Dental Management of patient with Parkinson’s Disease
Liosatos Alexios
Department of Oral and Maxillofacial Surgery, School of Dentistry, Aristotle University of Thessaloniki, Greece
DOI: 10.54936/haoms2511730
Abstract:
Background: Parkinson’s disease (PD) is a chronic progressive neurodegenerative disorder. This disease affects about 1 in 1000 people in the general population and 1% of the over 60 age group. The main features of the disease are: resting tremor, bradykinesia, postural instability, muscle rigidity and inexpressible face (mask-like face).
People with PD face a series of pathological manifestations from the oromaxillofacial region related to the disease, while some of the drugs used to treat PD also lead to adverse effects from the oral cavity.
Purpose: The dentist should be able to recognize the basic signs and symptoms of the disease, its basic oral manifestations and the basic dental management protocols of patients with PD. This review aims to contribute in this direction.
Method: In pubmed database we searched with keywords “dental and Parkinson’s disease”, “Parkinson disease and dental management”, ‘Parkinson and periodontal’, “oral hygiene and Parkinson disease’, “periodontitis and Parkinson’s disease”. We concluded that 141 papers were to be used in our review.
We also used Little’s and Scully’s books on the medically compromised patient, as well as Dougall’s series of articles for disabled patients. Last, we used few website links of official dental sites.
Conclusion: PD patients may suffer from a multitude of pathological manifestations from the oral-maxillofacial area, while they need special dental management due to motor, mental and autonomic neural system disorders. The insufficient experience and training of the majority of dentists in treating patients with PD is given. The dental community in collaboration with the medical community and the State is important to contribute to the improvement of the oral health of PD patients, by educating patients and dentists.
KEY WORDS: Parkinson Disease, Dental Management
REFERENCES
1. Little JW, Falace DA, Miller CS, Rhodus NL: Dental Management of the Medically Compromised Patient. 9th ed. St. Louis. Elsevier Inc, 2018:522-527
2. Prete BRJ, Ouanounou A: Medical Management, Orofacial Findings, and Dental Care for the Patient with Parkinson’s Disease. J Can Dent Assoc 2021; 87:l10
3. Packer ME: Are Dental Implants the Answer to Tooth Loss in Patients with Parkinson’s Disease? Prim Dent J 2015; 4(2):35-41
4. De Bowes SL, Tolle SL, Bruhn AM: Parkinson’s disease: considerations for dental hygienists. Int J Dent Hyg 2013; 11(1):15-21
5. Dougall A, Fiske J: Access to special care dentistry, part 9. Special care dentistry services for older people. Br Dent J 2008; 205(8):421-34
6. Jeter CB, Rozas NS, Sadowsky JM, Jones DJ: Parkinson’s Disease Oral Health Module: Interprofessional Coordination of Care. Med Ed PORTAL 2018; 14:10699
7. Kaka S, Lane H, Sherwin E: Dentistry and Parkinson’s disease: learnings from two case reports. Br Dent J 2019; 227(1):30-36
8. Scully C: Scully’s Medical Problems in Dentistry. 7th ed. London. Elsevier Ltd. 2014:368-370
9. Grover S, Rhodus NL: Dental management of Parkinson’s disease. Northwest Dent 2011; 90(6):13-9
10. Jolly DE, Paulson RB, Paulson GW, Pike JA: Parkinson’s disease: a review and recommendations for dental management. Spec Care Dentist 1989; 9(3):74-8
11. Barbe AG, Bock N, Derman SHM, Felsch M, Timmermann L, Noack MJ: Self-assessment of oral health, dental health care and oral health-related quality of life among Parkinson’s disease patients. Gerodontology 2017; 34(1):135-143
12. Rozas NS, Sadowsky JM, Jones DJ, Jeter CB: Incorporating oral health into interprofessional care teams for patients with Parkinson’s disease. Parkinsonism Relat Disord 2017; 43:9-14
