Tuesday, May 14, 2024

Parkinson’s And Mouth Problems

Your Doctor May Be Able To Help You Find Relief

Parkinsons Disease – Speech and Swallowing Problems: Karen Kluin

There are several ways that your doctor may be able to help you combat this particular symptom, experts say. “Oral medications, botulinum toxin injections, surgical interventions, radiotherapy, speech therapy, and trials of devices may be used to treat sialorrhea in PD,” explains the Movement Disorders study, noting that more research is needed to fully understand the efficacy of those treatments.

Early interventions, such as physical therapy, may also help control sialorrhea, given that the underlying cause can sometimes be muscular. By working to maintain coordination in the face, mouth, tongue, and throat, you may be able to minimize the effects of these symptoms/

What Is Dry Mouth

Dry mouth is a common but often unreported symptom of PD. It is a condition that results in decreased saliva production.

Saliva is a liquid substance secreted by glands into the mouth, and it keeps our mouths wet and helps to clean it by swallowing. It is needed to maintain good oral health including strong, clean teeth and an infection-free mouth. It also contains enzymes that aid in digestion.

People may experience varying degrees of dry mouth, which can impact swallowing and contribute to tooth decay and mouth infections.3 Dry mouth can be an early indication of autonomic involvement in PD.2,4 It can affect your ability to speak and to eat. Some dry mouth conditions can lead to salivary gland dysfunction, resulting in more serious conditions.

Sialorrhea Isn’t A Symptom Of Parkinson’s Alone

If you do develop excessive salivation as an adult, Parkinson’s is considered the most likely cause, “with 70 to 80 percent of PD patients demonstrating sialorrhea,” according to a separate study published in Toxins in 2013.

However, there are several other reasons you may experience this symptom. Your doctor may wish to screen you for other neurological disorders, such as amyotrophic lateral sclerosis or cerebral palsy , or to review any medications you take which could cause sialorrhea as a side effect. In some cases, “Pathologic sialorrhea can be an isolated phenomenon due to hypersalivation,” which can be caused by problems in the salivary glands. If you notice any major changes in your swallow reflex or salivation, talk to your doctor to figure out the root causeParkinson’s or notas soon as possible.

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Vocalizations As Part Of Stereotypies

The precise definition of stereotypies and their exact phenomenological distinction from other repetitive motor behaviors, for example, tics, is difficult. The term denotes a repetitive, often continuous, non-goal-directed movement pattern that is typically distractible. As with echolalic behaviors, stereotypies are also part of physiological development that often abate within the first years of life. Although the persistence of stereotypic vocalizations may still be part of normal development, in many cases it signifies pathology, and indeed stereotypic utterances are part of the diagnostic criteria of ASD . One large case series of 83 patients with Rett syndrome described phonic stereotypies with repetitive sounds, words, or phrases in only 6% of patients. We recently observed loud stereotypic vocalizations in a patient with 15q13.3 microdeletion syndrome and late-treated cases with phenylketonuria. Further, stereotypic vocalizations have been documented in patients with schizophrenia.

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Origins Of Breathing Disorders

What is Parkinson

The book by Leon Chaitow and co-authors cited above explains how breathing disorders are intrinsically linked to chronic stress and anxiety. The shallow, fast chest breathing through the mouth is a hallmark of the body preparing itself for the exertion of flight or fight due to a stress response. While this adaptive in acute stress situations, when stress is chronic and the body is spending a lot of time in fight or flight, the associated pattern of breathing becomes habitual, and eventually the system gets stuck in the new equilibrium of the CO2 intolerant state. However, the vicious circle work both ways, because overbreathing itself puts the body into a stress response state and feeds anxiety. A very good tutorial about the two way links between anxiety and breathing patterns is given by Robert Litman in the video below.

