Are dental implants a better option than dentures for people with Parkinson’s disease (PD) who have lost teeth? A recent study finds that, although people with PD can benefit from dental implants, there are pitfalls too. Implants can break if a person clenches their jaw or grinds their teeth as part of PD movement symptoms and can be costly and time-consuming to maintain. The study appears in the May 2015 issue of Primary Dental Journal.
For many reasons, it is often difficult for people with PD to maintain healthy teeth and gums. Movement symptoms can interfere with brushing and flossing. Both dry mouth and too much saliva contribute to bacterial growth in the mouth that leads to inflammation. Getting out to go to the dentist may be a challenge too. As a result, people with PD have more cavities, gum disease and lost teeth than other people of the same age.
When it comes to replacing lost teeth, removable dentures are one option. However, because of dyskinesias and other movement difficulties that can affect the mouth, people with PD often find dentures problematic. Another choice is a dental implant — a replacement tooth that is surgically secured in the jaw. Dental implants help keep the jawbone intact and strong. A dental implant can be made to support a single tooth or provide an attachment point for several teeth (a “bridge”) or a denture for all lower or all upper teeth.
No one had previously evaluated the long-term success of dental implants for people with PD, so for 10 years Mark E. Packer, B.D.S., M.Phil., F.D.S.R.C.S., at King’s College London Dental Institute, followed four people with PD who had received dental implants in his department and were participants of an earlier, one-year long study on dental implants in PD.
- Dental implants made it significantly easier for study participants to eat.
- Study participants were satisfied with their implants.
- Three of the four participants broke their implants as a result of jaw clenching (a side effect of levodopa medication) or grinding the teeth, and all required further dental surgery over the course of the study.
- Over the 10-year follow-up, study participants averaged four visits a year to a dental specialist just to maintain their implants, in addition to regular dental visits to take care of their remaining natural teeth.
What Does It Mean?
When people with PD experience health issues unrelated to PD — including dental issues — they and their dentists who aren’t as familiar with the disease, may wonder if treatments should take into account the underlying PD diagnosis.
In this study, Dr. Packer shared his experience with four people with PD who had dental implants. Dental implants helped maintain a good quality of life. However, Dr. Packer concludes that dental implants are not necessarily better than other options for people with PD — they just present a different set of issues to address. If dental implants are used, he suggests focusing on the front teeth — what dentists call a “shortened dental arch.” With these teeth, a person can smile, talk and eat normally. Avoiding implants for the “back” molars helps prevent problems from breakage and the need for further surgeries.
The best strategy for people with PD is to prevent or minimize dental problems in order to keep as many natural teeth as possible. It’s important to clean the teeth and gums regularly, with the help of a care partner if needed, from the earliest stage of PD. Although it may be difficult to get out to the dentist or to sit in the examination chair, regular check-ups prevent problems later. A dentist also can prescribe high-fluoride toothpaste and chlorhexidine gel, which help prevent tooth decay.
Packer ME. (2015) Are Dental Implants the Answer to Tooth Loss in Patients with Parkinson’s Disease? Primary Dental Journal 2015;4(2):35-41