Oral health implications in Parkinson’s disease
Watt, R. G. et al. Ending the neglect of global oral health: time for radical action. Lancet 394, 261–272 (2019).
Google Scholar
Dorsey, E. R. et al. The Emerging Evidence of the Parkinson Pandemic. J. Parkinsons Dis. 8, S3–s8 (2018).
Google Scholar
Verhoeff, M. C. et al. Parkinson’s disease and oral health: A systematic review. Arch. Oral. Biol. 151, 105712 (2023).
Google Scholar
Bian, M., Chen, L. & Lei, L. Research progress on the relationship between chronic periodontitis and Parkinson’s disease. Zhejiang da xue xue bao Yi xue ban. J. Zhejiang Univ. Med. Sci. 51, 108–114 (2022).
Auffret, M. et al. Oral Health Disorders in Parkinson’s Disease: More than Meets the Eye. J. Parkinsons Dis. 11, 1507–1535 (2021).
Google Scholar
Wang, B. et al. Mechanisms of oral microflora in Parkinson’s disease. Behav. Brain Res. 474, 115200 (2024).
Google Scholar
Wang, Z. Z. et al. Risk of dementia or Parkinson’s disease in the presence of Sjögren’s syndrome: A systematic review and meta-analysis. Front. Integr. Neurosci. 16, 1027044 (2022).
Google Scholar
Nakamura, T. et al. Oral dysfunctions and cognitive impairment/dementia. J. Neurosci. Res. 99, 518–528 (2021).
Google Scholar
Said-Sadier N., et al. Association between Periodontal Disease and Cognitive Impairment in Adults. Int. J. Environ. Res. Public Health, 20, 4707 (2023).
Llena-Puy, C. The rôle of saliva in maintaining oral health and as an aid to diagnosis. Med. Oral. Patologia Oral. Y. Cirugia Bucal 11, E449–E455 (2006).
Pedersen, A. et al. Salivary functions in mastication, taste and textural perception, swallowing and initial digestion. Oral. Dis. 24, 1399–1416 (2018).
Google Scholar
Verhoeff, M. C. et al. Salivation in Parkinson’s disease: A scoping review. Gerodontology 40, 26–38 (2023).
Google Scholar
Fedorova, T. et al. Salivary acetylcholinesterase activity is increased in Parkinson’s disease: a potential marker of parasympathetic dysfunction. Parkinsons Dis. 2015, 156479 (2015).
Google Scholar
Špiljak, B. et al. Sialorrhea and xerostomia in Parkinson’s disease patients. Acta Clin. Croatica 61, 320–326 (2022).
Barbe, A. G. et al. Circadian rhythms and influencing factors of xerostomia among Parkinson’s disease patients. Oral. Dis. 25, 282–289 (2019).
Google Scholar
Zafar, S., Yaddanapudi, S. S. Parkinson Disease. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2025, StatPearls Publishing LLC; 2025.
Arnao, V. et al. In patient’s with Parkinson disease, autonomic symptoms are frequent and associated with other non-motor symptoms. Clin. Autonomic Res. 25, 301–307 (2015).
Google Scholar
Bird, A. M., Smith, T. L. & Walton, A. E. Current treatment strategies for clozapine-induced sialorrhea. Ann. Pharmacother. 45, 667–675 (2011).
Google Scholar
Kwon, T., Lamster, I. B. & Levin, L. Current Concepts in the Management of Periodontitis. Int. Dent. J. 71, 462–476 (2021).
Google Scholar
Yilmaz, M. et al. Parkinson’s disease is positively associated with periodontal inflammation. J. Periodontol. 94, 1425–1435 (2023).
Google Scholar
Abusrair, A. H., Elsekaily, W. & Bohlega, S. Tremor in Parkinson’s Disease: From Pathophysiology to Advanced Therapies. Tremor Other Hyperkinetic Mov. 12, 29 (2022).
Google Scholar
Kaur, T., Uppoor, A. & Naik, D. Parkinson’s disease and periodontitis – the missing link? A review. Gerodontology 33, 434–438 (2016).
Google Scholar
Minty, M. et al. Oral microbiota-induced periodontitis: a new risk factor of metabolic diseases. Rev. Endocr. Metab. Disord. 20, 449–459 (2019).
Google Scholar
Berthouzoz, E. et al. Oral and intestinal dysbiosis in Parkinson’s disease. Rev. Neurologique 179, 937–946 (2023).
Google Scholar
Langa, K. M. & Levine, D. A. The diagnosis and management of mild cognitive impairment: a clinical review. JAMA 312, 2551–2561 (2014).
