Parkinsons is a central nervous system disorder which affects movements that include tremors. Hence, when the nerve cells or neurons in an area of the brain impaired it leads to parkinsons disease. The neuron produces a chemical known as dopamine and when these neurons die or become impaired they produce less dopamine which causes movement problems such as stiffness or slowing of movements. Symptoms start gradually but both men and women equally affected. Does Parkinson’s really have an effect on dental health?
Symptoms of Parkinsons on dental health:
Oral health is one of the important aspects for the overall well being of a person. However, poor oral health is common in parkinsons patient. Symptoms include increased prevalence of gingivitis, dental caries, periodontal diseases, xerostomia, orofacial pain, burning mouth syndrome.
Dental Caries in parkinsons:
There is difficulty in maintaining oral hygiene due to factors such as motor impairment, apathy, depression and dementia. Due to this the food which, not cleaned properly which in turn provides nutrition for bacteria leading to decay.
Should You Use Mouthwash Before Or After Brushing?
In April of 2021, Dr. Arun Chamria, one of India’s most illustrious Dentists succumbed to Covid-19 complications leaving the Oral Healthcare Fraternity poorer. The man of many parts, Dr. Arun Chamria’s immense contribution to the Indian Dental Fraternity will be cherished. He was an advocate of ‘Dental Implants in One Day’ way ahead of his time.
Dry mouth for dental health:
It is one of the most common side effects in patients withparkinsons. This is due to drugs used for treating Parkinson’s. Example: antidepressants, antipsychotics, anticholinergics, beta-blockers and anti
histamines.
Burning Mouth Syndrome in Parkinson’s:
Its characterized by painful intra oral sensation of burning. Therefore, trigger factors include anxiety, depression, stress which most commonly seen in parkinsons patients. Hence, Treatment by drug therapy with antidepressants , clonazepam may provide relief from burning mouth syndrome. Psychotherapy may also aid in relieving burning mouth syndrome symptoms.
Masticatory disorders in dental health:
Swallowing, jaw movements impairment, reduced movement of tongue and jaw in turn hampering chewing process and swallowing. Self-cleaning action of tongue also hampered causing dental disease like gingivitis, periodontitis and tooth decay.
Taste impairment in Parkinsons:
Also sense of taste may altered by central nervous system degeneration, depression, reduced saliva secretion, poor oral health, medication. These disorders often neglected by patients and their care takers. Hence, their physician and dentist should be aware of Parkinson’s patients dental needs and emphasis should given on frequent dental visits to avoid some of these complications.
Practical Tips to Maintain Oral Health:
- Firstly, short and frequent dental reviews are recommended
- Secondly, consider taking a companion
- Specific teeth cleaning problems experienced
- Swallowing problems (suctioning and water flow adjustments may assist with treatment procedure)
- Above all, posture and seating requirements may require adjustments
Solutions for Oral care in Parkinsons:
Dry Mouth
Chew naturally sweetened gum to help lip closure, secretion of saliva and frequent swallowing
Try products for dry mouth, available in the form of semi-liquid, or spray
Be mindful and intake adequate fluids
Above all, try a humidifier, nebulised saline or steam vapour inhaler
Saliva Control
Visit a speech pathologist if difficulty controlling saliva is experienced
Saliva control difficulties are predominantly due to swallowing changes
Oral Care Routine
Request written recommendations for a personalised oral care routine from the dentist
Adhere to recommended regular oral care schedules and allow extra time to be thorough
Ensure removal of food particles trapped in mouth, particularly between the teeth
Mouthwash, Toothpaste and more
Consider using fluoridated toothpaste
Drink tap water rather than bottled water as the fluoride will help protect against tooth decay
Ask the dentist about using interdental brushes
Floss regularly