Parkinson’s disease is the second most common chronic and progressive neurodegenerative disease. It involves the neurons that are responsible for producing dopamine. Dopamine is a chemical that helps in transmitting messages between cells. Parkinson’s onset is typically between 55 and 66 years of age. There is a rare form of the disease which has been known to occur in teenagers. Affecting about 1 in 1000 people, an average dental practice of 2000 patients may treat up to 4 patients diagnosed with Parkinson’s disease.
This disorder is characterized by motor disturbances such as resting tremors, muscular rigidity, bradykinesia (slow & impaired movements), and postural instability. In addition, there can be varying degrees of cognitive impairment, mood disturbances and psychosis in some instances, which is related to dopaminergic medications.
For this reason, it is often difficult for these patients to sit still in a dentist’s chair (or even keep their mouth and jaws from moving), therefore sedation dentistry offers a good solution to enable proper dental treatment. Managing a patient with Parkinson’s entails diminishing any potential adverse consequences of tremors and muscle rigidity as well as avoiding drug interactions. These patients have a hard time opening their mouth for longer time and anxiety increases the Parkinson’s symptoms.
The patient’s treatment plan will need to be customized according to their level of motor and cognitive impairment. Assessment and planning should done early, as soon as the patient has been diagnosed with Parkinson’s whenever possible.
Muscle rigidity and tremors are contributing factors to the patient’s poor oral hygiene and as such, the dental team must assess the patient’s ability to keep his/her mouth clean. Medication used to treat Parkinsonism causes xerostomia (very dry mouth), which increases the risk of caries and fungal infections. It is important to teach the patient to maintain good oral hygiene using toothbrushing aids and adaptations which assist with self-care, fluoride rinses, toothpastes with higher concentrations of fluoride as well as diet and nutrition counselling. This involves the caregiver being educated in how they can best work within the patient’s physical and mental limitations.
Patient appointments should be booked at the time of day that their medications will have the optimal effects, typically 2-3 hours following taking them. Sedation may mitigate the presence of tremors or undesired movement during treatment.
While Dr. Lichtenstein has extensive surgical training, he prefers to offer treatment plans based on fixing and saving the patient’s dentition, not just removing teeth. There is no need for dental care to go untreated. The use of Sedation Dentistry can help you have a comfortable and pleasant dental experience, relaxing the patient and removing the anxiety.
Our office serves the overall comprehensive restorative aspects of the patient with autism and other special needs. This entails endodontic (root canal therapy), periodontal, and prosthetic (caps & crowns) needs, as well as basic fillings, diagnostic and preventive dental care services.
A significant part of our practice involves treating patients with special needs. This includes people who are extremely anxious and phobic, or patients with numbing difficulties, those who have numerous medical background concerns and issues, such as Parkinson’s Disease shaking and tremors. Using Sedation Dentistry and many years of experience, a trip to Dr. Lichtenstein allows the Parkinson’s patient to sit back and relax while getting the best in care.
Dr. Lee Lichtenstein and his highly trained staff offer general dentistry services as well as dental treatments that can be performed using sedation dentistry and general anesthesia techniques to make patients’ experiences more pleasant and comfortable.
Visit our practice to discuss your dental needs and concerns.
723 North Beers Street
Holmdel, NJ 07733.