Google Scholar
Jellinger, K. A. Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks. Int. J. Mol. Sci. 25, 498 (2023).
Hugo, J. & Ganguli, M. Dementia and cognitive impairment: epidemiology, diagnosis, and treatment. Clin. Geriatr. Med. 30, 421–442 (2014).
Google Scholar
Besser, L. M. et al. Mild cognitive impairment in Parkinson’s disease versus Alzheimer’s disease. Parkinsonism Relat. Disord. 27, 54–60 (2016).
Google Scholar
Jellinger, K. A. & Korczyn, A. D. Are dementia with Lewy bodies and Parkinson’s disease dementia the same disease?. BMC Med. 16, 34 (2018).
Google Scholar
Ohrbach, R. et al. Clinical orofacial characteristics associated with risk of first-onset TMD: the OPPERA prospective cohort study. J. Pain. 14, T33–T50 (2013).
Google Scholar
Gauer, R. L. & Semidey, M. J. Diagnosis and treatment of temporomandibular disorders. Am. Fam. Physician 91, 378–386 (2015).
Google Scholar
Romero-Reyes, M. & Bassiur, J. P. Temporomandibular Disorders, Bruxism and Headaches. Neurologic Clin. 42, 573–584 (2024).
Google Scholar
Beaumont, S. et al. Temporomandibular Disorder: a practical guide for dental practitioners in diagnosis and management. Aust. Dent. J. 65, 172–180 (2020).
Google Scholar
Minervini, G. et al. Prevalence of temporomandibular disorders in subjects affected by Parkinson disease: A systematic review and metanalysis. J. Oral. Rehabilit. 50, 877–885 (2023).
Google Scholar
Baram, S. et al. Orofacial function and temporomandibular disorders in Parkinson’s Disease: a case-controlled study. BMC Oral. Health 23, 381 (2023).
Google Scholar
Weintraub, D. et al. The neuropsychiatry of Parkinson’s disease: advances and challenges. Lancet Neurol. 21, 89–102 (2022).
Google Scholar
Weintraub, D. et al. Neuropsychiatric symptoms and cognitive abilities over the initial quinquennium of Parkinson disease. Ann. Clin. Transl. Neurol. 7, 449–461 (2020).
Google Scholar
Mendonça, I. P. et al. Neurobiological findings underlying depressive behavior in Parkinson’s disease: A review. Int. Immunopharmacol. 83, 106434 (2020).
Google Scholar
Ahmad, M. H. et al. Neurobiology of depression in Parkinson’s disease: Insights into epidemiology, molecular mechanisms and treatment strategies. Ageing Res. Rev. 85, 101840 (2023).
Google Scholar
Kisely, S. et al. The oral health of people with anxiety and depressive disorders – a systematic review and meta-analysis. J. Affect. Disord. 200, 119–132 (2016).
Google Scholar
Dibello, V., et al. Exploring the Association of Burning Mouth Syndrome with Depressive and Anxiety Disorders in Middle-Aged and Older Adults: A Systematic Review. J. Personalized Med., 13, 1014 (2023)
Khawaja, S. N., Alaswaiti, O. F. & Scrivani, S. J. Burning Mouth Syndrome. Dent. Clin. North Am. 67, 49–60 (2023).
Google Scholar
Pradeep, A. R. et al. Clinical evaluation of the periodontal health condition and oral health awareness in Parkinson’s disease patients. Gerodontology 32, 100–106 (2015).
Google Scholar
Auerbacher, M. et al. Oral health in patients with neurodegenerative and cerebrovascular disease: a retrospective study. Disabil. Rehabilit. 45, 2316–2324 (2023).
Google Scholar
Patel, B. et al. A comprehensive review of the diagnosis and treatment of Parkinson’s disease dysphagia and aspiration. Expert Rev. Gastroenterol. Hepatol. 14, 411–424 (2020).
Google Scholar
Sedghi, L. M., Bacino, M. & Kapila, Y. L. Periodontal Disease: The Good, The Bad, and The Unknown. Front. Cell. Infect. Microbiol. 11, 766944 (2021).
Google Scholar
Liu, F. & Steinkeler, A. Epidemiology, diagnosis, and treatment of temporomandibular disorders. Dent. Clin. North Am. 57, 465–479 (2013).
Google Scholar
Yemula, N. et al. Parkinson’s Disease and the Gut: Symptoms, Nutrition, and Microbiota. J. Parkinsons Dis. 11, 1491–1505 (2021).
Google Scholar
Kitamoto, S. et al. The Bacterial Connection between the Oral Cavity and the Gut Diseases. J. Dent. Res. 99, 1021–1029 (2020).
