Q: How Can Occupational Therapy Treatment Improve Oral Health
Occupational therapists specialize in improving fine motor control with exercise and adaptive modifications. By following instructions and recommendations from your occupational therapist, you can improve your ability to perform oral care and many other common daily activities . Consider asking your doctor for a referral to an occupational therapist to see if there are ways to improve your ability to brush and floss your teeth.
Incorporating adaptive tools into your dental routine can also improve your oral care. For example, electric toothbrushes are an easy way to incorporate adaptive tech into your daily routine. As an added bonus, many of these toothbrushes have handles that are easier to hold and grip. A number of electric toothbrushes offer timers that beep every 30 seconds to remind you to move on to another quadrant of your mouth so you brush for the recommended length of two minutes.
Another simple way to alleviate symptoms of dry mouth is to stay properly hydrated. Every healthy adult should drink 8 to 10 pint sized glasses of water each day in addition to incidental liquids obtained through food and other sources.
Tip!
Keep a water bottle with a tight fitting lid nearby so you can take small sips throughout the day to increase your water intake. This additional hydration will also improve medication efficiency and potentially improve symptoms of orthostatic hypotension .
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.
Dental Health In Parkinsons
Regular visits to the dentist are important for all of us. For a person with Parkinsons disease , dental care is particularly critical as PD can impact the health of the mouth, teeth and jaw and make dental care challenging. Poor dental hygiene can affect nutrition and increase risk for stroke, cognitive impairment and weight loss. People of all ages with PD face similar challenges, but for those who are older, the problems can be especially serious. Read below and follow the tips to enjoy eating foods you prefer for as long as possible, rather than limiting yourself to what your teeth will tolerate.
Barriers to Dental Health in PD
Physical Barriers:Because of the physical effects of Parkinsons, such as rigidity and tremor, nearly half of all people with PD have difficulty with their daily oral hygiene regimen. These symptoms also make going to the dentist more difficult and uncomfortable. Weakened swallowing ability can increase the risk of aspiration during treatment. Additionally, people with PD who have been on medications like levodopa for several years may begin to develop dyskinesias , which can affect the jaw and cause cracked teeth and teeth grinding. This may create problems during dental exams and at home.
Behavioral Barriers
People who experience cognitive changes also may be more likely to miss dental appointments and less likely to report dental pain to their care partners or dentist, leaving issues unaddressed for too long.
Maintaining Dental Care at Home
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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.
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Practical Tips For Effective Oral Self
Nearly half of all people with PD have difficulty with their daily oral hygiene regimens.3 Dental hygienists should provide patients with explicit instructions to help them maintain good oral hygiene. These instructions should be provided in both written and verbal forms to patients and caregivers.15
Dental hygienists should recommend that patients sit down to brush and floss. This not only reduces the risk of falling, but also helps conserve energy. A shower or commode chair works well for this. Patients can prop their elbows up on the bathroom sink if their shoulders tire easily.16
Patients with PD?may be better served with a power toothbrush or manual toothbrush specially designed for those with limited dexterity. Oral devices can be made easier to hold by attaching a tennis ball on the end of the handle. A dental water jet to provide at-home irrigation may also be helpful. Floss threaders, floss holders, other adjuncts used with traditional floss, and interdental brushes may improve the efficacy of flossing, as well as compliance.
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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.
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 .
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Dental Risks Related To Pd
Oral health problems arise directly and indirectly from the progression of Parkinsons. PD-related dental challenges may include:
- Too much saliva. Excessive saliva can lead to a fungal infection at the corners of the mouth.
- Too little saliva. Also known as dry mouth, too little saliva can increase the risk of cavities.
- Cavities. A cavity is a breeding ground for bacteria that can easily infiltrate the blood stream and harm other parts of the body.
- Infected teeth and gums. Your mouth can harbor bacteria that may infect devices, such as deep brain stimulation electrodes, prosthetic hips and knees, vascular stents and grafts.
- Altered face and tongue muscle function. These conditions may affect speech and chewing.
- Swallowing problems. Poorly chewed food can increase the risk of choking and aspiration.
If you take a medicine with a warning to tell your doctor about infections, make sure to report cavities, loose teeth or inflamed gums. Some immune-suppressing medications can significantly reduce white blood cells, which increases the risk for bacteria-causing dental diseases to spread elsewhere.
Barriers to Dental Health in PD
Symptoms of PD may hinder your ability to maintain proper oral hygiene, and can potentially worsen dental problems.
Non-movement Symptoms
10 Tips for Improving Dental Health
Follow these tips to keep your oral health in check while managing PD:
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Selection Of Studies And Data Extraction
Two authors independently reviewed the title and abstracts recovered through the search using the Rayyan platform . References identified as potentially eligible were analyzed in full text. Any disagreement was resolved by a third reviewer.
Data extraction from the studies included was performed by four independent reviewers using a pre-established data extraction form. The data gathered comprised the main characteristics of the studies included . Any disagreement was resolved by two other review authors.
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Impacted Tooth In Sinus With Dental Decay As Seen By 3d
Using a local anesthetic, the tooth was removed from the sinus area being careful to not disturb the maxillary tuberosity, sinus cavity, #15 crown and fracture the endodontic treated roots of #15. Lots of controlled force was used for this difficult impaction. A foul odor with pus and a significant amount of granulation tissue were evacuated from the sinus floor. The other high risk to be on the lookout will be the formation of an oro-antral communication in this elderly man who has a chronic infection.
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Considerations For Dental Management And Treatment
The goal of providing dental treatments to Parkinsons patients is to minimize the adverse outcomes of tremors and rigidity. It is also advised to avoid any drug interactions.