13. Tatsuyuki F, Ono T, Hori K, Wada Y, Uchiyama Y, Kasama S et al: Tongue Pressure Measurement and Videofluoroscopic Study of Swallowing in Patients with Parkinson’s Disease. Dysphagia. 2019; 34(1):80-88
14. Barbe AG, Deutscher DHC, Derman SHM, Hellmisch M, Noack MJ: Subjective and objective halitosis among patients with Parkinson’s disease. Gerodontology 2017; 34(4):460-468
15. Barbe AG, Ludwar L, Scharfenberg I, Hellmich M, Dano R, Barbe MT et al: Circadian rhythms and influencing factors of xerostomia among Parkinson’s disease patients. Oral Dis 2019; 25(1):282-289
16. Tiigimae-Saar J, Tamme T, Rosenthal M, Kadastik-Eerme L, Taba P: Saliva changes in Parkinson’s disease patients after injection of Botulinum neurotoxin type A. Neurol Sci 2018; 39(5):871-877
17. Fiske J, Hyland K: Parkinson’s disease and oral care. Dent Update 2000; 27(2):58-65
18. Martimbianco ALC, Prosdocimi FC, Anauate-Netto C, dos Santos EM, Mendes GD, Fragoso YD: Evidence-Based Recommendations for the Oral Health of Patients with Parkinson’s Disease. Neurol Ther 2021 10:391–400
19. Einarsdottir ER, Gunnsteinsdottir H, Hallsdottir MH, Sveinsson S, Jonsdottir SR, Olafsson VG et al: Dental health of patients with Parkinson’s disease in Iceland. Spec Care Dentist 2009; 29(3):123-7
20. Friedlander AH, Mahler M, Norman KM, Ettinger RL: Parkinson disease: systemic and orofacial manifestations, medical and dental management. J Am Dent Assoc 2009 Jun; 140(6):658-69
21. Clifford T, Finnerty J: The dental awareness and needs of a Parkinson’s disease population. Gerodontology 1995; 12(12):99-103
22. Miwa H, Komdo T: Alteration of eating behaviors in patients with Parkinson’s disease: possibly overlooked? Neurocase 2008; 14(6):480-4
23. Dougall A, Fiske J: Access to special care dentistry, part 4. Education. Br Dent J 2008; 205(3):119-30
24. Fiske J, Frenkel H, Griffiths J, Jones V, British Society of Gerodontology, British Society for Disability and Oral Health: Guidelines for the development of local standards of oral health care for people with dementia. Gerodontology 2006; 23(1):5-32
25. Robbins MR: Neurologic Diseases in Special Care Patients. Dent Clin North Am 2016; 60(3):707-35
26. Auffret M, Meuric V, Boyer E, Bonnaure-Mallet M, Verin M: Oral Health Disorders in Parkinson’s Disease: More than Meets the Eye. J Parkinsons Dis 2021; 11(4):1507-1535
27. Gosnell R, Lazear J, Hemphill JC, Dotson D: Development of guidelines for improving oral health in individuals with Parkinson’s disease. Gerodontology 2019 ;36(3):229-235
28. Kojima Y, Kojima M, Nohara K, Sakaguchi Y: Dental Treatment Effect on Deep Brain Stimulation System in Parkinson’s Disease. Bull Tokyo Dent Coll 2018; 59(2):133-137
29. Shapiro M, Sgan-Cohen HD, Parush S, Melmed RN: Influence of adapted environment on the anxiety of medically treated children with developmental disability. J Pediatr 2009; 154(4):546-50
30. https://decisionsindentistry.com/article/dental-care-patients-special-needs/ όπως αυτό εμφανίζεται την 28/10/2022
31. Dougall A, Fiske J. Access to special care dentistry, part 3. Consent and capacity. BDJ 2008; 205(2):71-81
32. Sixel-Doering F, Trenkwalder C, Kappus C, Hellwig D: Abscess at the implant site following apical parodontitis. Hardware-related complications of deep brain stimulation. Nervenarz 2006; 77(8):946-7
33. Zlotnik Y, Balash Y, Korczyn AD, Giladi N, Gurevich T: Disorders of the oral cavity in Parkinson’s disease and parkinsonian syndromes. Parkinsons Dis 2015; 2015:379482
34. Barbe AG, Heinzler A, Derman SHM, Hellmich M, Timmermann L, Noack MJ. Hyposalivation and xerostomia among Parkinson’s disease patients and its impact on quality of life. Oral Dis 2017; 23(4):464-470