Google Scholar
Sampson, T. R. et al. Gut Microbiota Regulate Motor Deficits and Neuroinflammation in a Model of Parkinson’s Disease. Cell 167, 1469–80.e12 (2016).
Google Scholar
Pereira, P. A. B. et al. Oral and nasal microbiota in Parkinson’s disease. Parkinsonism Relat. Disord. 38, 61–67 (2017).
Google Scholar
Cryan, J. F. et al. The Microbiota-Gut-Brain Axis. Physiological Rev. 99, 1877–2013 (2019).
Google Scholar
Wang, Q., Yang, Q. & Liu, X. The microbiota-gut-brain axis and neurodevelopmental disorders. Protein Cell 14, 762–775 (2023).
Google Scholar
Loh, J. S. et al. Microbiota-gut-brain axis and its therapeutic applications in neurodegenerative diseases. Sig. Transduct. Target. Ther. 9, 37 (2024).
Google Scholar
Lin, J. C. et al. Association Between Parkinson’s Disease and Inflammatory Bowel Disease: a Nationwide Taiwanese Retrospective Cohort Study. Inflamm. Bowel Dis. 22, 1049–1055 (2016).
Google Scholar
Claudino, D. O. S. et al. Role of enteric glia and microbiota-gut-brain axis in parkinson disease pathogenesis. Ageing Res. Rev. 84, 101812 (2023).
Google Scholar
Dong, S. et al. Brain-gut-microbiota axis in Parkinson’s disease: A historical review and future perspective. Brain Res. Bull. 183, 84–93 (2022).
Google Scholar
Keightley, P. C., Koloski, N. A. & Talley, N. J. Pathways in gut-brain communication: evidence for distinct gut-to-brain and brain-to-gut syndromes. Aust. N.Z. J. Psychiatry 49, 207–214 (2015).
Google Scholar
Cirstea, M. S. et al. Microbiota Composition and Metabolism Are Associated With Gut Function in Parkinson’s Disease. Mov. Disord. 35, 1208–1217 (2020).
Google Scholar
Wallen, Z. D. et al. Characterizing dysbiosis of gut microbiome in PD: evidence for overabundance of opportunistic pathogens. NPJ Parkinsons Dis. 6, 11 (2020).
Google Scholar
Minato, T. et al. Progression of Parkinson’s disease is associated with gut dysbiosis: Two-year follow-up study. PloS One 12, e0187307 (2017).
Google Scholar
Li, C. et al. Systemic inflammation and risk of Parkinson’s disease: A prospective cohort study and genetic analysis. Brain Behav. Immun. 117, 447–455 (2024).
Google Scholar
Mou, Y. et al. Gut Microbiota Interact With the Brain Through Systemic Chronic Inflammation: Implications on Neuroinflammation, Neurodegeneration, and Aging. Front. Immunol. 13, 796288 (2022).
Google Scholar
Muñoz-Delgado, L. et al. Peripheral Inflammation Is Associated with Dopaminergic Degeneration in Parkinson’s Disease. Movement disorders : official journal of the Movement Disorder. Society 38, 755–763 (2023).
Knight, E. et al. The Role of Diet and Dietary Patterns in Parkinson’s Disease. Nutrients 14, 4472 (2022).
Bianchi, V. E., Rizzi, L. & Somaa, F. The role of nutrition on Parkinson’s disease: a systematic review. Nutritional Neurosci. 26, 605–628 (2023).
Google Scholar
Galindo-Moreno, P. et al. The impact of tooth loss on cognitive function. Clin. Oral. Investig. 26, 3493–3500 (2022).
Google Scholar
Burgos, R. et al. ESPEN guideline clinical nutrition in neurology. Clin. Nutr. 37, 354–396 (2018).
Google Scholar
Bianchi, V. E., Herrera, P. F. & Laura, R. Effect of nutrition on neurodegenerative diseases. A systematic review. Nutritional Neurosci. 24, 810–834 (2021).
Google Scholar
Zhang, Q. et al. Approach to Cognitive Impairment in Parkinson’s Disease. Neurotherapeutics : the journal of the American Society for Experimental. NeuroTherapeutics 17, 1495–1510 (2020).
Google Scholar
Weijenberg, R. A., Scherder, E. J. & Lobbezoo, F. Mastication for the mind–the relationship between mastication and cognition in ageing and dementia. Neurosci. Biobehav. Rev. 35, 483–497 (2011).
Google Scholar
Wei, T. et al. Association between adverse oral conditions and cognitive impairment: A literature review. Front. Public Health 11, 1147026 (2023).
