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Baram S, Rosing K, Bakke M, Karlsborg M, Øzhayat EB. Dental care utilization among persons with Parkinson's disease in Denmark. Community Dent Oral Epidemiol 2023; 51:527-534. [PMID: 36317764 DOI: 10.1111/cdoe.12809] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/07/2022] [Accepted: 10/21/2022] [Indexed: 05/22/2023]
Abstract
OBJECTIVES Persons with Parkinson's disease (PD) have a higher prevalence of oral diseases and orofacial dysfunction, but knowledge about the use of dental care and whether their dental care needs are met is sparse. This study aimed to investigate the dental attendance and usage of dental care services of the total PD population in Denmark and compare it with a control group. METHODS National registers were used to identify the total PD population in Denmark (n = 6874) and to obtain data on their dental care from 2015 to 2019. These data were compared with a five-fold age-, gender- and geographically matched control group without PD (n = 34 285). Register data on age, gender, civil status, educational level, income, nursing homes status and mortality were also collected and adjusted for in the analyses. The dental attendance was analysed using χ2 -test with Bonferroni correction, and the type of dental care services was analysed using negative binomial regression analysis. RESULTS A significantly higher proportion of persons with PD were irregular attenders of the dental care system (21.0%), compared with the control group (16.9%). Persons with PD had a significantly higher overall usage of dental cares services. Most prominent was the high usage of treatment services, where persons with PD had a 1.50 times higher incidence rate of tooth extractions and a 1.71 times higher incidence rate of tooth fillings in the five years compared with the control group. CONCLUSION Persons with PD are more often irregular users of dental care and receive more treatment services than the control group. This indicates a need for high-quality prophylactic initiatives to prevent high filling and tooth extraction rates. Furthermore, this knowledge can be used by clinicians and decision makers to ensure optimal dental care for persons with PD.
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Affiliation(s)
- Sara Baram
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Rosing
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Bakke
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Karlsborg
- Department of Neurology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Esben Boeskov Øzhayat
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Auffret M, Meuric V, Boyer E, Bonnaure-Mallet M, Vérin M. Oral Health Disorders in Parkinson's Disease: More than Meets the Eye. JOURNAL OF PARKINSONS DISEASE 2021; 11:1507-1535. [PMID: 34250950 PMCID: PMC8609694 DOI: 10.3233/jpd-212605] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Despite clinical evidence of poor oral health and hygiene in Parkinson’s disease (PD) patients, the mouth is often overlooked by both patients and the medical community, who generally focus on motor or psychiatric disorders considered more burdensome. Yet, oral health is in a two-way relationship with overall health—a weakened status triggering a decline in the quality of life. Here, we aim at giving a comprehensive overview of oral health disorders in PD, while identifying their etiologies and consequences. The physical (abnormal posture, muscle tone, tremor, and dyskinesia), behavioral (cognitive and neuropsychiatric disorders), and iatrogenic patterns associated with PD have an overall detrimental effect on patients’ oral health, putting them at risk for other disorders (infections, aspiration, pain, malnutrition), reducing their quality of life and increasing their isolation (anxiety, depression, communication issues). Interdisciplinary cooperation for prevention, management and follow-up strategies need to be implemented at an early stage to maintain and improve patients’ overall comfort and condition. Recommendations for practice, including (non-)pharmacological management strategies are discussed, with an emphasis on the neurologists’ role. Of interest, the oral cavity may become a valuable tool for diagnosis and prognosis in the near future (biomarkers). This overlooked but critical issue requires further attention and interdisciplinary research.
