Jaw Exercises, Oral Hygiene Advice Aids Life Quality in Later Parkinson’s

A program of jaw-related exercises, coupled with individualized advice for oral hygiene, can improve quality of life as it relates to oral health among people with Parkinson’s disease, a small study reported.

The study,  “Effect of orofacial physiotherapeutic and hygiene interventions on oral health related quality of life in patients with Parkinson’s disease. A randomised controlled trial,” was published in the Journal of Oral Rehabilitation.

Problems with oral health and poorer orofacial (mouth-and-face) control, such as difficulty chewing and problems with swallowing and drooling, are common to people with Parkinson’s disease, and can affect quality of life.

A team of scientists in Denmark previously devised a program aiming to help these people improve their oral health and orofacial function. It consisted of three exercises aiming to strengthen the muscles controlling mouth movements, coupled with individualized counseling about oral health.

In a prior study, the researchers showed that their program significantly “improved objective measurements of jaw mobility, masticatory [chewing] function and oral hygiene,” they reported. The team here evaluated the program in terms of oral health-related quality of life (OHRQoL).

The study enrolled 29 adults with moderate to advanced Parkinson’s — 15 men and 14 women, ranging in age from 32 to 79 and diagnosed between three and 20 years earlier — who were randomly divided into two groups: Group A received the intervention, and Group B did not.

Participants were evaluated after two months. Both groups then received the training: Group A got a refresher, while Group B underwent the program for the first time. Fresh evaluations were given two months later.

OHRQoL was measured with the Oral Health Impact Profile-14 (OHIP-14), a questionnaire about oral health, and with a structured interview called the Nordic Orofacial Test – Screening (NOT-S). Participants also were asked to self-rate their chewing ability and problems with drooling.

Pooled data from both groups showed that, two months after the intervention, NOT-S scores were significantly lower, indicating better OHRQoL. The score change was not statistically significant when each group was analyzed separately.

OHIP-14 scores did not significantly change after two months, in either group or the pooled group. However, among patients in Group A, OHIP-14 scores indicated significantly better OHRQoL after four months (i.e., after both the initial and refresher program). Further analysis of OHIP-14 results indicated that the improvement was more pronounced in females than males after two months.

Data from both groups, pooled and separately, showed a significant decrease in self-reported drooling problems two months after the intervention.

“In our previous publication we showed that with a standardised exercise program and an individualized oral hygiene program performed at home it was possible to improve jaw mobility chewing efficiency and oral hygiene. … In the present study, we showed that the effect was not only clinically measurable, but the patients also felt functional improvement and better OHRQoL, four months after the start of the intervention,” the researchers wrote.

“This study shows that with relatively simple interventions and cheap assistive devices, it is possible to improve both the oral health and orofacial function as well as the OHRQoL and self-reported orofacial function,” they concluded.

Further research in larger numbers of patients is needed to validate these results, the researchers noted. They also stressed the importance of collaboration between different specialist care providers — such as dentists and neurologists — when caring for people with a complex condition like Parkinson’s.