35. Ribeiro GR, Campos CH, Garcia RCMR: Influence of a removable prosthesis on oral health-related quality of life and mastication in elders with Parkinson disease. J Prosthet Dent 2017; 118(5):637-642
36. Haralur SB: Clinical strategies for complete denture rehabilitation in a patient with Parkinson disease and reduced neuromuscular control. Case Rep Dent 2015; 2015:352878
37. Durham TM, Hodges ED, Henry MJ, Geasland J, Straub P: Management of orofacial manifestations of Parkinson’s disease with splint therapy: a case report. Spec Care Dentist 1993; 13(4):155-8
38. Al-Omari FA, Al Moaleem MM, Al-Qahtani SS, Al Garni AS, Sadatullah S, Luqman M: Oral Rehabilitation of Parkinson’s Disease Patient: A Review and Case Report. Case Rep Dent 2014; 2014: 432475
39. Farrow-Hamblen A: Prostheses in Parkinson’s disease. Br Dent J 2019; 227(5):329
40. Singh Y, Saini M, Garg N: Oral rehabilitation of a Parkinson’s patient: A case report. World J Clin Cases 2013; 1(1):67-70
41. Packer M, Nikitin V, Coward T, Davis DM, Fiske J: The potential benefits of dental implants on the oral health quality of life of people with Parkinson’s disease. Gerodontology 2009; 26(1):11-8
42. Faggion Jr CM: Critical appraisal of evidence supporting the placement of dental implants in patients with neurodegenerative diseases. Gerodontology 2016;33(1):2-10
43. Heckmann SM, Heckmann JG, Weber HP: Clinical outcomes of three Parkinson’s disease patients treated with mandibular implant overdentures. Clin Oral Implants Res 2000; 11(6):566-71
44. Wilson NJ, Lin Z, Villarosa A, Lewis P, Philip P, Sumar B, George A: Countering the poor oral health of people with intellectual and developmental disability: a scoping literature review. BMC Public Health 2019; 19(1):1530
45. Chadwick D, Chapman M, Davies G: Factors affecting access to daily oral and dental care among adults with intellectual disabilities. J Appl Res Intellect Disabil 2018; 31(3):379-394
Department of Oral and Maxillofacial Surgery, School of Dentistry, Aristotle University of Thessaloniki, Greece
DOI: 10.54936/haoms2511730
Abstract:
Background: Parkinson’s disease (PD) is a chronic progressive neurodegenerative disorder. This disease affects about 1 in 1000 people in the general population and 1% of the over 60 age group. The main features of the disease are: resting tremor, bradykinesia, postural instability, muscle rigidity and inexpressible face (mask-like face).
People with PD face a series of pathological manifestations from the oromaxillofacial region related to the disease, while some of the drugs used to treat PD also lead to adverse effects from the oral cavity.
Purpose: The dentist should be able to recognize the basic signs and symptoms of the disease, its basic oral manifestations and the basic dental management protocols of patients with PD. This review aims to contribute in this direction.
Method: In pubmed database we searched with keywords “dental and Parkinson’s disease”, “Parkinson disease and dental management”, ‘Parkinson and periodontal’, “oral hygiene and Parkinson disease’, “periodontitis and Parkinson’s disease”. We concluded that 141 papers were to be used in our review.
We also used Little’s and Scully’s books on the medically compromised patient, as well as Dougall’s series of articles for disabled patients. Last, we used few website links of official dental sites.
Conclusion: PD patients may suffer from a multitude of pathological manifestations from the oral-maxillofacial area, while they need special dental management due to motor, mental and autonomic neural system disorders. The insufficient experience and training of the majority of dentists in treating patients with PD is given. The dental community in collaboration with the medical community and the State is important to contribute to the improvement of the oral health of PD patients, by educating patients and dentists.
