HOW CAN PARKINSON’S CHANGE THE WAY YOU LOOK AFTER YOUR TEETH?
The physical symptoms of Parkinson’s can present challenges both for daily dental hygiene and regular visits to the dentist. Poor motor function means nearly half of all people with Parkinson’s have difficulty with their daily oral hygiene routine. Tooth brushing, flossing and mouth rinsing require co-ordination, digital dexterity and tongue-cheek-lip control. Tremor and other movement disorders associated with Parkinson’s can cause difficulty for dental hygiene routines.
Some Parkinson’s medications lead to a dry mouth, which increases the risk of tooth decay and infections. Tooth grinding at night is also common in Parkinson’s patients and can be the cause of abnormal wear and tear on teeth. Yet, a healthy mouth is critical to chewing, tasting, swallowing and speaking. For people who have difficulty swallowing, good dental hygiene is important to help prevent chest infections.
WHAT HAPPENS WHEN TEETH AREN’T HEALTHY?
A cavity or decay of a tooth is known as dental caries. Oral bacteria combine with foods that contain sugar or starch to produce acids, which eat away at tooth enamel. About 9 out of 10 adults have some type of tooth decay.
Prevention includes good oral hygiene through brushing twice daily, flossing, eating nutritious meals and limiting snacking, and visiting the dentist on a regular basis.
Another common problem is dental abscesses. This is a collection of pus that accumulates in teeth or gums as a result of bacterial infection giving rise to a severe throbbing pain. It is caused by consuming sugary or starchy food and poor dental hygiene and is treated by a dentist draining the pus and possibly removing an infected tooth.
You can reduce the likelihood of suffering from dental abscesses through following the prevention tips for tooth decay already mentioned.
WHAT CAN I DO TO IMPROVE MY DENTAL HYGIENE?
The key to good dental health is consistent preventive dental care. You can reduce the number of times a day that you eat sugar or sugary foods. Ensure your dentures are cleaned daily. It’s vital that any dental problems are identified and treated in their early stages, so visit your dentist and hygienist every six to 12 months.
If you are able to do so safely, use a non-alcohol mouthwash to keep your mouth clean. (Please note some people with Parkinson’s are at risk of choking when using mouthwash. You can ask your GP about whether using mouthwash is safe for you).
TIPS FOR PEOPLE WITH NATURAL TEETH
You need to ensure you brush your teeth at least once a day (preferably twice), making sure you clean all sides of your teeth. If you find brushing your teeth tiring, you could clean one part of your mouth in the morning and the other in the evening.
An electric toothbrush provides the repetitive motion required to clean teeth effectively and may make cleaning your teeth easier. Cleaning between teeth with loss or special brushes is important. There are special holders for loss which can make it easier to use. Your dentist may be able to prescribe you with a fluoride gel to help prevent tooth decay. They may also be able to provide strategies for dealing with a dry mouth. If your carer helps you clean your teeth, they may find it easier to stand behind you (like a dentist does) to effectively brush and floss your teeth.
TIPS FOR PEOPLE WITH DENTURES
Some of the symptoms of Parkinson’s may make wearing dentures difficult, for example: loss of muscle tone, difficulty controlling facial muscles, dry mouth and problems swallowing. It is important your dentures it you correctly, because badly fitting dentures can cause problems with speech and damage your gums, which may lead to infection and problems eating.
There are also behavioral changes in some people with Parkinson’s that may impact on dental care. These include apathy, depression and forgetfulness, all of which may lead a person with Parkinson’s to pay less attention to their daily dental health. You may want to keep this in mind if your Parkinson’s means you are depressed or apathetic.
TIPS FOR DENTIST’S VISITS
It’s important that people with Parkinson’s visit their dentist every 6 to 12 months for a checkup. Some symptoms of Parkinson’s can be aggravated by anxiety so it is important to make your visit to the dentist as low stress as possible.
Some tips when visiting your dentist:
• Book an early morning visit as the waiting times are likely to be shorter
• If you are prone to troublesome dyskinesia it will be easier if you time your visit for a period when your dyskinesia is minimal.
• If you take levodopa, take it 60 to 90 minutes before your appointment so your dentist visit coincides with the drug’s peak response period.
• Make several brief visits to the dentist for any remedial work you require, rather than one long visit.
• Tell your dentist about all the medications you take, including over the counter medicines, vitamins and herbal supplements. You may find it difficult to hold your mouth open for long periods of time and to control your tongue movements and swallowing. Your dentist has special devices that can help. For example, a rubber bite block may be placed between your teeth to keep your mouth open and reduce stress on your muscles. A tongue retractor may be used to keep your tongue in one place.