How Does Parkinsons Disease Affect Our Dental Health
Theprogressive movement disorder also affects the orofacial muscular system thatleads to problems like difficulties in chewing and swallowing. Likewise, theanti-parkinsonian medications also tend to create an imbalance in the pH ofsaliva. It leads to less salivary flow in PD patients than normal.
Such reduced salivation flow & hindered nutrient intake due to poor chewing will weaken your oral cavity. This is followed by the proliferation of harmful microbes in the mouth and ends in dental illnesses as follows:
As swallowingbecomes difficult due to compromised orofacial muscular system, it disruptssaliva production. Meanwhile, the muscles that seal lips also become weakennow. So they cannot control the saliva, causing excessive drooling.
On the other hand, the partnership of poor quality dental hygiene actions and the bacteria attacks weaken your oral cavity. For instance, researchers observed that people suffering from Parkinsons disease have higher chances of bone loss followed by plaque build-up than others.
Towards Better Assessment And Care
The oral health deserves more attention in PD than a sole assessment of dysphagia, sialorrhea and dysarthria. To overcome the limitations of the MDS-UPDRS scale as a measurement of PD orofacial symptoms , there is a need for better tools and questionnaires assessing all the oral symptoms associated with PD that could be used routinely by the neurologist and dental teams . Fully addressing these disorders is a first step for offering optimal treatment .
In general, patients and caregivers should be encouraged to be aware of oral symptoms and to report them during consultations. Specific PD patient-rated assessments of discomfort and oral health impact on quality of life should also be developed, to favor symptoms reporting during dental and neurology consults.
Quality Dental Care & Parkinsons Disease
Dr. Kurtzman and the staff at David Kurtzman, DDS have worked very hard to create a practice that provides safe, effective and pain free Atlanta dental care for patients with Parkinsons Disease. Our office is specially equipped to handle special care patients, however, it is safer to treat many patients with Parkinsons Disease in a hospital setting.
Dr. Kurtzman treats patients with Parkinsons Disease in specially equipped operating rooms at Wellstart Windy Hill and Kennestone Hospitals. In the hospital setting, patients are placed under general anesthesia by Anesthesiologists or specially trained Anesthetists under a doctors supervision. To assure the patients safety, the Anesthesiologist or Anesthetist monitors their health and breathing while they are under general anesthesia. Treating these special care patients in a hospital setting with close monitoring enables Dr. Kurtzman to provide them with effective, pain free dental care while at the same time ensuring their safety.
Dr. Kurtzman welcomes patients with Parkinsons Disease who are referred by other dental practices. In fact, patients with Parkinsons Disease travel from as far as South Georgia, Alabama and Tennessee to see Dr. Kurtzman. Dr. Kurtzman provides them with the special care they need and then returns them to their referring practice for recall and recare.
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What Causes Tooth Sensitivity After Getting A Dental Filling
Tooth sensitivity after placement of a filling is fairly common. Your tooth may be sensitive to pressure, air, sweet foods, or temperature. Usually, the sensitivity goes away on its own within a few weeks. Until then, avoid the cause of the sensitivity. You usually dont need to take a pain reliever.
Contact your dentist if the sensitivity doesnt go away within two to four weeks or if your tooth is extremely sensitive. He or she may recommend using a desensitizing toothpaste, may apply a desensitizing agent to the tooth, or possibly suggest a root canal procedure.
Negative Facts About Mercury:
- A Taiwan study found that people with amalgam fillings were 1.6 times more likely to get Parkinsons than those without exposure to them regardless of sex or age.References:
- Association between History of Dental Amalgam Fillings and Risk of Parkinsons Disease: A Population-Based Retrospective Cohort Study in Taiwan
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Mercury Fillings Implicated In Parkinson’s
Mercury, contained in millions of tooth fillings which are leaking toxic metals into our organism on a daily basis, has long been suspected of causing damage due to the inherent toxicity of the compound.
