Systematic review links dysbiotic oral microbiome and age-related inflammation in elderly periodontitis

This narrative systematic review synthesized mechanistic studies, human cohorts, and preclinical models to examine how oral dysbiosis interacts with age-related immune dysfunction in periodontitis among older adults. The authors found that aging alters immune responses to oral pathogens through mechanisms including impaired TLR9 sensing, amplified inflammasome-macrophage responses to P. gingivalis, and accumulation of senescent cells that promote inflammation. At the systemic level, periodontitis was associated with multi-organ frailty-like features, neuroinflammatory changes, and persistent gut dysbiosis.