ODONTOLOGICAL ASPECTS OF PARKINSON’S DISEASE INCLUDING A CASE STUDY
Parkinson's disease (PD) is a neurodegenerative disorder normally first appearing after the age of 50. Orofacially, PD often results in stiff and mask-like facial expressions, reduced blink reflex, low and monotonous voice, difficult swallowing, and unintentional drooling. The sialorrhea is not due to increased saliva production, in fact dryness of the mouth is a common side effect of PD medication, but it is caused by decreased swallowing function. Oral dyskinesia, i.e. involuntary movements, is also a side effect of the medical treatments. Oral health is poorer than in people without PD, and also the chewing and mouth opening are affected. In addition the disease involves non-motor symptoms such as cognitive decline, depression and dementia. When treating people with PD, it is essential to cooperate with their medical doctor and relatives, and implement careful instructions in oral hygiene, exercises and regular professional dental care. Dental treatment and tooth replacements must be carefully planned according to current and future conditions, as PD is a progressive disease, and the masticatory muscles become stiffer and tooth brushing more difficult, and dentures will be difficult to handle with impaired motor skills. Also the patients become less mobile and have cognitive impairment, which makes it more difficult for them to visit their dentist.