Perceptions on the Impact of Periodontal Health on Cognitive Disorders: A Questionnaire-Based Study

Submission Date Approved Date Resubmission Date Not Approved Date

10/10/2025

Title of the Research Proposal Perceptions on the Impact of Periodontal Health on Cognitive Disorders: A Questionnaire-Based Study

Name of the Institution Kamineni Institute of Dental Sciences,

Sreepuram, Narketpally - 508 254,

Nalgonda (Dist.) Telangana.

Name of the Principal Investigator (PI) with Qualification and Designation Dr. Suryakanth Malgikar

Reader

Department of Periodontics,

Kamineni Institute of Dental Sciences, Narketpally

Name of the Co-Investigator (s) Co-PI with Qualification and Designation Dr. Suvarna Vankudothu, BDS

Kamineni Institute of Dental Sciences, Narketpally

Dr. Samhitha Dudyala, Intern

Kamineni Institute of Dental Sciences, Narketpally

Source of funding & financial allocation for the Project/ Trial Internal Funding from Kamineni Education Society

Duration of the Project/Trial 3 Months

Name of the Institute / Dept. where research is to be conducted Kamineni Institute of Dental Sciences,

Department of Periodontics,

Narketpally, Nalgonda (Dist.) - 508254

Telangana, India

Is the research proposal approved by the Research Committee

Is approval by other Ethics Committees required?

List of documents enclosed for ethical review YES

Research Proposal: Main Objectives To analyze attitudes toward integrating oral–systemic health knowledge, especially oral–brain health links, into dental education and clinical practice.

Usefulness of the Project / Trial To generate insights into the level of awareness among dental professionals regarding the link between periodontal disease and Alzheimer’s disease

Expected ‘benefits’ to Volunteer / Community 1. This survey will increase awareness among dental professionals about the possible link between periodontal disease and Alzheimer’s disease.

2. Volunteers may gain insight into the importance of oral systemic health and patient counselling.

The findings will help identify knowledge gaps and guide improvements in dental education and practice.

3. At the community level, it can support public health campaigns and preventive strategies for better oral and general health

Describe the Informed Consent Process Consent will be obtained electronically by asking participants to click on an “Next” option before accessing the questionnaire.

Disclose Conflict of Interest, if any No conflicts of interest

Source of funding & financial allocation for the project/ trial Internal Funding from Kamineni Education Society

BRIEF DESCRIPTION OF THE INTENDED WORK:

NEED FOR THE STUDY:

Periodontal disease is a common chronic inflammatory condition affecting a large proportion of the adult population worldwide. Beyond its local effects on the oral cavity, research has increasingly highlighted its potential role in systemic diseases.1 Among these, Alzheimer’s disease a progressive neurodegenerative disorder has gained attention due to its significant impact on quality of life, healthcare systems, and society.2,3

Emerging evidence suggests that chronic periodontal infection may contribute to Alzheimer’s disease through multiple pathways, including the systemic spread of oral bacteria, the release of inflammatory mediators, and immune system dysregulation.4,5 While several studies6-9 have reported associations between poor periodontal health and cognitive decline, other studies have been inconclusive, often due to differences in study designs, diagnostic criteria, and patient populations. This inconsistency emphasizes the need for more focused research and awareness in this area.

Despite these findings, the awareness of oral–systemic links, particularly the periodontal–Alzheimer’s connection, remains low among many dental professionals. Limited exposure during dental education, lack of emphasis in continuing dental education (CDE) programs, and insufficient inter-professional collaboration may further restrict the application of this knowledge in clinical practice. As a result, patients may not receive adequate counselling about the potential systemic consequences of periodontal disease, including its possible relationship with cognitive health.

Assessing the current level of awareness, perceptions, and attitudes of dental students and practitioners is therefore essential. Such an assessment will help identify knowledge gaps, highlight barriers in clinical application, and suggest areas where educational interventions and collaborative strategies can be strengthened. The outcomes of this study will provide valuable insights for improving dental curriculum, designing targeted CDE programs, enhancing patient education, and ultimately contributing to public health strategies that integrate oral–systemic health more effectively.

Hence, the present study proposal is needed to generate baseline data that can bridge the gap between existing scientific evidence and practical implementation, ensuring that dental professionals are better equipped to recognize and address the broader implications of periodontal disease, including its possible role in Alzheimer’s disease.

REVIEW OF LITERATURE

Kamer et al.,1 (2008) suggested that chronic periodontitis could be a potential risk factor for Alzheimer’s disease, as systemic inflammation and bacterial products may accelerate neurodegeneration.

Ide et al.,3 (2013) concluded that elderly individuals with poor periodontal health had a significantly greater risk of developing cognitive decline compared to those with healthier gums.

Singhrao et al.,7 (2015) reported that Porphyromonas gingivalis and its virulence factors were detected in the brain, indicating a direct role of periodontal pathogens in Alzheimer’s pathology.