KEY WORDS: Parkinson Disease, Dental Management
REFERENCES
1. Little JW, Falace DA, Miller CS, Rhodus NL: Dental Management of the Medically Compromised Patient. 9th ed. St. Louis. Elsevier Inc, 2018:522-527
2. Prete BRJ, Ouanounou A: Medical Management, Orofacial Findings, and Dental Care for the Patient with Parkinson’s Disease. J Can Dent Assoc 2021; 87:l10
3. Packer ME: Are Dental Implants the Answer to Tooth Loss in Patients with Parkinson’s Disease? Prim Dent J 2015; 4(2):35-41
4. De Bowes SL, Tolle SL, Bruhn AM: Parkinson’s disease: considerations for dental hygienists. Int J Dent Hyg 2013; 11(1):15-21
5. Dougall A, Fiske J: Access to special care dentistry, part 9. Special care dentistry services for older people. Br Dent J 2008; 205(8):421-34
6. Jeter CB, Rozas NS, Sadowsky JM, Jones DJ: Parkinson’s Disease Oral Health Module: Interprofessional Coordination of Care. Med Ed PORTAL 2018; 14:10699
7. Kaka S, Lane H, Sherwin E: Dentistry and Parkinson’s disease: learnings from two case reports. Br Dent J 2019; 227(1):30-36
8. Scully C: Scully’s Medical Problems in Dentistry. 7th ed. London. Elsevier Ltd. 2014:368-370
9. Grover S, Rhodus NL: Dental management of Parkinson’s disease. Northwest Dent 2011; 90(6):13-9
10. Jolly DE, Paulson RB, Paulson GW, Pike JA: Parkinson’s disease: a review and recommendations for dental management. Spec Care Dentist 1989; 9(3):74-8
11. Barbe AG, Bock N, Derman SHM, Felsch M, Timmermann L, Noack MJ: Self-assessment of oral health, dental health care and oral health-related quality of life among Parkinson’s disease patients. Gerodontology 2017; 34(1):135-143
12. Rozas NS, Sadowsky JM, Jones DJ, Jeter CB: Incorporating oral health into interprofessional care teams for patients with Parkinson’s disease. Parkinsonism Relat Disord 2017; 43:9-14
13. Tatsuyuki F, Ono T, Hori K, Wada Y, Uchiyama Y, Kasama S et al: Tongue Pressure Measurement and Videofluoroscopic Study of Swallowing in Patients with Parkinson’s Disease. Dysphagia. 2019; 34(1):80-88
14. Barbe AG, Deutscher DHC, Derman SHM, Hellmisch M, Noack MJ: Subjective and objective halitosis among patients with Parkinson’s disease. Gerodontology 2017; 34(4):460-468
15. Barbe AG, Ludwar L, Scharfenberg I, Hellmich M, Dano R, Barbe MT et al: Circadian rhythms and influencing factors of xerostomia among Parkinson’s disease patients. Oral Dis 2019; 25(1):282-289
16. Tiigimae-Saar J, Tamme T, Rosenthal M, Kadastik-Eerme L, Taba P: Saliva changes in Parkinson’s disease patients after injection of Botulinum neurotoxin type A. Neurol Sci 2018; 39(5):871-877
17. Fiske J, Hyland K: Parkinson’s disease and oral care. Dent Update 2000; 27(2):58-65
18. Martimbianco ALC, Prosdocimi FC, Anauate-Netto C, dos Santos EM, Mendes GD, Fragoso YD: Evidence-Based Recommendations for the Oral Health of Patients with Parkinson’s Disease. Neurol Ther 2021 10:391–400
19. Einarsdottir ER, Gunnsteinsdottir H, Hallsdottir MH, Sveinsson S, Jonsdottir SR, Olafsson VG et al: Dental health of patients with Parkinson’s disease in Iceland. Spec Care Dentist 2009; 29(3):123-7
20. Friedlander AH, Mahler M, Norman KM, Ettinger RL: Parkinson disease: systemic and orofacial manifestations, medical and dental management. J Am Dent Assoc 2009 Jun; 140(6):658-69
21. Clifford T, Finnerty J: The dental awareness and needs of a Parkinson’s disease population. Gerodontology 1995; 12(12):99-103
22. Miwa H, Komdo T: Alteration of eating behaviors in patients with Parkinson’s disease: possibly overlooked? Neurocase 2008; 14(6):480-4
23. Dougall A, Fiske J: Access to special care dentistry, part 4. Education. Br Dent J 2008; 205(3):119-30
