As a person who lives daily with Parkinson’s disease, I find there are many complexities to this disease. One of the least thought about but is important; is maintaining proper dental care with Parkinson’s. Many doctors do not realize or recognize why some patient’s with Parkinson’s disease may find it difficult to sustain a daily regimen of healthy oral care. What are the barriers that prevent proper dental care? What are some of the early signs indicating a poor dental care problem? These questions will be addressed below.
Barriers in PD patients that prevent healthy dental care
#1-Physical symptoms of Parkinson’s disease can present a challenge for patients at home and during dental visits. Effective brushing of the teeth requires muscle -eye-coordination, digitaldexterity and tongue-cheek-lipcontrol. The PD patient’s tremors play a role in hindering good oral hygiene. Rigidity and poor posture can hinder the dentist from achieving a fully effectual dental exam or cleaning. Weakened swallowing ability can increase the risk of choking on certain substances dentists use during an exam or cleaning. Dyskinesias can affect the jaw and cause teeth grinding which can cause problems at home as well as at dental exams. People with Parkinson’s may also experience a very dry mouth which can further complicate swallowing issues and lead to developing gum diseases.
#2- Non-motor symptoms also make it challenging for PD patients to maintain a good oral hygiene. Mood swings, apathy, depression, and forgetfulness can make it difficult to regularly maintain dental care. Many Parkinson patients develop a decreased appetite, and that combined with poor dental hygiene often leaves patients hesitant to eat enough vegetables and other nutrient rich foods that require more chewing. In turn they may develop a sweet tooth, encouraging cavity growth. Mild to severe cognitivechanges also play a role in the decline of many self-care routines including dental care and missing dental appointments.
Signs to look for in PD patients indicating poor dental care
#3- Early signs to look for if you’re own or a loved one’s dental care seems to be declining include infrequent brushing, difficulties in rinsing during daily dental care, lack of denture care, and trouble sitting through a meal, as well as weight loss.
James M Noble, M.D., M.S., C.P.H.; Dental Care and Parkinson’s disease; http://www.pdf.org/en/winter09_dental