Ways To Manage Patients With Parkinson’s Disease During Dentist Appointments
Parkinson’s disease is a chronic and aggressive neuro-dengerative disorder that occurs when there is a dopamine deficiency in the brain. The disorder is a constellation of debilitating symptoms that are continuous. Although the symptoms of the disorder can range from pre-motor effects to motor effects like stiffness, tremors, constipation and loss of muscle coordination, other problems and symptoms can appear as Parkinson’s progresses.
Some of the symptoms are directly related to the disease, while others are amplified due to the natural aging process. Out of all of these problems, dental diseases, along with their associated problems, must be handled as quickly as possible so the patient is more comfortable.
Some dental problems may occur because of the disease, and other become present as a result of the medication that is taken to manage the disease. In addition, some of the problems that are associated with Parkinson’s can make it challenging for patients to properly care for their teeth.
The Causes For Dental Problems With Parkinson’s
Rigidity, tremors and other motor problems can make it very difficult for Parkinson’s patients to brush and floss their teeth correctly. If they do not receive proper assistance, they may become unable to take part in a routine daily dental hygiene program at home. As a result, they may suffer with tooth decay.
There are also some drugs that are taken for the treatment and management of Parkinson’s can cause the patient to develop dry mouth, xerostomia. The diminished presence or lack of saliva in the mouth is one cause of periodontal disease and tooth decay. It is essential to have saliva in the mouth to keep bacteria from growing in the mouth. This bacteria can lead to tooth decay.
If this is the case, the patient may be advised to drink water more frequently, place Vaseline on their lips and chew sugar free gum often to keep saliva levels high in the mouth. It is important that the patient does not smoke because smoking can make dryness increase in the mouth.
Dental procedures that are necessary for the patient may become complicated to perform if the patient has extremely rigid muscles. Tremors and agitation can also make the completion of dental procedures difficult if the patient is not able to remain still.
It is also common for some Parkinson’s patients to develop a sweet tooth. As they begin to increase their consumption of carbohydrates and refined sugar, their chances of developing tooth decay also increases.
Drooling is another commonly seen symptom in patients with Parkinson’s. The disorder affects the patients ability to completely swallow the saliva out of their mouth. An accumulation of saliva can complicate sores and cracks on the sides of the mouth. If the cracks become infected, it can become difficult for the patient to eat or talk.
Considerations For Dental Management And Treatment
The goal of providing dental treatments to Parkinson’s patients is to minimize the adverse outcomes of tremors and rigidity. It is also advised to avoid any drug interactions.
The most important consideration for the patient with Parkinson’s is to maintain open communication about their dental health and the implications of dental disease.
The dental team must also make an assessment to determine how well the patient can care for the teeth on their own, and if they could benefit from any dental aids and adaptations. These tools can aid in better self-care. Nutrition and diet counseling may also be beneficial. The dentist may also want to schedule the patient for more follow up appointments throughout the year.
Whenever it is possible, self-care should be encouraged. However, it may be necessary to train caregivers and family members to ensure good oral hygiene is maintained.
The treatment plan should always correlate with the level of motor and physical impairment the patient has. It is also important, however, that a pragmatic approach is taken with the patient’s dental health as soon as they receive a diagnosis of Parkinson’s. This will help to ensure that the patient’s oral health is cared for early before it is more difficult to provide care later on.
All of the patient’s appointments should be booked at a time when the medications they are taking have reached optimal levels in their body. This generally occurs after 2 to 3 hours of taking the medicine. Mild sedation and soft restraints on the arms may help mitigate any undesired movements like tremors during treatment.
It may also be necessary to cradle the patient’s head to provide more stability during treatment, and mouth props may also be used during treatment.
If there are impaired swallowing capabilities in the patient, airway protection can be used. Rubber dams are commonly used in these types of cases. A rubber dam will help to minimize any risk of pulmonary aspiration due to debris and/or saliva.
Patients with Parkinson’s require special considerations during in-home dental hygiene and during professional dental visits. You should speak with your dentist ahead of time to discuss any special requirements and considerations.