Note the scull and crossbones on this label for dental amalgam containing mercury and other metals.
Professor of physiology and biophysics Dr. Fritz Lorscheider of the University of Calgary, Canada, says he found and recorded the damage caused to neurons by the mercury contained in mercury amalgam fillings.
Now there is an indication of what may be the exact mechanism which is directly implicated in bringing about the symptoms of Parkinson’s disease. Prof. Galzigna, former holder of the chair of biochemistry of Padova University, has told an international biological dentristry congress held this weekend in Padova, Italy, that mercury has the capacity of transforming dopamine, a naturally present neurotransmitter in the brain, into a toxic compound called dopaminochrome.
Friday, 7 November 2003 15:42Accusing mercury in tooth fillings: it leads to Parkinson’s
Source: www.italiasalute.it
Here is the original as appeared on Yahoo News in Italian:
Venerdì 7 Novembre 2003, 15:42
Sotto accusa il mercurio per le otturazioni: provoca il Parkinson
Di Italiasalute.it
See also these related links:
Discover Magazine – March 2005: Our Preferred PoisonA little mercury is all that humans need to do away with themselves quietly, slowly, and surely
Dental Health Issues In People With Parkinsons Disease
ParkinsonsDisease is a neurological illness that infects the nerve cells in the brainresponsible for body movements. The disorder begins with the selectivedestruction of mesencephalic dopaminergic neurons and it is prevalent in peopleaged above 65 years. It affects both the motor & non-motor skills of ourbody and is characterized by instability, reduced dexterity, slowness ofmovement, dizziness, etc.
As it is amultisystem disorder and affects the spontaneous movements in arms, legs, andparts of our body, handling our daily activities will become burdensome. Forinstance, tooth brushing with a shaking hand will reduce the oral hygieneactivity quality. Right?
Besides this,such motor limitations will harm our oral cavity in certain other ways.
Many dentists do not have enough experience to treat dental illnesses in people with Parkinsons Disease. Based on our experience and research, we have explained the impact of this neurodegenerative disorder on oral health and tips to combat its aftereffects to an extent here.
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Increased Decay Of Teeth
Caries is caused by bacteria in teeth plaque. These bacteria change sugar into acid, which damages the teeth. To prevent caries, it is therefore important to limit the frequency and amount of sugar intake and to remove teeth plaque from teeth surface. Fluoride in toothpaste can contribute to stronger teeth. Recent research demonstrates that people with Parkinsons tend to have more dental caries than other people.
Advice to prevent caries includes:
- Try to limit sugary food to mealtimes only, and no more than four times a day.
- Limit sugary drinks to mealtimes only. Tea or coffee should be taken without sugar between meals.
- Do not rinse your mouth after brushing your teeth. This allows fluoride to continue to work to protect your teeth.
- Try to avoid eating or drinking for 30 minutes after brushing your teeth.
Georgia Dentist Who Treats Patients With Parkinsons Disease
Do you need to find a Georgia dentist who treats patients with Parkinsons disease Paralysis Agitans or Parkinsons Disease is a progressive condition resulting from a dopamine deficiency in the brain. Dopamine is a chemical that transmits messages from the brain to the muscles. Without sufficient amounts of dopamine, messages from the brain are disrupted.
Symptoms of Parkinsons Disease may include the following:
- Tremor or shaking when the body or limbs are at rest
- Slowness or difficult in beginning a voluntary movement
- Muscle stiffness or rigidity
- Impaired balance
Problems with shaking, muscle stiffness and muscle control make it very difficult and even dangerous for patients with Parkinsons Diseases disorder to receive dental care in a traditional dental office setting. Most dental practices are simply not equipped to safely treat these special care patients in performing complex dental work.
We offer the high quality comprehensive dental care previously available in a dental office only to able bodied and minded inviduals to Special Needs clients and their families in the safety and security of the hospital operating room. Our care extends from the oral care and dental care structure of the families and caregivers.