The most important consideration for the patient with Parkinsons is to maintain open communication about their dental health and the implications of dental disease.
The dental team must also make an assessment to determine how well the patient can care for the teeth on their own, and if they could benefit from any dental aids and adaptations. These tools can aid in better self-care. Nutrition and diet counseling may also be beneficial. The dentist may also want to schedule the patient for more follow up appointments throughout the year.
Whenever it is possible, self-care should be encouraged. However, it may be necessary to train caregivers and family members to ensure good oral hygiene is maintained.
The treatment plan should always correlate with the level of motor and physical impairment the patient has. It is also important, however, that a pragmatic approach is taken with the patients dental health as soon as they receive a diagnosis of Parkinsons. This will help to ensure that the patients oral health is cared for early before it is more difficult to provide care later on.
It may also be necessary to cradle the patients head to provide more stability during treatment, and mouth props may also be used during treatment.
Communication With Your Dentist
As I mentioned before, I was recently at the dentist to remove some bad teeth that had broken and were giving me trouble. I knew deep down the importance of healthy teeth and the adverse health effects overall if I waited. So, I chose a dentist based on a recommendation by my neurologist, with whom he consulted with regarding sedation and other precautions.
This gave me a little less anxiety, but I feared the pain and anguish of drooling all over myself. Which I did! But I digress. After the procedure, I was prescribed appropriate pain medication and given instructions that would avoid infection.
Looking back at the whole experience, I needed to address two real problems: the importance of oral health in general and, ensuring the dentist is understanding and accommodating for people with Parkinsonâs. I cant say that I am for sure dento-phobic, but I am assured that my dentist understands my Parkinsons and accommodates me accordingly.
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Dental Treatment Of Patients With Stroke Residual
In patients who have experienced physical deficits , personal oral hygiene efforts may be compromised. Treatment planning should include the following:
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Comprehensive oral hygiene instruction that may include instruction on use of an electric toothbrush or a large hand-held toothbrush or water irrigation instrument coupled with plaque-revealing tablets running a washcloth through the vestibule can help to reduce accumulation of food matter
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Recommendation regarding anticaries preparations, including rinses containing fluoride and xylitol or the use of xylitol lozenges to help reduce the oral bacterial burden of Streptococcus mutans
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The possible need for an antifungal prescription, as the accumulation of saliva in patients with facial palsy may be problematic at the corners of the mouth and can predispose the patient to fungal infection
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Awareness that depending on the type of stroke, the poststroke patient may have been prescribed anticoagulant medication
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Increased Inflammation Of The Gums And Periodontal Disease
Due to the presence of teeth plaque and tartar, gums can become inflamed. The gums look red, bleed easily , and can feel painful. When the plaque is removed, the gums mostly recover. However, when not only the gums are infected, but also the underlying alveolar bone , it is called periodontal disease. When you suffer from periodontal disease, the alveolar bone weakens, and as a result teeth can become loose and eventually fall out. This process is irreversible. Inflammation of the gums and periodontal disease can be prevented by good oral hygiene and regular professional teeth cleaning. Smoking has a strongly negative effect on the gums and the periodontal system.
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The Basics Of Oral Health And Parkinsons
Every year, the top Parkinsons experts from around the world who treat people with Parkinsons at a Parkinsons Foundation-designated Center of Excellence convene to discuss the latest Parkinsons research and treatments. This article summarizes the 2018 Center Leadership Conference presentation on oral health by neuroscientist Cameron Jeter, PhD, The University of Texas Health Science Center at Houston speech-language pathologist Linsey Heidrick, MA, CCC-SLP, University of Kansas Medical Center geriatric dentist Marsha Pyle, DDS, University of Missouri-Kansas City and moderator Irene Litvan, MD, UC San Diego School of Medicine. Read the articles covering some of the other topics discussed: intimacy issues, art therapy, new therapies in trial and music therapy.
Maintaining oral health is important for people with Parkinsons disease . Parkinsons symptoms can easily complicate dental care. A panel of PD experts at a Parkinsons Foundation conference recently discussed oral health and saliva management two PD-related issues not discussed often enough.
When it comes to Parkinsons and oral health, the goals are to preserve dental health and minimize the negative impact disease treatment may have. People with PD commonly experience problems related to the four dreaded Ds of oral health:
Strategies For Improving Dental Care
It is easier to prevent a problem than to fix one.
Maintaining Dental Care at Home
Try using a toothbrush with a large-handled grip and soft bristles. A small brush head reaches the corners better. To make the toothbrush easier to grasp, place the handle inside a bike handlebar grip or tennis ball. Another option is to use an electric toothbrush. It will provide the fine, repetitive motions that protect teeth most effectively.
Aim to brush after every meal for two minutes, and also brush the tongue. Its best to brush one-handed, using the stronger side of the body. To be thorough, be organized and consistent with your brushing pattern. Start on one surface, going from right to left, or vice versa, before moving to the next. And dont rush! If its not possible to brush after a meal, simply rinsing the mouth with water will help. Flossing is important, but may mean getting help from a care partner.
Mouthwashes are discouraged for people with PD because of the risk of choking, but in cases where they are still an option, look for one that is non-alcohol based and that uses either chlorhexidine or baking soda. If swishing and spitting are difficult, the dentist may recommend a brush or sponge applicator. A fluoridated toothpaste or rinse can also be used. Fluoride helps increase the resistance of teeth to the harmful effects of bacteria. Prescription-strength, topical stannous fluoride gel treatments can also be a good preventive strategy, as directed by your dentist.
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