It is not surprising therefore that people with PD can present with disordered breathing associated with chronic stress and anxiety, since there are very significant overlaps between the other symptoms of chronic stress and those of Parkinsons Diseases, and ingrained fight or flight behaviours are common to the pre-diagnosis background histories of people with PD. Conversely, it is important to note that techniques which have been developed to treat breathing disorders should also help to decrease the symptoms of PD, including reduction of anxiety and increasing resilience to stress.

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Towards New Diagnostic And Predictive Tools: Landmark Symptoms And Biomarkers

The chronology and combination of orofacial symptoms may give insights into disease progression . The Swedish Jönköping Parkinson Registry has recently highlighted that orofacial symptoms were correlated with PD severity, symmetry of motor disturbances, and autonomic disorders. The more severe orofacial burden was at baseline, the faster patients progressed to more advanced stages . As stated earlier, some orofacial symptoms occurs early in the disease course , whereas others are more apparent and frequent in advanced stages . Considering that only a few of these disorders have been thoroughly assessed in PD, more longitudinal studies with larger stratified samples are needed to further explore their predictive value. A recent Korean nationwide population-based cohort study has thus suggested that an increased number of missing teeth may be an important risk indicator of new-onset PD .

If You Notice Excessive Salivation Get Checked For Parkinson’s Disease

Though non-motor symptoms of Parkinson’s disease are often overlooked, experts say that they are common. In particular, many PD patients experience sialorrheaexcessive salivation which can sometimes lead to drooling. “Sialorrhea in PD is thought to be caused by impaired or infrequent swallowing, rather than hypersecretion,” a study published in the medical journal Movement Disorders reveals, noting that this symptom occurs in many Parkinson’s patients.

In fact, sialorrhea is a common symptom of many neurological diseases. According to a 2020 study published in the journal Toxins, Sialorrhea has been under-recognized in Parkinson’s disease patients. Despite this, many patients rank sialorrhea as one of the most debilitating complaints of Parkinson’s disease.” Patients say this is in part because of the social stigma associated with drooling, though it can also cause irritation of the skin, as well as respiratory infections.

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Dental Caries And Periodontal Disease

A study conducted to evaluate the prevalence of periodontal disease in different groups of seniors aged between 60 and 79 years, including patients with PD, patients with mild neurological disease but no cognitive or motor impairment, and patients suffering from acute ischemic stroke revealed a higher frequency of patients with PD with untreated caries. More PD patients had caries, fewer remaining teeth, and higher rate of deep periodontal pockets compared to the other study groups.

The study proposed that many factors contributed to the inability of PD patients to maintain proper oral hygiene, including:

Physical Barriers

The physical symptoms of PD makes it hard for patents to maintain proper daily hygiene, and even harder to keep up with periodic office examinations. Typical dental care home practices require digital dexterity, muscle-eye-coordination, and tongue-lip-cheek control. Any disease that interferes with these faculties hinders the effectiveness of associated oral hygiene procedures.

Nearly 50 percent of PD patients have difficulty maintaining their daily oral hygiene regimen, which makes them less likely to clean their teeth or dentures daily.

Other symptoms of Parkinsons, such as rigidity, tremor, and abnormal posture, may make it difficult for patients to visit a dentist for oral examination. Some patients may also experience:

Behavioral Barriers

Dystonia Sometimes Affects These Other Areas Of The Body

Parkinson’s Disease & Medication – What’s New

Though oromandibular dystonia specifically relates to the face, jaw, and tongue, there are several other types of dystonia that can be associated with PD and may affect different parts of the body. These other types can affect the neck and head , the legs, feet, arms, and hands , the vocal cords , or eyes .ae0fcc31ae342fd3a1346ebb1f342fcb

Be sure to speak with your medical provider if you notice involuntary movement or prolonged muscle contractions in any area of your body.

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How Does Chemotherapy Affect Your Taste

Chemotherapy is known for causing a bitter, metallic or chemical taste in the mouth , with around half of people treated reporting taste changes.

Some chemotherapy drugs are thought to damage the delicate cells in the lining of the mouth, while others can change the balance of bacteria in the mouth, leading to taste changes. Meanwhile, certain chemotherapy treatments are specifically known to cause a metallic taste you can talk to your medical team to find out whether your particular chemo treatment is likely to have this side effect.