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Dental Care For People With Parkinsons Disease
Parkinsons disease is the second most common chronic and progressive neurodegenerative disease. It involves the neurons that are responsible for producing dopamine. Dopamine is a chemical that helps in transmitting messages between cells. Parkinsons onset is typically between 55 and 66 years of age. There is a rare form of the disease which has been known to occur in teenagers. Affecting about 1 in 1000 people, an average dental practice of 2000 patients may treat up to 4 patients diagnosed with Parkinsons disease.
This disorder is characterized by motor disturbances such as resting tremors, muscular rigidity, bradykinesia , and postural instability. In addition, there can be varying degrees of cognitive impairment, mood disturbances and psychosis in some instances, which is related to dopaminergic medications.
For this reason, it is often difficult for these patients to sit still in a dentists chair , therefore sedation dentistry offers a good solution to enable proper dental treatment. Managing a patient with Parkinsons entails diminishing any potential adverse consequences of tremors and muscle rigidity as well as avoiding drug interactions. These patients have a hard time opening their mouth for longer time and anxiety increases the Parkinsons symptoms.
Visit our practice to discuss your dental needs and concerns.
723 North Beers Street
Oral Health In Parkinsons Disease: A Complex Picture
Oral health is multidimensional , subjective, and dynamic. It is essential for daily functions like eating, swallowing, speaking, and socializing . These functions involve the action of the teeth, lips, cheeks, tongue, and oro-facial-pharyngeal muscles. The imbalance caused by motor , nonmotor, and sensory deficits in PD leads to a variety of orofacial manifestations . To date, there is no consensus regarding the most prevalent issues in PD patients, and results vary across studies . Several factors may account for these discrepancies , as many papers failed to adjust for clinical, environmental, and pharmaceutical variables. Differences are identified within study populations: gender, age, comorbidities, and subjects randomly selected or actively seeking dental treatment. Moreover, specific differences are also found within PD groups: idiopathic PD versus parkinsonism, PD stage, subtype, severity, and duration, antiparkinsonian medications, living at home versus institutionalized. The quality, accessibility and affordability of the healthcare systems also account for discrepancies. Other contributing factors are methodological: subjective and objective assessments, questionnaires, and ambiguous definitions. However, all studies but two point out towards a weakened or disturbed oral status with objective and subjective differences between PD patients and control groups.
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Problems Faced In Maintaining Good Oral Care At Home
Brushing, flossing, and interproximal brushing are critical components of oral self-care . These hygiene maneuvers require muscle-eye coordination, digital dexterity, and tongue-cheek-lip control. Such actions become more difficult to achieve as PD progresses, due to tremor of hands, lips and tongue, bradykinesia, dyskinesia of the hands and jaws, fluctuations, muscle stiffness, and postural deformities . Decline in the quality of the toothbrushing and lack of interdental cleaning reduce the efficacy of plaque control, promoting gingivitis, and initiating or aggravating periodontitis and dental caries. Moreover, such fine movement impairments induce more difficulties in the frequency and quality of prosthesis hygiene, leading to biofilm accumulation . Discomfort with mouthwashes, possibly due to dysphagia and fear of choking, has also been reported . These ineffective oral hygiene measures add to the pre-existing disturbed self-cleaning mechanisms of the mouth .
Finally, when present, neuropsychiatric disorders also contribute to patients difficulties: apathy, depression, fatigue, anosognosia, cognitive decline and dementia may all lead to negligence in daily care, making compliance with a home care regimen difficult .
Disadvantages Of Silver Fillings:
Silver fillings have many drawbacks. The edges of the silver filling can wear down, become weak or break. This results in the tooth not being protected and lets cavities get started once again. With age, the metal of a silver filling expands, contracts, and can split.
Silver fillings contain 50 percent mercury. They can corrode, leak and cause stains on your teeth and gums.
Fortunately, silver fillings can safely be replaced with Tooth-Colored Restorations.
