Parkinson's disease and periodontitis – the missing link? A review

Objective: In this article an attempt has been made to postulate a possible link between Parkinson’s disease and periodontal disease. Background: Various systemic diseases such as cardiac disease, diabetes, renal diseases, low birth weight and Alzheimer’s disease have been proposed to be linked with periodontal disease on the basis of systemic inflammation. Parkinson’s disease is a chronic progressive neurodegenerative disorder with multifactorial aetiology. Until now, periodontal disease and Parkinson’s disease has been linked only on the basis of poor motor and cognitive control in Parkinson’s patient which leads to poor oral health maintenance. Evidence now suggests that chronic neuroinflammation is consistently associated with the pathophysiology of Parkinson’s disease. Also, recently, systemic inflammation has been suggested as one of the contributing factors for neurodegeneration. Material and methods: Dental and medical literature especially those dealing with neurosciences were selected which highlighted the link between systemic inflammation and infection. Results: So far there is no direct evidence implicating an effect of periodontitis in the pathogenesis of Parkinson’s disease. To clarify this link, studies on population based case–control or cohort design are needed. This would be especially significant in the present era where there is paucity for preventive measures as far as a cognitive disorder such as Parkinson’s disease is concerned. Conclusion: We cannot cure Parkinson’s disease, but if in future this missing link is established, an attempt can be made to prevent it by tackling one of its possible contributors (periodontitis) for systemic inflammation by simple preventive oral hygiene measures.