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Affiliation(s)
- Manon Auffret
- Behavior & Basal Ganglia Research Unit (EA 4712), University of Rennes 1, Rennes, France.,Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France
| | - Vincent Meuric
- INSERM, INRAE, Université de Rennes 1, CHU de Rennes, Nutrition Metabolisms and Cancer, Rennes, France
| | - Emile Boyer
- INSERM, INRAE, Université de Rennes 1, CHU de Rennes, Nutrition Metabolisms and Cancer, Rennes, France
| | - Martine Bonnaure-Mallet
- INSERM, INRAE, Université de Rennes 1, CHU de Rennes, Nutrition Metabolisms and Cancer, Rennes, France
| | - Marc Vérin
- Behavior & Basal Ganglia Research Unit (EA 4712), University of Rennes 1, Rennes, France.,Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France.,Movement Disorders Unit, Neurology Department, Pontchaillou University Hospital, Rennes, France
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Kaka S, Lane H, Sherwin E. Dentistry and Parkinson's disease: learnings from two case reports. Br Dent J 2019; 227:30-36. [DOI: 10.1038/s41415-019-0470-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Jeter CB, Rozas NS, Sadowsky JM, Jones DJ. Parkinson's Disease Oral Health Module: Interprofessional Coordination of Care. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2018; 14:10699. [PMID: 30800899 PMCID: PMC6342393 DOI: 10.15766/mep_2374-8265.10699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 02/21/2018] [Indexed: 06/09/2023]
Abstract
Introduction Patients with Parkinson's disease (PD) suffer progressive neurodegeneration and experience motor and nonmotor symptoms. Oropharyngeal dysfunctions are increasingly recognized as nonmotor PD symptoms that negatively impact a patient's quality of life. This module was primarily created to update dental health professionals and educate dental students on the oral health needs of patients with PD, with an emphasis on interprofessional collaboration and evidence-based dentistry. The module may also benefit other health professionals from different disciplines working with patients with PD. Methods The module was developed to be delivered in one 55-minute large-group session followed by a short assessment and case study discussion. Associated materials include PowerPoint slides with transcript, a narrated video version of the PowerPoint lecture, a quiz, and the case study. Thirty-four first-year dental students were invited to watch the narrated presentation, complete a pre-/postsurvey, and take the quiz. Results All participants agreed dental schools should provide education regarding oral health in patients with neurological disorders, as only 29% of them had previously taken a related class. After watching the presentation, students reported that most of the information was new content and that the difficulty level met their expectations. All students reported that the lecture increased their interest in interprofessional collaboration. In a quiz taken immediately after the presentation, the class average grade was 82.7, with 94% of the class passing the quiz with a grade of 70 or more. Discussion Educating dental professionals regarding care of patients with PD must emphasize interprofessional collaborations among health care providers.
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Affiliation(s)
- Cameron B. Jeter
- Assistant Professor, Department of Diagnostic and Biomedical Sciences, School of Dentistry, University of Texas Health Science Center at Houston
| | - Natalia S. Rozas
- Research Assistant II, Department of Diagnostic and Biomedical Sciences, School of Dentistry, University of Texas Health Science Center at Houston
| | - June M. Sadowsky
- Associate Professor, Department of General Dentistry and Dental Public Health, School of Dentistry, University of Texas Health Science Center at Houston
- Dentist Geriatrician, Department of General Dentistry and Dental Public Health, School of Dentistry, University of Texas Health Science Center at Houston
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Abstract
Individuals with Parkinson's disease present a challenge to dental clinicians as this degenerative disease leads to problems accessing care and maintaining an adequate level of oral health. This article provides an overview of the implications of Parkinson's disease on oral health and explores the role of dental implants in the management of such patients.
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Talwar M, Malik G. Oral health considerations for the elderly – problems and management strategies. Indian J Dent 2013. [DOI: 10.1016/j.ijd.2011.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ameer N, Palaparthi R, Neerudu M, Palakuru SK, Singam HR, Durvasula S. Oral hygiene and periodontal status of teenagers with special needs in the district of Nalgonda, India. J Indian Soc Periodontol 2013; 16:421-5. [PMID: 23162340 PMCID: PMC3498715 DOI: 10.4103/0972-124x.100923] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 02/15/2012] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess oral hygiene status, oral hygiene practices and periodontal status among 14-17-year-old visually impaired, deaf and dumb, intellectually disabled and physically challenged and normal teenagers in the district of Nalgonda, South India. MATERIALS AND METHODS Seven hundred and fifty teenagers in the age group of 14-17 years, constituting visually impaired, deaf and dumb, intellectually disabled, physically challenged and normal teenagers, were studied. Oral hygiene status and periodontal status were assessed using clinical indices and compared. RESULTS Among the five groups chosen for the study, the intellectually disabled group had the highest plaque scores and poor oral hygiene. The visually impaired and deaf and dumb had better oral hygiene compared with other disability groups. Physically handicapped showed higher loss of attachment scores and deleterious and parafunctional habits. Normal teenagers had good oral hygiene and lower plaque scores. Oral health status relied basically on proper use of oral hygiene aids and training of the groups by their care takers. CONCLUSION Disabled groups showed poor oral hygiene and higher incidence of periodontal disease, which may be attributed to the lack of coordination, understanding, physical disability or muscular limitations. Hence, more attention needs to be given to the dental needs of these individuals through ultimate, accurate and appropriate prevention, detection and treatment.