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Safe Mercury Amalgam Removal Technique:
The International Academy of Oral Medicine and Toxicology has developed the Safe Mercury Amalgam Removal Technique protocol recommendations.The IAOMT website also has a searchable worldwide dentist databaseor check out Dr. McGuire’s database for a dentist with skills to meet the IAOMT protocol for removing amalgam fillings.
IAOMT Safe Mercury Amalgam Removal Technique protocol. Ignore the comment about taking chlorella as it is not a good chelator and will move rather than remove mercury.
Amalgam fillings can be replaced with porcelain inlays or onlays bonded to the tooth or with a composite. Be sure to use one of the newer bonding agents which do not contain Bisphenol A which is a bio-accumulative, xenoestrogen endocrine disrupting chemical which has estrogen hormone like properties.This is also true in choosing composite filling materials. Choose materials which are BPA-free.Also be sure to reduce your BPA exposure by choosing glass over canned food products and don’t microwave polycarbonate plastic food containers.Dental materials testing panel: Clifford Consulting and Research
Binders such as activated charcoal can be taken 20 to 30 minutes before the amalgam removal procedure starts for the purpose of attaching to any mercury particles that may be ingested.For more on binders, see below.
Removing dental mercury amalgam using the SMART protocol Dr McBride DDS
For more details and photos see the IAOMT SMART protocol for mercury amalgam removal.
Ratio NBMI:Hg is 1:1
Oral Health Is Poorer In Pd
Few international studies have been published on oral health in PD patients . Differences in methodologies, populations, and countries are notable, which complicates both the interpretation and comparison of results. However, while many of these studies do not represent large samples of patients , they highlight a concerning oral health deficit, with symptoms coexisting in different combinations. Despite being often underreported, these oral symptoms increase the overall disease burden as PD progresses . Compared to controls, PD patients appear to have a significantly weakened oral status , with periodontal diseases. 3and dental caries , leading to more mobile and missing teeth . Patients report more discomfort as well as chewing difficulties and dysphagia. They have a worse perception of their oral health , and a decreased oral health-related quality of life . Of interest, changes in the oral microbiota are also reported, though the significance and extent of such alterations, as well as their link with PD remain to be determined .
Table 1
Summary of the main findings found in international literature regarding oral health disorders in patients with Parkinsons disease . For detailed results, please refer to Supplementary Table 1
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Do I Need To See A Dentist Who Specializes In Parkinsons
Most dentists will be able to treat you regardless of how advanced your Parkinsons disease is. However, it is vital that you tell your dentist you have Parkinsons disease and the associated symptoms.Your dentist will suggest a routine adapted to the condition of your mouth in order to prevent, identify and treat the problems most often associated with Parkinsons disease. They will also be able to give you brushing techniques that are best suited for the condition of your mouth.
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What Are Indirect Fillings
Indirect fillings are similar to composite or tooth-colored fillings except that they are made in a dental laboratory and require two visits before being placed. Indirect fillings are considered when you dont have enough tooth structure remains to support a filling, but your tooth is not so severely damaged that it needs a crown.
During the first visit, decay or an old filling is removed. An impression is taken to record the shape of the tooth being repaired and the teeth around it. The impression is sent to a dental laboratory that makes the indirect filling. A temporary filling is placed to protect the tooth while your restoration is being made. During the second visit, the temporary filling is removed, and the dentist checks the fit of the indirect restoration. If the fit is acceptable, it will be permanently cemented into place.
There are two types of indirect fillings inlays and onlays.
- Inlays are similar to fillings but the entire work lies within the cusps on the chewing surface of the tooth.
- Onlays are more extensive than inlays, covering one or more cusps. Onlays are sometimes called partial crowns.
Inlays and onlays are more durable and last much longer than traditional fillings up to 30 years. They can be made of tooth-colored composite resin, porcelain or gold. Inlays and onlays weaken the tooth structure, but do so to a much lower extent than traditional fillings.
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