Genco et al.,9 (2020) emphasized that although scientific evidence supports the oral–systemic link, awareness among dental professionals regarding periodontal disease and Alzheimer’s remains limited.

AIM AND OBJECTIVE OF THE STUDY:  To evaluate the level of knowledge about the role of periodontal disease in systemic health, particularly its potential link with Alzheimer’s disease.

MATERIALS AND METHODS:

SOURCE OF DATA:

Participants will be dental students, interns, and dental practitioners who voluntarily agree to take part in the online survey. The survey questionnaire will be distributed electronically through Google Forms.

INCLUSION CRITERIA:

1. Dental students (undergraduate and postgraduate), interns, and dental practitioners.

2. Individuals who voluntarily agree to participate in the survey.

EXCLUSION CRITERIA:

1. Non-dental professionals.

2. Incomplete or duplicate survey responses.

SAMPLE SIZE: The study aims to include a minimum of 100 participants. The final sample size will depend on the number of completed responses received during the survey period

Group I:  Undergraduate dental students

Group II: Post graduate dental students / Residents

Group III: Practicing dentists & Faculty

CLINICAL PARAMETERS

No clinical measurements will be recorded.

MICROBIOLOGICAL PARAMETERS

No laboratory tests will be performed as part of this study.

Does the study require any investigations or interventions to be conducted on patients or other humans or animals? If so, please describe briefly.

No, the study does not require any investigations or interventions to be conducted on patients, humans, or animals. This is a questionnaire-based study designed to assess dental professionals’ knowledge, attitudes, and perceptions regarding the relationship between periodontal health and cognitive disorders.  Data will be collected through an online or printed survey form, and no clinical procedures, biological sampling, or patient interventions will be performed.

LIST OF REFERENCES: -

1. Kamer, A. R., Dasanayake, A. P., Craig, R. G., Glodzik-Sobanska, L., Bry, M., & de Leon, M. J. Alzheimer’s disease and peripheral infections: the possible contribution from periodontal infections, model and hypothesis. J Alzheimers Dis. 2008 May;13(4):437-49.

2. Dominy, S. S., Lynch, C., Ermini, F., Benedyk, M., Marczyk, A., Konradi, A., ... & Potempa, J. Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Sci Adv. 2019 Jan 23;5(1): eaau3333.

3. Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes--systematic review. J Periodontol. 2013 Apr;84(4 Suppl): S181-94.

4. Leira, Y., Domínguez, C., Seoane, J., Seoane-Romero, J. M., Pías-Peleteiro, J. M., Takkouche, B., & Blanco, J. Is periodontal disease associated with Alzheimer’s disease? A systematic review with meta-analysis. Neuroepidemiology, (2017); 48(1-2), 21–31.

5. Kamer AR, Pirraglia E, Tsui W, Rusinek H, Vallabhajosula S, Mosconi L, Yi L, McHugh P, Craig RG, Svetcov S, Linker R, Shi C, Glodzik L, Williams S, Corby P, Saxena D, de Leon MJ. Periodontal disease associates with higher brain amyloid load in normal elderly. Neurobiol Aging. 2015 Feb;36(2):627-33.

6. Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, Taylor R. Periodontitis and diabetes: a two-way relationship. Diabetologia. 2012 Jan;55(1):21-31.

7. Singhrao, S. K., Harding, A., Poole, S., Kesavalu, L., & Crean, S. Porphyromonas gingivalis periodontal infection and its putative links with Alzheimer’s disease. Mediators Inflamm, 2015: 137357.

8. Nazir, M. A. Prevalence of periodontal disease, its association with systemic diseases and prevention.  Int J Health Sci (Qassim), 2017 Apr-Jun;11(2):72-80.

9. Genco, R. J., & Borgnakke, W. S. Risk factors for periodontal disease. Periodontology 2000, (2020); 83(1), 9–13.

NAME & DESIGNATION OF PRINCIPLE INVESTIGATOR Dr. Suryakanth Malgikar

Reader,

Department of Periodontics,

Kamineni Institute of Dental Sciences, Narketpally.

SIGNATURE

NAME OF CO INVESTIGATOR Dr. Suvarna Vankudothu

BDS Graduate,

Kamineni Institute of Dental Sciences, Narketpally.

Dr. Samhitha Dudyala

Intern,

Kamineni Institute of Dental Sciences, Narketpally.

SIGNATURE Dr. Suvarna Vankudothu

Dr. Samhitha Dudyala

NAME OF HEAD OF THE DEPARTMENT Dr. Vidya Sagar S, MDS

Professor and HOD

Department of Periodontics,

Kamineni Institute of Dental Sciences, Narketpally Nalgonda (Dist.) – 508 254.

SIGNATURE

NAME OF THE PRINCIPAL Dr. Mahesh Pulagam

Principal,

Professor and Head,

Department of Prosthodontics,

Kamineni Institute of Dental Sciences, Narketpally, Nalgonda (Dist.) – 508254.

SIGNATURE