Ask the MD: Dental Care and Parkinson’s
Wednesday, 19th January 2022

Seeing the dentist regularly for a cleaning and check-up might not be at the top of your to-do list. You also may have, understandably, postponed visits during the pandemic. But dental care is important if you have Parkinson’s disease (PD). People with PD may be more likely to experience oral or dental changes, and Parkinson’s can bring challenges to caring for your teeth and visiting the dentist.

A few things to know:

  • Parkinson’s symptoms can impact dental health.
    Some people, especially later in Parkinson’s, may have trouble chewing or swallowing, or difficulty with drooling. Others might have extra movements (dyskinesia) in the mouth or jaw, or they could grind their teeth. 

    • ​​​​​​​​​​​​​​Slowness, stiffness, dyskinesia and even mood changes could make tooth brushing or flossing harder. See your dentist every six months so that they can check for changes and, if necessary, treat them early. Also ask your dentist, doctor or occupational therapist for strategies and tools to make tooth care easier, such as an electric or weighted toothbrush and devices for flossing.
    • Parkinson’s medications may cause dry mouth.
      Dry mouth increases the risk of cavities or gum disease. Dry mouth is a common side effect of many medications. Examples include the Parkinson’s drug trihexyphenidyl as well as certain antidepressants and medications for bladder or urinary symptoms. If you have dry mouth:

      • Ask your doctor if medication is contributing and can be switched,
      • Try sugar-free gum, mints or an over-the-counter saliva substitute,
      • Brush and floss your teeth at least twice a day, and
      • Drink a lot of water.
  • There are ways to ease challenges around dental visits.
    Parkinson’s can be unpredictable. But try to book your appointment for a time of day when symptoms typically are under good control. Tell the office you have Parkinson’s when you schedule a visit. And tell your hygienist about symptoms, such as tremor or dyskinesia, that may increase with the stress of the visit. Talk to your dentist about any symptoms, such as dry mouth, tooth pain or drooling. And ask them to review your medication list. Also remind them if you have a deep brain stimulator (DBS), especially before any procedure. Dentists sometimes use a technique called diathermy, which uses electrical energy, to cut tissue or stop bleeding. People with DBS should not have diathermy because it can potentially damage the DBS system.