau dissemination from the nearby locus coeruleus (LC). Objective: To elucidate the relevance of oral conditions and amyloid-β (Aβ) and tau pathologies in human participants. Methods: We examined the number of remaining teeth and the biofilm–gingival interface index in 24 AD-spectrum patients and 19 age-matched healthy controls (HCs). They also underwent positron emission tomography (PET) imaging of Aβ and tau with specific radiotracers, ¹¹C-PiB and ¹⁸F-PM-PBB3, respectively. All AD-spectrum patients were Aβ-positive, and all HCs were Aβ-negative. We analyzed the correlation between the oral parameters and radiotracer retention. Results: No differences were found in oral conditions between the AD and HC groups. ¹¹C-PiB retentions did not correlate with the oral indices in either group. In AD-spectrum patients, brain-wide, voxel-based image analysis highlighted several regions, including the LC and associated brainstem substructures, as areas where ¹⁸F-PM-PBB3 retentions negatively correlated with the remaining teeth and revealed the correlation of tau deposits in the LC (r = –0.479, p = 0.018) primarily with the hippocampal and neighboring areas. The tau deposition in none of the brain regions was associated with the periodontal status. Conclusions: Our findings with previous preclinical evidence imply that tooth loss may enhance AD tau pathogenesis, promoting tau spreading from LC to the hippocampal formation.