Oral Environment and Aspiration Pneumonia Risk in Parkinson's Disease: A Narrative Review and Conceptual Framework
Hiroyasu Furuya, Diane Longnecker, Erika Almazan, Orlando Hinojosa, Tarah Rochester, Giselle CarnabyABSTRACT
Background
Aspiration pneumonia is a major clinical concern in Parkinson's disease (PD) and is associated with poor prognosis. Dysphagia is a well‐recognized risk factor for aspiration pneumonia, but the oral environment may also contribute to this risk.
Objective
This narrative review aims to synthesize knowledge on the relationship between the oral environment and dysphagia in PD and to propose a conceptual framework that incorporates oral environment management into dysphagia management.
Methods
We searched PubMed, Scopus and Google Scholar for publications from January 2000 to December 2025. We synthesized findings on the oral environment in PD across three domains (clinical oral findings, saliva‐related symptoms and the oral microbiome), with attention to disease stage where reported and examined their relationships with dysphagia.
Results
The oral environment in PD was reported to be associated with disease‐related motor and non‐motor features and was reported to worsen with disease progression. Deterioration of the oral environment was also associated with dysphagia. Based on these findings, we proposed a stage‐based conceptual framework for assessment and management of both the oral environment and swallowing function.
Conclusion
Assessment of both the oral environment and swallowing function across all disease stages should be considered as part of aspiration pneumonia risk management in PD. The oral environment remains a modifiable factor even in advanced stages of PD.