Parkinson’s Disease

PEOPLE with Parkinson’s may not be aware of their swallowing difficulties.

And this may lead to poor oral health, according to a study, “Impact of Progression of Parkinson’s Disease on Swallowing Ability and Oral Environment”, published in the Parkinson’s Disease journal.

Patients often experience swallowing difficulties as Parkinson’s progresses. In medical terms it’s called dysphagia, a condition when people find it difficult to swallow food and liquid.

The study looked at 87 patients with Parkinson’s (mean age 72 years).

Their regular diet type was classified into three of seven levels based on the Functional Oral Intake Scale (FOIS), with patients belonging to three categories: level zero (tube dependent); level six (total oral intake with no special preparation, but must avoid specific foods or liquid items); and level seven (total oral intake with no restrictions).

For each patient, the study measured motor symptoms, a self-reported questionnaire of swallowing disturbances and the oral bacterial count.

The study suggests that dysphagia progression may reduce the number of oral bacteria in patients with Parkinson’s disease despite their limited ability to maintain oral hygiene by themselves.

It found that disease progression is associated with more severe swallowing difficulties.

The results indicate low self-awareness of dysphagia among patients with Parkinson’s and highlight the importance of careful monitoring of diets.

The study recommends that patients and clinicians should be alert for deterioration in oral health with swallowing dysfunction, reports parkinsonsnewstoday.com

Parkinson’s is a movement disorder mainly characterized by rigidity, slowness and tremors, says Dr. Raymond L. Rosales, a neurologist and a Full Professor in the Department of Neurology and Psychiatry, University of Santo Tomas Hospital.

There are non-motor effects of Parkinson’s such as depression, cognitive impairment, fatigue, dyspepsia, nausea, constipation, hallucinations and even serious sleep problems. 

It is still unclear what causes Parkinson’s, but studies, says Dr. Rosales. Risks, however, are associated with age, gender, genetics and some environmental causes. In rare cases, it could be caused by trauma, like the boxing bouts of Muhammad Ali.

“It would seem that older people and males are more at risk of Parkinson’s than younger people and females, says Dr. Rosales.

Some environmental factors have been associated with Parkinson’s, like pesticides and air pollution, but these are “associations,” which means that there are no clear direct connections yet.

There are about 120,000 PD cases in the Philippines and about 6.3 million worldwide. These are only the diagnosed patients. Dr. Rosales believes there are more cases that are undiagnosed.

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Dr. Joseph D. Lim is  the former Associate Dean of the UE College of Dentistry, former  Dean of the College of Dentistry, National University, past president and honorary fellow of the Asian Oral Implant Academy, and honorary fellow of the Japan College of Oral Implantologists. Honorary Life Member of Thai Association of Dental Implantology. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515./PN

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