Kaur Tejaswani, Uppoor Ashita, Naik Dilip
Department of Periodontology, Manipal College of Dental Sciences, Manipal University, Mangalore, India.
Gerodontology. 2016 Dec;33(4):434-438. doi: 10.1111/ger.12188. Epub 2015 Feb 9.
In this article an attempt has been made to postulate a possible link between Parkinson's disease and periodontal disease.
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.
Dental and medical literature especially those dealing with neurosciences were selected which highlighted the link between systemic inflammation and infection.
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.
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.
本文试图推测帕金森病与牙周病之间可能存在的联系。
基于全身炎症，已提出多种全身性疾病如心脏病、糖尿病、肾脏疾病、低出生体重和阿尔茨海默病与牙周病有关。帕金森病是一种病因多因素的慢性进行性神经退行性疾病。到目前为止，牙周病和帕金森病仅在帕金森病患者运动和认知控制差导致口腔健康维护不佳的基础上存在关联。现在有证据表明，慢性神经炎症始终与帕金森病的病理生理学相关。此外，最近全身性炎症被认为是神经退行性变的促成因素之一。
选择牙科和医学文献，尤其是那些涉及神经科学的文献，这些文献突出了全身炎症与感染之间的联系。
到目前为止，尚无直接证据表明牙周炎在帕金森病发病机制中有作用。为阐明这种联系，需要基于人群的病例对照或队列设计研究。在目前这个时代，就帕金森病等认知障碍而言，预防措施匮乏，这一点尤其重要。
我们无法治愈帕金森病，但如果未来能确定这个缺失的联系，就可以尝试通过简单的预防性口腔卫生措施来应对其全身性炎症的一个可能促成因素（牙周炎），从而预防该病。
