Epidemiology, Pathogenicity and Treatment of Oral Parasitic Infections: A Review

Oral parasitic diseases, such as those caused by Entamoeba gingivalis and Trichomonas tenax species are emergent in the sense that they are hitherto neglected oral pathologies occurring in some periodontal patients not responding to conventional therapy. Molecular diagnostics support higher prevalence rates then assumed before, hence increased interest in their epidemiology and clinical relevance. There is evidence that these protozoa are potentially involved in tissue damage, biofilm disruption and host immune response modification that increase disease severity. They are commonly – but not exclusively – found in combination with low oral hygiene standards, deep pockets and various systemic risk factors. Despite mechanical periodontal therapy being the mainstay of treatment adjunctive antiseptic and antiparasitic treatments have potential to improve oral parasitic burden. Prevention is based on strict oral hygiene, risk-factor management and periodic clinical follow-up. Although evidence is increasing, the pathogenic significance and therapeutic implications of these parasites need more research. This review strives to synthesize existing information about epidemiology, pathogenicity and treatment strategies in order to recommend more optimal diagnostic and therapeutic approaches.