Its important to remember that taste changes caused by chemotherapy usually wear off around 3-6 weeks after your treatment has stopped.

What Is Tardive Dyskinesia

Tardive dyskinesia is a drug-induced movement disorder. Taking specific medications, often for a mental health disorder, can cause it.

Tardive dyskinesia causes involuntary facial tics . It can also cause uncontrollable movements like lip-smacking.

Tardive means delayed or late. Dyskinesia refers to involuntary muscle movements. With this condition, theres a delay between when you start a medicine and when you develop dyskinesia. Most people take a medicine for years before developing the disorder.

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How Do I Know If I Have A Speech Or Voice Problem

  • My voice makes it difficult for people to hear me.
  • People have difficulty understanding me in a noisy room.
  • My voice issues limit my personal and social life.
  • I feel left out of conversations because of my voice.
  • My voice problem causes me to lose income.
  • I have to strain to produce voice.
  • My voice clarity is unpredictable.
  • My voice problem upsets me.
  • My voice makes me feel handicapped.
  • People ask, “What’s wrong with your voice?”

Every Person With Parkinsons May Experience Different Movements


There are multiple types of movements that a person with Parkinsons disease can experience. Some people may have just one or two of these symptoms, while another may experience all of them. Likewise, the degree of severity can vary from person to person, and symptoms that may bother some people may not bother others at all.

Its important to note that theres not a single answer that works for every person with Parkinsons, says Todd Herrington, MD, PhD, a neurologist at Massachusetts General Hospital in Boston and an instructor in neurology at Harvard Medical School in Cambridge, Massachusetts. You have to ask the person, What bothers you, and how much does it affect you? What the caregiver or the even the physician observes as the most severe symptoms may not feel that way to the person with Parkinsons.

Here are eight types of movements that people with Parkinsons may experience. Learn more about what these symptoms are and what can be done to prevent them.

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Oral Dysfunction In Parkinsons: Swallowing Problems And Drooling

Two common and distressing problems that can develop in Parkinsons disease are swallowing dysfunction and drooling. I want to help you better understand these issues and learn what you can do to improve them so read on!

Thank you to Christine Sapienza, PhD, CCC-SLP and Bari Hoffman Ruddy, PhD, CCC-SLP for providing some of the material below.

Whats Causing Bad Smell In My Nose And How To Get Rid Of It

There are times when bad smells emanate from your nose. If you are experiencing this condition then you are in the right place. Read further to know whats causing a bad smell in my nose and how to get rid of it?

A lot of health conditions, most of which are linked with your sinuses, can trigger a rotten smell in the nose. However, most of these foul smells are temporary and not any sign of a serious or life-threatening condition. They might be indications that polyps or mucus are blocking your airways.

You must understand this that if a bad smell is filling your nose, then you must look inward. To do this, you should take the help of your doctor who would examine your sinuses and throat to find out any clues for the unpleasant or bad smell in your nose.

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Eligibility Criteria For Including Studies

Clinical trials and observational studies assessing different aspects of oral health among patients with PD were included in this review. These involved associations between different aspects of PD and oral cavity diseases, along with any type of treatment or preventive strategies. Case reports, reviews, guidelines and experimental studies were excluded. This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

Eating Swallowing And Saliva Management

Swallowing Problems in Parkinson’s Disease

Some people with Parkinsons may find they have difficulties with eating, swallowing and saliva control at some stage of their journey with Parkinsons.

Parkinsons can cause the muscles in the jaw and face to become stiff which affects the control of chewing and swallowing.

Another symptom of Parkinsons can be producing excessive saliva. The stiffer facial muscles can change the nature of saliva, which may become thicker and stickier.

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How Is Tardive Dyskinesia Managed Or Treated

Your healthcare provider may gradually lower your medication dose. Eventually, you may stop the drug. If you need ongoing treatment, your healthcare provider may prescribe a different medicine.

