Parkinson’s Disease (PD) is often associated with mobility complexities, but new studies suggest that PD patients also suffer from a variety of non-motor symptoms that increase the overall burden of the disease. Among these are oral cavity problems, such as gingivitis and dental problems, orofacial pain, bruxism, the burning mouth syndrome, xerostomia, and diurnal and nocturnal sialorrhea.
Dental Caries and Periodontal Disease
A study conducted to evaluate the prevalence of periodontal disease in different groups of seniors aged between 60 and 79 years, including patients with PD, patients with mild neurological disease but no cognitive or motor impairment, and patients suffering from acute ischemic stroke revealed a higher frequency of patients with PD with untreated caries. More PD patients had caries, fewer remaining teeth, and higher rate of deep periodontal pockets compared to the other study groups.
The study proposed that many factors contributed to the inability of PD patients to maintain proper oral hygiene, including:
Physical Barriers
The physical symptoms of PD makes it hard for patents to maintain proper daily hygiene, and even harder to keep up with periodic office examinations. Typical dental care home practices require digital dexterity, muscle-eye-coordination, and tongue-lip-cheek control. Any disease that interferes with these faculties hinders the effectiveness of associated oral hygiene procedures.
Nearly 50 percent of PD patients have difficulty maintaining their daily oral hygiene regimen, which makes them less likely to clean their teeth or dentures daily.
Other symptoms of Parkinson’s, such as rigidity, tremor, and abnormal posture, may make it difficult for patients to visit a dentist for oral examination. Some patients may also experience:
- Sialorrhea – resulting from the excess production of saliva or difficulty in clearing it from the mouth (swallowing dysfunction), or both.
- Xerostomia – Dry mouth is a more frequent complaint in individuals with PD, and an initiator of both caries and periodontal disease
- Bruxism – Teeth bracing, clenching, or grinding can also occur in sleep or awake state.
- Burning mouth syndrome (BMS) and Orofacial Pain – Characterized by painful, intraoral burning sensation with no physical or laboratory correlate. Increased risk of BMS for PD patients suffering from psychological factors, such as depression, anxiety, cancer phobia, and compulsive disorders.
Behavioral Barriers
Besides motor-related challenges associated with PD, some behavioral changes may negatively impact dental care, such as forgetfulness, apathy, and depression. Such problems can interfere with one’s nutrition, causing them to avoid nutrient-rich foods and opt for overly sweet foods, putting them at greater risk for cavities.
Failure to address dental health concerns (both physical and behavioral) can affect nutrition, and increase the risk for cognitive impairment, stroke, and weight loss. A dentist can propose personalized strategies to help improve dental care for PD patient, such as proposing a suitable mouthwash, topical fluoride gel treatments, and timely administration of medication or surgery.