Symptoms of PD that May Affect the Provision of Oral Health Care

Patients diagnosed with PD routinely experience problems in the oral cavity such as oral motor and sensorimotor impairment, salivary dysfunction, dysphagia, burning mouth pain, loss of taste, and olfactory dysfunction.6,27,28 Factors such as medications, dry mouth, nutritional deficiencies, and functional deficiencies contribute to developing these problems.22,27 The ways these impairments could affect the provision of oral health care are listed in Figure 5. Dental providers must be attentive to these impairments because they may lead to inadequate oral self-care, poor oral health, decreased quality of life, and increased risk for developing oral infections such as caries, periodontal involvement, tooth mobility, and tooth loss.18,27,29-33 Dental providers must be attentive to salivary dysfunction (conditions of sialorrhea in conjunction with xerostomia) because this can increase problems with dysphagia and result in choking, sudden coughing, and “silent aspiration” pneumonia.27 Providers must also be attentive to the medications patients are taking and the length of time the patient has been taking each medication. Patients who have been taking levodopa for several years may begin to develop dyskinesia which can affect the jaw and create difficulty in safely accessing the patient’s mouth.6 Patients diagnosed with PD have high or extremely high caries risk and should be offered more frequent recare appointments, caries preventive measures such as fluoride varnish at every prophylaxis, and a prescription for fluoridated toothpaste (5000 parts per million) to use at home.22,34

Figure 5. Impairments that may affect the provision of oral health care.6,22,27,28,35
oral health care impairments