Oral Health and Parkinson's Disease
Oral care should be an important part of maintaining general health for everyone. While most people are able to maintain proper oral health with no thought, for people with Parkinson’s, it can become challenging when facial muscles start to fail and doing things that were once routine now require preparation and forethought.
Poor oral health has long been prevalent among patients with Parkinson’s. Whether this is due to a lack of proper care on the part of caregivers, physicians, or the patient themselves is not clear. A combination of reasons not solely related to the progression of the disease often lead to poor oral hygiene as well. Symptoms of dementia, apathy, or depression may contribute to a lack of proper oral hygiene. It is thus important that caregivers and physicians be diligent in addressing all the unique issue that patients with the disorder can face.
Oral health for people with Parkinson’s can be quite challenging when the facial muscles fail to move and operate as they used to. Poor oral hygiene has been prevalent among such patients for a long time, although the exact reason is not known. A lack of good oral hygiene can be contributed to symptoms such as depression, apathy, and dementia, so patients with these disorders should address them and all unique issues with both physicians and caregivers.
Oral cavity problems associated with this disorder have been largely ignored. However, in the last few decades, greater importance has been placed on evaluating and treating these issues. Chewing and swallowing becomes more debilitating and dangerous due to the difficulty associated with moving the muscles of the face and speaking. As muscles freeze, people with dentures or missing teeth face more difficulties. There is also a risk of pneumonia due to the aspiration of saliva and food particles, and this also brings a risk of choking.
The medications taken to manage Parkinson’s disease can cause a decrease in saliva production. Saliva lubricates the mouth and also contains enzymes and antibacterial properties that prevent sugar from accumulating on teeth. A lack of it causes dry mouth.
Dental plaque contains bacteria that converts sugar into acid and attacks the teeth, causing decay. If saliva is less, then plaque may harden quickly due to faster sugar conversion and cause more damage. Also, gum disease can be caused due to dry mouth. Tooth decay becomes more likely as the gums shrink and tooth roots are exposed.
Management and Treatment
A proper treatment plan should be formed between the patient, the caregiver, and their dental team. The plan should be tailored to combat all current and future symptoms that are assessed and addressed. A diagnosis should be done so that preventive steps can be taken. The dental team should look for root caries, burning mouth, drooling, xerostomia, and dysphagia.
The dental team needs to know how long the patient can keep their mouth open because of the muscle tremors and rigidity. Dental dams aspirating or electronic toothbrushes, mouth washes, and high fluoride concentrate toothpastes all can help maintain proper oral care. However, if, due to severe tremors, these are not possible, maintenance of oral care should be stressed.
Carefully clean the inside and outside areas of the mouth. Pay special attention to the place where the teeth and gums meet, and clean the biting surface. In order to make sure that dental plaque is removed effectively, use a dental scalar. To make things easier, a three-sided toothbrush and dental aids can be used. Dentures should be removed before cleaning. To get rid of plaque build-up, use a dental pik.
Oral health is a not a problem for all people with Parkinson’s. As soon as a Parkinson’s diagnosis has been made, you can be proactive about your dental care. Although not necessarily in the initial stages, you may need to visit a dentist later on in the disease’s progression. Poorly managed oral hygiene can cause potentially devastating secondary health problems. For proper self-care, and for oral health management specifically, a wide array of products are available.
For Parkinson’s patients, poor oral health can lead to uncomfortable situations and may actually be the difference between life and death.