Dental & oral health

People with Parkinson’s often face several oral and dental health challenges.

Tooth decay & damage

Dental decay may result from plaque, the sticky film of bacteria and sugars constantly coating the teeth. Tooth brushing needs to be done regularly, either by alternating the brush in either hand or using an electric toothbrush.

Assistance with oral hygiene may help to ensure it is done effectively as the disease progresses.

Erosion, dyskinesia and grinding of teeth could also result in loss of tooth structure and sensitivity.

Gum disease

Gum disease, also known as gingivitis, is an inflammation of the gums. If left untreated, it can lead to periodontitis, a gum infection that damages soft tissues and destroys the bone supporting teeth.

Increased risk of infection arises from bacteria accumulating in gum pockets, entering the bloodstream and travelling to other areas of the body, Regular visits to the dentist are encouraged.

Loss of control of saliva

Sialorrhea, or drooling, occurs when there’s less control over saliva. This can happen if you have poor lip closure, altered mouth sensations, reduced swallowing, and changes in head and trunk posture. These issues can impact social confidence and hygiene.

Saliva that remains in the mouth and throat may enter the airway, increasing the risk of aspiration pneumonia.

Dry mouth

Also known as xerostomia, dry mouth results from reduced saliva production and flow. This can be caused by:

• Parkinson’s symptoms and medication side effects
• mouth breathing and swallowing less
• stress and anxiety
• not drinking enough water.

If medication side effects are determined to be a concern or are causing problems, this should be discussed with your care team and medical specialist.

Dry mouth can significantly impact your ability to chew and swallow, diminishing your enjoyment of food. It can also interfere with speech and lead to difficulties in swallowing medication. Additionally, dry mouth may cause bad breath, a burning sensation, tongue ulcers, cracked lips, gum disease, increased dental cavities, and mouth infections.

Saliva plays a crucial role in maintaining oral health by helping to wash away food particles and neutralise harmful acids produced by plaque bacteria. For those experiencing dry mouth, there are artificial saliva sprays available that can provide relief and help maintain oral hygiene.

Halitosis

Bad breath, or halitosis, can be caused by dry mouth, poor flossing or cleaning between teeth, gum disease, insufficient fluid intake, bacterial activity in the mouth and throat, postnasal discharge, and various medical conditions. A dentist can evaluate the underlying cause and recommend appropriate treatments.

Pain & burning of the mouth

Burning mouth syndrome (involving tongue, cheeks, and palate) without an overt cause is rare but can occur among people with Parkinson’s. There is some empirical evidence that this problem can be medication-related or can result from dry mouth.

Dopamine has been documented to be both potential cause and cure. The role of psychological factors such as stress, anxiety, and depression in burning mouth also remains unclear. Good oral health needs to be maintained.