It is estimated that almost half of people with Parkinson's have dental issues. This may be due to the physical effects of PD (rigidity, bradykinesia, akinesia, etc.) that make it difficulty to maintain proper dental hygiene. Poor oral health has been associated with other health conditions like heart disease and diabetes. Learning how to have good dental hygiene and health is important, especially if you have Parkinson's.
Why do people with PD have a harder time maintaining good oral hygiene?
Difficulty maintaining saliva. Many people with PD report drooling or excessive saliva. This can lead to fungal infections at the corners of the mouth.
Difficulty swallowing. This tends to come hand in hand with difficulty maintaining saliva. Poor swallowing can lead to food left in teeth.
Dry mouth. PD medications can sometimes cause dry mouth. Too little saliva can increase the risk of cavities. Cavities can lead to increased bacteria that has the potential to enter the blood stream and spread throughout the body.
Dyskinesias of the jaw. These involuntary movements can sometimes lead to cracked teeth or grinding of the teeth, impacting the integrity of you teeth.
Movement symptoms. Rigidity and tremor can impact a persons ability to brush and floss their teeth thoroughly enough to maintain good hygiene.
Non-movement symptoms. Apathy, depression, forgetfulness, and cognitive changes are all non-motor symptoms that can influence someone's ability to take care of their dental health.
Nutrition. People with PD tend to experience a decreased appetite but especially for those with dyskinesias, people with PD require a greater caloric intake. Poor diet/nutrition can influence the health and strength of your teeth.
How to improve dental health
Stay hydrated! Dehydration can lead to poor oral health. Drinking water helps wash out any food left over and helps dilute acids from plaque, food, and other beverages to help protect your teeth.
Use a toothbrush with a large handle grip and soft bristles. A smaller head brush is thought to reach the corners of your teeth better.
Use an electric toothbrush if you have difficulty with regular toothbrushes. Make sure the toothbrush is oscillating and rotating.
Brush after every meal for 2 minutes. If you cannot brush after every meal, try rinsing your mouth with water until you can brush your teeth. This includes dentures.
Avoid any products with alcohol if you have dry mouth. Toothpastes and mouthwash with alcohol can make your dry mouth worse.
Avoid mouthwash if you have difficulty with swallowing. Mouthwash can increase your risk of choking if your symptoms are impacting your ability to swallow or chew at all. Talk with your neurologist if you are unsure if you are safe to use mouthwash.
Floss. If flossing is too difficult, use a water pick instead!
Tell your dentist you have Parkinson's. This may seem silly, but make sure everyone is on the same page. If you do not have a tremor or any dyskinesias, your dentist might not notice you have PD. Tell your dentist if you are taking an MAO-B inhibitor (rasagiline or selegiline), as sometimes these medications can interact with anesthetics. If you struggle with swallowing, ask to keep the dental chair more upright. This makes it easier to swallow.
Schedule your dentist appointment 60-90 minutes after your medication dose. This makes sure you are on your "on" time. This may vary with different medications.
Consider scheduling more appointments throughout the year. Scheduling your appointments like every 3-6 months instead of just 6 months.
If you wear dentures, your dentist should screen you for oral cancer and evaluate the fit of your dentures every time you go to the dentist.
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