Taking care of your oral health is especially important for people with Parkinson’s disease (PD). Parkinson’s can impact the health of the mouth, teeth and jaw and make dental care challenging.
June is National Oral Health Month. Read on to learn about common dental problems in people with PD and tips for maintaining oral health.
Dental Risks Related to PD
Oral health problems arise directly and indirectly from the progression of Parkinson’s. PD-related dental challenges may include:
- Too much saliva. Excessive saliva can lead to a fungal infection at the corners of the mouth.
- Too little saliva. Also known as dry mouth, too little saliva can increase the risk of cavities.
- Cavities. A cavity is a breeding ground for bacteria that can easily infiltrate the blood stream and harm other parts of the body.
- Infected teeth and gums. Your mouth can harbor bacteria that may infect devices, such as deep brain stimulation electrodes, prosthetic hips and knees, vascular stents and grafts.
- Altered face and tongue muscle function. These conditions may affect speech and chewing.
- Swallowing problems. Poorly chewed food can increase the risk of choking and aspiration.
If you take a medicine with a warning to tell your doctor about infections, make sure to report cavities, loose teeth or inflamed gums. Some immune-suppressing medications can significantly reduce white blood cells, which increases the risk for bacteria-causing dental diseases to spread elsewhere.
Barriers to Dental Health in PD
Symptoms of PD may hinder your ability to maintain proper oral hygiene, and can potentially worsen dental problems.
Nearly half of all people with PD have difficulty with their daily oral hygiene regimen, due to movement symptoms such as rigidity and tremor. These symptoms also make going to the dentist more difficult and uncomfortable, as weakened swallowing ability can increase the risk of choking during treatment.
Additionally, people with PD who have been on medications like levodopa for several years may begin to develop involuntary movements, which can affect the jaw and cause cracked teeth and teeth grinding. This may create problems during dental exams and at home.
Non-movement symptoms of Parkinson’s, such as apathy, depression, and forgetfulness, may lead a person with PD to pay less attention to their daily dental health. People who experience cognitive changes also may be more likely to miss dental appointments and less likely to report dental pain to their care partners or dentist, leaving issues unaddressed for too long.
Other behavior changes can affect nutrition. People with PD require greater caloric intake than those without PD, but some people experience decreased appetite. Combined with poor dental hygiene, this often leads to a tendency to avoid nutrient-rich foods, like vegetables, that require the ability to chew well. Some people may also develop a “sweet tooth,” which may put them at greater risk for cavities.
10 Tips for Improving Dental Health
Follow these tips to keep your oral health in check while managing PD:
- Stay hydrated. Always eat and drink in an upright position, taking small bites and sips.
- Brush after every meal for two minutes. If it is not possible to brush after a meal, rinsing the mouth with water will help.
- Remove dentures after each meal, brush and rinse them. Brush or clean dentures in a solution at night.
- Use a toothbrush with a large-handled grip and soft bristles. If you prefer an electric toothbrush, be sure it is an oscillating, rotating power toothbrush.
- Do not use products that include alcohol, as they make dry mouth conditions worse. Your dentist can recommend special products like toothpaste and gels that can help with dry mouth and other oral health problems.
- Floss. If movement symptoms make flossing difficult, consider using a water pick instead.
- Avoid using mouthwash. Mouthwashes are typically discouraged for people with PD because of the risk of choking. Ask your doctor or dentist if it is safe for you to use mouthwash.
- Notify your dental office of your PD symptoms. This will help the dentist and the staff provide better treatment.
- Schedule dentist appointments wisely. Plan short dental appointments for the time of day your symptoms are most effectively controlled.
- Have your dental health providers work collaboratively with your other healthcare providers to improve oral health-based quality of life.
If you have concerns about your oral health or you are experiencing dental challenges that may be related to PD, contact your doctor or dentist. Your care team can help you find strategies to take care of your dental health.
To learn more about managing swallowing issues and oral care with Parkinson’s disease, listen to our podcast.