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Affiliation(s)
- Nazia Ameer
- Department of Periodontics and Implantology, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, Andhra Pradesh, India
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Abstract
BACKGROUND More than 1.5 million Americans have Parkinson disease (PD), and this figure is expected to rise as the population ages. However, the dental literature offers little information about the illness. TYPES OF STUDIES REVIEWED The authors conducted a MEDLINE search using the key terms "Parkinson's disease," "medical management" and "dentistry." They selected contemporaneous articles published in peer-reviewed journals and gave preference to articles reporting randomized controlled trials. RESULTS PD is a progressive neurodegenerative disorder caused by loss of dopaminergic and nondopaminergic neurons in the brain. These deficits result in tremor, slowness of movement, rigidity, postural instability and autonomic and behavioral dysfunction. Treatment consists of administering medications that replace dopamine, stimulate dopamine receptors and modulate other neurotransmitter systems. CLINICAL IMPLICATIONS Oral health may decline because of tremors, muscle rigidity and cognitive deficits. The dentist should consult with the patient's physician to establish the patient's competence to provide informed consent and to determine the presence of comorbid illnesses. Scheduling short morning appointments that begin 90 minutes after administration of PD medication enhances the patient's ability to cooperate with care. Inclination of the dental chair at 45 degrees, placement of a bite prop, use of a rubber dam and high-volume oral evacuation enhance airway protection. To avoid adverse drug interactions with levodopa and entacapone, the dentist should limit administration of local anesthetic agents to three cartridges of 2 percent lidocaine with 1:100,000 epinephrine per half hour, and patients receiving selegiline should not be given agents containing epinephrine or levonordefrin. The dentist should instruct the patient and the caregiver in good oral hygiene techniques.
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Packer M, Nikitin V, Coward T, Davis DM, Fiske J. The potential benefits of dental implants on the oral health quality of life of people with Parkinson's disease. Gerodontology 2009; 26:11-8. [PMID: 19278520 DOI: 10.1111/j.1741-2358.2008.00233.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To investigate how dental implants impact on the oral health quality of life of people with Parkinson's disease (PD). BACKGROUND PD is a progressive neurological disorder that can result in a number of oral health care challenges, including denture difficulties. Lack of evidence related to use of implants in PD prompted this study to investigate their use in this group of people. MATERIALS AND METHODS Nine people with PD were provided with either fixed or removable prostheses using Astra-Tech implants. Participants completed the socio-dental questionnaire, 'The Dental Impact on Daily Living Assessment' (DIDL) prior to implant surgery, and at 3 and 12 months after provision of the final prosthesis. DIDL comprises two components - the Oral Health Quality of Life Inventory (OH-QoL) and the Self-Reported Assessment of Oral Health and Functional Status (SROH). RESULTS Nine people (with an age range of 54-77 years) had implants placed. The implant success rate was 85 and 81% in the maxilla and mandible, respectively. The OH-QoL and SROH results (analysed using the one-way analysis of variance and pairwise multiple comparisons) demonstrated a significant improvement in the domains of eating and satisfaction with the prosthesis after 3 months, which was maintained at the twelve month review. The OH-QoL indicated a gradual improvement in oral well-being over the 12-month period. CONCLUSION The oral health quality of life of people with PD was improved by the use of dental implants, indicating this as a viable treatment option.
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Affiliation(s)
- Mark Packer
- Department of Prosthetic Dentistry, King's College London Dental Institute at King's Hospital, London, UK
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Dougall A, Fiske J. Access to special care dentistry, part 9. Special care dentistry services for older people. Br Dent J 2009; 205:421-34. [PMID: 18953303 DOI: 10.1038/sj.bdj.2008.891] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This article looks at three common neurological conditions associated with later years: stroke, Parkinson's disease and dementia. All of them impact on oral health, access to dental services and delivery of dental care, and treatment goals need to be adapted to take into account patients' changing needs, medical status, pattern of recovery or the stage of dementia that they have reached. The article concludes by considering the topic of elder abuse. The dental team may have a role both in identifying abuse and ensuring appropriate action is taken.
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Affiliation(s)
- A Dougall
- Division One/Special Care Dentistry, Dublin Dental School and Hospital, Lincoln Place, Dublin 2, Ireland
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Scully C, Ettinger RL. The influence of systemic diseases on oral health care in older adults. J Am Dent Assoc 2007; 138 Suppl:7S-14S. [PMID: 17761840 DOI: 10.14219/jada.archive.2007.0359] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OVERVIEW Systemic diseases are more common in older adults than in younger people, even among those who are functionally independent. Dentists should understand how these diseases can affect the dental care of their aging patients. The authors review some of the management issues associated with selected systemic diseases common in older adults who are functionally independent. CONCLUSIONS To provide good oral health care, dental professionals must understand the special needs of older people and their ability to undergo and respond to care; they should work closely with the rest of the health care team; and they should be prepared to manage emergencies. CLINICAL IMPLICATIONS Many older people have a variety of systemic diseases that have an impact on their oral health care. The dentist may need to consult with the patient's physician to develop an appropriate treatment plan.