For some people, these changes end tardive dyskinesia symptoms. You should only make medication changes under your healthcare providers care.

Some people still have symptoms despite medication changes. Over time, the symptoms may improve and go away. Rarely, symptoms become worse.

If symptoms persist, these treatments may help:

  • Tetrabenazine, the only approved drug for the treatment of movement disorder symptoms.
  • Botulinum toxin injections , which blocks facial nerve signals for a few months.
  • Deep brain stimulation, an implantable device that blocks irregular nerve signals to areas of the brain that control movements.

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What Is A Swallowing Evaluation

If because of the above signs there is concern that swallowing difficulties exist, your doctor may recommend a swallow evaluation, which can be performed by a speech and language pathologist.

There are two main ways to evaluate someones swallow:

  • Modified barium swallow study This is the most common test that is performed. The person is asked to ingest different consistencies of barium and moving x-rays are taken that follow the barium as it is swallowed. This x-ray video pinpoints the areas of the swallow that are problematic and helps to determine the correct exercises to address the problem.
  • Fiberoptic endoscopic evaluation of swallowing is another type of test that can be performed to evaluate swallow. During this procedure, a very thin flexible fiberoptic tube which is hooked up to a camera and light source, is passed through the nasal passage. The tube does not go down the throat, but allows swallowing to be observed. This procedure is painless and well-tolerated by most individuals.

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Home Remedies To Treat Metallic Taste

  • Baking Soda

To do away with the metallic taste, you can use a mix of toothpaste, hydrogen peroxide and baking soda to brush your teeth. This mixture can be used instead of toothpaste alone to eliminate the bad taste whenever it happens.

  • Salt Rinse

Mix one table spoon of salt in about 8 oz. of water to create a saltwater solution that can be effectively used to neutralize the pH level in your mouth and eliminate the weird taste in your mouth.

  • Vinegar Marinated Food Items

Tend to have food items that are marinated in vinegar quite often. These may include simple things like pickles. Having such food items quite often can help in the excess secretion of saliva that will help to wash off any bad taste that occurs.

  • Citrus Fruits

Make sure that you include a lot of citrus fruits in your daily diet. Fruits such as lemon and orange are known to boost saliva secretion, thus helping in fighting off germs and bacteria. This helps improve overall oral hygiene naturally and also cure metal mouth with ease.

  • Herbal Teas

Taking herbal tea on a daily basis may also be considered an effective solution to the problem. One may also drink milk mixed with honey to help cure the problem.

  • Yogurt

Fresh yogurt is alkaline in nature and thus, increases saliva secretion which aids in maintaining better oral hygiene.

  • Oil Pulling

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Mouth And Dental Issues

Parkinsonâs disease: Stages of symptoms can include these mouth ...

Some people with Parkinsons may have problems with their mouth and dental health.

A healthy mouth will help you to chew, taste, swallow and speak properly. Strong, healthy teeth allow you to enjoy your choice of food.

Parkinson’s symptoms and Parkinson’s medication might cause some problems with your dental and mouth health .

These can include:

Saliva is really important for good mouth health:

  • It helps you taste your food.
  • It lubricates food to help you swallow.
  • It is antibacterial and has enzymes to help you eat and digest food.

Without enough saliva you may experience a dry mouth. A dry mouth can lead to higher rates of tooth decay and gum disease. It can increase your risk of getting tooth decay in the exposed roots. It may also cause dentures to become loose and hard to control.

A dry mouth can also increase the damaging effects of sugar on your teeth. Because of this it is important to watch what you eat and when you eat.

Some Parkinsons drugs can reduce the flow of saliva to your mouth. Tell your dentist if you experience this as they can discuss options which might help. They may ask you what drugs you take, so take a list of your medication to your appointments.

Tell your GP, specialist or Parkinsons nurse too as they may be able to prescribe different treatments that may not cause this problem. Saliva substitutes are also available. You can ask your dentist or local pharmacist about them.

The following tips may help reduce dry mouth.


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