24. Fiske J, Frenkel H, Griffiths J, Jones V, British Society of Gerodontology, British Society for Disability and Oral Health: Guidelines for the development of local standards of oral health care for people with dementia. Gerodontology 2006; 23(1):5-32
25. Robbins MR: Neurologic Diseases in Special Care Patients. Dent Clin North Am 2016; 60(3):707-35
26. Auffret M, Meuric V, Boyer E, Bonnaure-Mallet M, Verin M: Oral Health Disorders in Parkinson’s Disease: More than Meets the Eye. J Parkinsons Dis 2021; 11(4):1507-1535
27. Gosnell R, Lazear J, Hemphill JC, Dotson D: Development of guidelines for improving oral health in individuals with Parkinson’s disease. Gerodontology 2019 ;36(3):229-235
28. Kojima Y, Kojima M, Nohara K, Sakaguchi Y: Dental Treatment Effect on Deep Brain Stimulation System in Parkinson’s Disease. Bull Tokyo Dent Coll 2018; 59(2):133-137
29. Shapiro M, Sgan-Cohen HD, Parush S, Melmed RN: Influence of adapted environment on the anxiety of medically treated children with developmental disability. J Pediatr 2009; 154(4):546-50
30. https://decisionsindentistry.com/article/dental-care-patients-special-needs/ όπως αυτό εμφανίζεται την 28/10/2022
31. Dougall A, Fiske J. Access to special care dentistry, part 3. Consent and capacity. BDJ 2008; 205(2):71-81
32. Sixel-Doering F, Trenkwalder C, Kappus C, Hellwig D: Abscess at the implant site following apical parodontitis. Hardware-related complications of deep brain stimulation. Nervenarz 2006; 77(8):946-7
33. Zlotnik Y, Balash Y, Korczyn AD, Giladi N, Gurevich T: Disorders of the oral cavity in Parkinson’s disease and parkinsonian syndromes. Parkinsons Dis 2015; 2015:379482
34. Barbe AG, Heinzler A, Derman SHM, Hellmich M, Timmermann L, Noack MJ. Hyposalivation and xerostomia among Parkinson’s disease patients and its impact on quality of life. Oral Dis 2017; 23(4):464-470
35. Ribeiro GR, Campos CH, Garcia RCMR: Influence of a removable prosthesis on oral health-related quality of life and mastication in elders with Parkinson disease. J Prosthet Dent 2017; 118(5):637-642
36. Haralur SB: Clinical strategies for complete denture rehabilitation in a patient with Parkinson disease and reduced neuromuscular control. Case Rep Dent 2015; 2015:352878
37. Durham TM, Hodges ED, Henry MJ, Geasland J, Straub P: Management of orofacial manifestations of Parkinson’s disease with splint therapy: a case report. Spec Care Dentist 1993; 13(4):155-8
38. Al-Omari FA, Al Moaleem MM, Al-Qahtani SS, Al Garni AS, Sadatullah S, Luqman M: Oral Rehabilitation of Parkinson’s Disease Patient: A Review and Case Report. Case Rep Dent 2014; 2014: 432475
39. Farrow-Hamblen A: Prostheses in Parkinson’s disease. Br Dent J 2019; 227(5):329
40. Singh Y, Saini M, Garg N: Oral rehabilitation of a Parkinson’s patient: A case report. World J Clin Cases 2013; 1(1):67-70
41. Packer M, Nikitin V, Coward T, Davis DM, Fiske J: The potential benefits of dental implants on the oral health quality of life of people with Parkinson’s disease. Gerodontology 2009; 26(1):11-8
42. Faggion Jr CM: Critical appraisal of evidence supporting the placement of dental implants in patients with neurodegenerative diseases. Gerodontology 2016;33(1):2-10
43. Heckmann SM, Heckmann JG, Weber HP: Clinical outcomes of three Parkinson’s disease patients treated with mandibular implant overdentures. Clin Oral Implants Res 2000; 11(6):566-71
44. Wilson NJ, Lin Z, Villarosa A, Lewis P, Philip P, Sumar B, George A: Countering the poor oral health of people with intellectual and developmental disability: a scoping literature review. BMC Public Health 2019; 19(1):1530
45. Chadwick D, Chapman M, Davies G: Factors affecting access to daily oral and dental care among adults with intellectual disabilities. J Appl Res Intellect Disabil 2018; 31(3):379-394
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