Link between periodontal inflammatory disease and Parkinson’s disease: Case reports

Parkinson's disease (PD) is caused by a loss of nerve cells in the part of the brain called the substantianigra. Nerve cells in this part of the brain are responsible for producing a chemical called dopamine. The symptoms of Parkinson's disease usually only start to develop when around 80% of the nerve cells in the substantianigra have been lost. Uncontrolled severe periodontitis caused by periodontal pathogens represents a major infectious threat to the entire body, since released toxins and other inflammatory mediators can reach and affect distant organs. 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. The local inflammatory responses at the site of infection are often linked to CNS disorders such as Parkinson's disease. Infections in the oral cavity, untreated conditions, foci can contribute to the worsening of Parkinson's disease. It is concluded that it is necessary to repair the oral cavity in all patients in order to achieve possible improvement, and on the other hand in these patients it is necessary to fully rehabilitate the oral cavity due to daily functions of the oral cavity which are difficult due to the clinical condition.