Google Scholar
Clifford, T. & Finnerty, J. The dental awareness and needs of a Parkinson’s disease population. Gerodontology 12, 99–103 (1995).
Google Scholar
Nakayama, Y., Washio, M. & Mori, M. Oral health conditions in patients with Parkinson’s disease. J. Epidemiol. 14, 143–150 (2004).
Google Scholar
Barbe, A. G. et al. Self-assessment of oral health, dental health care and oral health-related quality of life among Parkinson’s disease patients. Gerodontology 34, 135–143 (2017).
Google Scholar
Baram, S. et al. Dental care utilization among persons with Parkinson’s disease in Denmark. Community Dent. Oral. Epidemiol. 51, 527–534 (2023).
Google Scholar
Lexomboon, D. et al. Discontinued dental care attendance among people with dementia: A register-based longitudinal study. Gerodontology 38, 57–65 (2021).
Google Scholar
García-De-La-Fuente, A. M. et al. Facts and controversies regarding oral health in Parkinson’s disease: A case-control study in Spanish patients. Med. Oral. Patologia Oral. Y. Cirugia Bucal 27, e419–e425 (2022).
Google Scholar
John, T. K. et al. Does parkinsonism affect periodontal health? A cross-sectional study in a tertiary hospital. J. Indian Soc. Periodontol. 25, 538–543 (2021).
Google Scholar
Conway, F. Powered or manual toothbrushes for people with disabilities – which is better?. Evid. Based Dent. 25, 45–46 (2024).
Google Scholar
Meng, D. et al. Prevalence of Parkinson’s disease among adults aged 45 years and older in China: a cross-sectional study based on the China health and retirement longitudinal study. BMC Public Health 24, 1218 (2024).
Google Scholar
Chen, Z., Li, G. & Liu, J. Autonomic dysfunction in Parkinson’s disease: Implications for pathophysiology, diagnosis, and treatment. Neurobiol. Dis. 134, 104700 (2020).
Google Scholar
Zenthöfer, A. et al. Poor dental hygiene and periodontal health in nursing home residents with dementia: an observational study. Odontology 105, 208–213 (2017).
Google Scholar
Wårdh, I., Jonsson, M. & Wikström, M. Attitudes to and knowledge about oral health care among nursing home personnel–an area in need of improvement. Gerodontology 29, e787–e792 (2012).
Google Scholar
Lauritano, D., et al. Aging and Oral Care: An Observational Study of Characteristics and Prevalence of Oral Diseases in an Italian Cohort. Int. J. Environ. Res. Public Health, 16, 3763 (2019).
Girestam Croonquist, C. et al. Effects of Domiciliary Professional Oral Care for Care-Dependent Elderly in Nursing Homes – Oral Hygiene, Gingival Bleeding, Root Caries and Nursing Staff’s Oral Health Knowledge and Attitudes. Clin. Interventions Aging 15, 1305–1315 (2020).
Google Scholar
Bloem, B. R., Okun, M. S. & Klein, C. Parkinson’s disease. Lancet 397, 2284–2303 (2021).
Google Scholar
Li, Z. et al. Shigella evades pyroptosis by arginine ADP-riboxanation of caspase-11. Nature 599, 290–295 (2021).
Google Scholar
Toktas, H. et al. FPL tendon thickness, tremor and hand functions in Parkinson’s disease. Open Med. 11, 16–20 (2016).
Google Scholar
Wong-Yu, I. S. K., Ren, L. & Mak, M. K. Y. Impaired Hand Function and Its Association With Self-Perceived Hand Functional Ability and Quality of Life in Parkinson Disease. Am. J. Phys. Med. Rehabilit. 101, 843–849 (2022).
Google Scholar
Kobayashi-Cuya, K. E. et al. Observational Evidence of the Association Between Handgrip Strength, Hand Dexterity, and Cognitive Performance in Community-Dwelling Older Adults: A Systematic Review. J. Epidemiol. 28, 373–381 (2018).
Google Scholar
Obeso, J. A. et al. Past, present, and future of Parkinson’s disease: A special essay on the 200th Anniversary of the Shaking Palsy. Mov. Disord. 32, 1264–1310 (2017).
Google Scholar
Khan, I. Falls: considerations for the dental surgeon. Br. Dent. J. 228, 509–514 (2020).
Google Scholar
Peres, M. A. et al. Oral diseases: a global public health challenge. Lancet 394, 249–260 (2019).
Google Scholar
Li, Z. et al. Oral, Nasal, and Gut Microbiota in Parkinson’s Disease. Neuroscience 480, 65–78 (2022).