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Affiliation(s)
- Crispian Scully
- University College London Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD, England.
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Lobbezoo F, Naeije M. Dental implications of some common movement disorders: a concise review. Arch Oral Biol 2006; 52:395-8. [PMID: 17125732 DOI: 10.1016/j.archoralbio.2006.09.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2006] [Revised: 09/07/2006] [Accepted: 09/09/2006] [Indexed: 12/21/2022]
Abstract
Movement disorders - or dyskinesias - are characterized by involuntary movements. Despite the major role for medical specialists in the diagnosis and treatment of dyskinesias, dentists are confronted with such disorders as well. Unfortunately, the literature regarding the dental implications of movement disorders is still scarce. This concise review describes the dental implications of some common dyskinesias, viz., Gilles de la Tourette's syndrome, Huntington's disease, idiopathic torsion dystonia, oral dyskinesias, and Parkinson's disease. It was concluded that these dyskinesias may have profound dental implications. Not only do generalized dyskinesias have focal manifestations in the orofacial region, but there are also dyskinesias that exclusively affect the orofacial area. The oral manifestations of dyskinesias are in part directly related to the disorder, and in part medicine-related. Dentists should be able to recognize the oral manifestations and, when properly trained, to manage them adequately. In most instances, a multidisciplinary approach upon referral is necessary, including the medical specialists involved. Unfortunately, the level of evidence of the selected papers was generally low. In our rapidly ageing population, it is a challenge for all of us to improve the quality of this emerging field, for the sake of this sometimes heavily infirmed category of patients.
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Affiliation(s)
- Frank Lobbezoo
- Department of Oral Function, Section of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA Amsterdam, The Netherlands.
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Gill Y, Scully C. Attitudes and Awareness of Final-Year Predoctoral Dental and Medical Students to Medical Problems in Dentistry. J Dent Educ 2006. [DOI: 10.1002/j.0022-0337.2006.70.9.tb04170.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Yehuda Gill
- University of Witwatersrand; Johannesburg South Africa
- Eastman Dental Institute for Oral Health Care Sciences and International Centres for Excellence in Dentistry; WHO Collaborating Centre for Disability, Culture and Oral Health
- University College London, University of London
| | - Crispian Scully
- Eastman Dental Institute for Oral Health Care Sciences and International Centres for Excellence in Dentistry; WHO Collaborating Centre for Disability, Culture and Oral Health
- University College London, University of London
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Abstract
BACKGROUND: Oral health conditions and related factors of patients with Parkinson’s disease (PD) have not been well elucidated. The aim of the present study was to investigate oral health conditions and related factors which may influence oral health conditions among patients with PD. METHODS: We compared oral health conditions and related factors between 104 PD patients and 191 inhibitants (controls) who received dental health check-ups in Hokkiado, Japan. The unconditional logistic regression model was used for adjusting for sex and age. We also conducted stratified analysis by sex and age group using this model. The χ2 test and the Cochran-Mantel-Haenzel test were used for simple and stratified analyses of knowledge of oral health among PD patients, respectively. RESULTS: In the present survey, we found the following results. (1) PD patients had more complaints of chewing difficulties and denture discomfort than controls. (2) Fewer PD patients had their own teeth than controls regardless of sex. (3) Fewer PD patients cleaned their dentures every day than controls, regardless of sex or age. (4) More than half of the PD patients had problems with swallowing. CONCLUSION: We found that PD patients had more complaints about their oral health and more problems in oral health behavior than the general population. These findings may provide useful information for the caregivers of PD patients to conduct oral health care as well as for making oral health plans for PD patients and for medical and welfare services.
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Abstract
There is growing recognition that gastrointestinal dysfunction is common in Parkinson's disease (PD). Virtually all parts of the gastrointestinal tract can be affected, in some cases early in the disease course. Weight loss is common but poorly understood in people with PD. Dysphagia can result from dysfunction at the mouth, pharynx, and oesophagus and may predispose individuals to aspiration (accidental inhalation of food or liquid). Gastroparesis can produce various symptoms in patients with PD and may cause erratic absorption of drugs given to treat the disorder. Bowel dysfunction can consist of both slowed colonic transit with consequent reduced bowel-movement frequency, and difficulty with the act of defecation itself with excessive straining and incomplete emptying. Recognition of these gastrointestinal complications can lead to earlier and potentially more effective therapeutic intervention.
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