Ways of Better Ensuring Good Dental Care in Parkinson’s Reviewed

Regular dental visits and routine tooth brushing with alternating hands are among recommendations for better oral health in people with Parkinson’s disease, researchers report.

Tooth decay and receding gums are known problems for these patients, and often overlooked due to the nature of this neurodegenerative disorder, the team noted.

The paper, “Evidence-Based Recommendations for the Oral Health of Patients with Parkinson’s Disease,” was published in Neurology and Therapy.

Disabling motor and non-motor symptoms mark Parkinson’s, and managing this progressive disease can be complex and stressful. For many patients, oral healthcare may not be seen as a priority, which could set the stage for an increased risk of oral diseases.

Researchers in Brazil conducted a review of published studies to better understand the relationship between Parkinson’s and oral health.

“The objective of the present study was to review different aspects of oral health in PD [Parkinson’s disease] and to establish evidence-based recommendations for the prevention and treatment of oral cavity diseases,” the researchers wrote.

Data from 14 studies, reported in 16 published papers, were included. Collectively, these studies involved nearly 800 people with Parkinson’s.

Broadly, “the studies pointed out that patients with PD had reduced quality of oral health and hygiene,” the researchers wrote.

Parkinson’s was linked with a variety of specific problems, including gum recession, tooth decay, periodontal disease (infections of the gums), dry mouth, difficulty swallowing, and excessive drooling.

Researchers noted that proper oral hygiene and healthcare may prevent many of these conditions, but such care is often neglected with these patients. Dentists, for example, are rarely included on interdisciplinary teams that care for people with Parkinson’s.

“There is no question that oral health is important for everyone,” the scientists wrote. “Although oral diseases are largely preventable, they are among the most prevalent diseases globally, thus creating a public health problem.”

They provided evidence-based recommendations for oral healthcare in Parkinson’s patients. These included routine tooth-brushing, as well as regular trips to a dentist or other oral healthcare specialist, and that neurologists question patients for  their adherence to dental care.

The team also advised that patients practice brushing their teeth with both their left and right hands, in case rigidity or tremor makes one hand more difficult to use as the disease progresses.

Better oral healthcare would likely lower the rates of periodontal disease, tooth loss and similar dental problems, the researchers said. They also recommended some conditions-specific treatments, like artificial saliva sprays to ease dry mouth, and carefully applied botulinum toxin (the active ingredient in Botox) for excessive drooling.

“Patients with PD have a variety of oral diseases that needs to be prevented, diagnosed and treated. The present paper provides a list of evidence-based recommendations for neurologists and dentists caring for these patients,” the team concluded.