Google Scholar
Umemoto, G. & Furuya, H. Management of Dysphagia in Patients with Parkinson’s Disease and Related Disorders. Intern. Med. 59, 7–14 (2020).
Google Scholar
Rozas, N. S. et al. Incorporating oral health into interprofessional care teams for patients with Parkinson’s disease. Parkinsonism Relat. Disord. 43, 9–14 (2017).
Google Scholar
Liddell, A. & Locker, D. Changes in levels of dental anxiety as a function of dental experience. Behav. Modif. 24, 57–68 (2000).
Google Scholar
Connolly, B. S. & Lang, A. E. Pharmacological treatment of Parkinson disease: a review. JAMA 311, 1670–1683 (2014).
Google Scholar
Fereshtehnejad, S. M. et al. Dental care utilization in patients with different types of dementia: A longitudinal nationwide study of 58,037 individuals. Alzheimers Dement. 14, 10–19 (2018).
Google Scholar
Friedlander, A. H. et al. Parkinson disease: systemic and orofacial manifestations, medical and dental management. J. Am. Dent. Assoc. 140, 658–669 (2009).
Google Scholar
Lobbezoo, F. & Naeije, M. Dental implications of some common movement disorders: a concise review. Arch. Oral. Biol. 52, 395–398 (2007).
Google Scholar
Martimbianco, A. L. C. et al. Evidence-Based Recommendations for the Oral Health of Patients with Parkinson’s Disease. Neurol. Ther. 10, 391–400 (2021).
Google Scholar
Gosnell, R. et al. Development of guidelines for improving oral health in individuals with Parkinson’s disease. Gerodontology 36, 229–235 (2019).
Google Scholar
Morimoto, Y. et al. Management for the patients with severe Parkinson’s disease during dental treatments and tooth extractions: A retrospective observational study. J. Dent. Sci. 19, 261–267 (2024).
Google Scholar
Starr, C. Interaction between pethidine and selegiline. Lancet 337, 554 (1991).
Google Scholar
Nicholson, G., Pereira, A. C. & Hall, G. M. Parkinson’s disease and anaesthesia. Br. J. Anaesth. 89, 904–916 (2002).
Google Scholar
Cotzias, G. C., Papavasiliou, P. S. & Gellene, R. Modification of Parkinsonism–chronic treatment with L-dopa. N. Engl. J. Med. 280, 337–345 (1969).
Google Scholar
Verhoeff, M. C., Raphael, K. G. & Lobbezoo, F. A personal exploration of oral health in Parkinson’s disease through the eyes of a multifaceted authority. J. Oral. Rehabilit 51, 1645–1652 (2024).
Google Scholar
Verhoeff, M. C. et al. Clinicians’ view on the management of oral health in Parkinson’s disease patients: a qualitative study. BDJ open 9, 20 (2023).
Google Scholar
Yay, E. et al. Oral and gut microbial profiling in periodontitis and Parkinson’s disease. J. Oral. Microbiol. 16, 2331264 (2024).
Google Scholar
Debowes, S. L., Tolle, S. L. & Bruhn, A. M. Parkinson’s disease: considerations for dental hygienists. Int. J. Dent. Hyg. 11, 15–21 (2013).
Google Scholar
Tsukita, K., Sakamaki-Tsukita, H. & Takahashi, R. Long-term Effect of Regular Physical Activity and Exercise Habits in Patients With Early Parkinson Disease. Neurology 98, e859–e871 (2022).
Google Scholar
Xu, Z., Anderson, K. N. & Pavese, N. Longitudinal Studies of Sleep Disturbances in Parkinson’s Disease. Curr. Neurol. Neurosci. Rep. 22, 635–655 (2022).
Google Scholar
Mavandadi, S. et al. Social Control and Health Behaviors Among Individuals Living with Parkinson’s Disease: A Pilot Study. Int. J. Behav. Med. 31, 799–805 (2024).
Google Scholar
Reichmann, H. et al. Life style and Parkinson’s disease. J. Neural Transm. 129, 1235–1245 (2022).
Google Scholar
Holmberg, B. et al. Assenting to exposedness – meanings of receiving assisted bodily care in a nursing home as narrated by older persons. Scand. J. Caring Sci. 33, 868–877 (2019).
Google Scholar
Zhang, X. et al. Zinc Deficiency Exacerbates Behavioral Impediments and Dopaminergic Neuron Degeneration in a Mouse Model of Parkinson Disease. J. Nutr. 153, 167–175 (2023).
Google Scholar
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