Parkinson’s disease has been more in the spotlight in the last decade, and its frequency is on the rise. From an observer’s perspective, when we think about Parkinson’s we usually think of difficult speech, stiffness, and tremors. Actor and advocate Michael J. Fox has worked very hard to bring the disease into national awareness.
My first experience with Parkinson’s disease was right after finishing dental school. I was working in a small town in Oregon, and one of my favorite patients brought her husband in for emergency dental care. Her husband had advanced Parkinson’s disease, and she had always been his caregiver.
This patient’s Parkinson’s had progressed to the point where his wife could not brush his teeth anymore. The Parkinson’s medications caused severe dry mouth, and there were deep cavities everywhere. We attempted to fix some of these cavities, but it was extremely difficult on the patient, his wife, and also for me, his dentist. Because of tremors and stiffness it can be almost impossible to get dentistry done on patients with advanced Parkinson’s disease. Stiffness and tremors become even more severe in stressful situations. I knew from that day forward that I would find a way to help these patients retain their sense of confidence and I would try to find a way to make it as easy and stress free as possible.
One thing that has not been mentioned thus far is how Parkinson’s disease can destroy a healthy mouth and smile. Because of the complex nature of the dentistry we do, we have many patients come to us with Parkinson’s disease. They want answers on why their teeth are decaying and breaking, how to stop this, and how to find a long-term solution for their dental health.
For many patients, their symptoms have gotten so bad that they cannot brush their teeth anymore and the medications they take are causing severe dry mouth, which allows cavities to spread quickly. Dry mouth means there is little or no saliva being produced. Saliva is important because it helps to wash away the food debris and bacteria that cause tooth decay.
There are two important things happening here: the inability to properly brush and floss the teeth allows cavities to start rapidly, and the Parkinson’s medication-induced dry mouth causes the cavities to grow larger.
Many of my patients with Parkinson’s disease don’t know what their options are. They know something is happening to their teeth. Their first symptoms are usually toothache, broken teeth, and discoloration. For many patients, the teeth have gotten so bad or are getting so bad that the best option is to start fresh with a long term solution that will last them the rest of their lives, especially as their Parkinson’s symptoms advance.
What we have started to do for many of our Parkinson’s disease patients is to remove all of the teeth, place dental implants on the top and bottom jaws, and connect full arch prosthetics to rehabilitate the mouth and smile. These are also known as implant dentures.
This new set of teeth needs little maintenance, has excellent long-term success rates, looks natural, and is very secure. These new implant dentures give my Parkinson’s patients a huge boost in confidence and it also provides them an enormous sense of relief. No longer do they have to worry about cavities and abscesses, and since the implant dentures need so little maintenance it is much easier for their caregivers and/or spouses to clean them periodically.
Parkinson’s disease is a life changing condition. No one has ever talked about how to maintain the teeth as symptoms progress. My job is to educate and help my patients retain their smile and confidence as they fight this disease.