Essay --

Introduction of Clinical Question In a normal brain neurons in the substantia nigra produce a chemical called dopamine that acts to control motor functions. In a person with Parkinson’s disease, there is insufficient dopamine and motor symptoms such as tremors, rigidity, problems with balance and bradykinesia can occur. According to the National Parkinson Foundation, four to six million people worldwide are estimated to have Parkinson’s Disease. In the United States alone, the incidence is estimated at fifty to sixty thousand new cases diagnosed each year. Additionally, the Center for Disease Control puts complications from Parkinson’s disease as the 14th leading cause of death. While there is no cure, the symptoms can be controlled with medications and surgery. [6] A 2011 German cross sectional study revealed that people with Parkinson’s Disease had poorer oral health. They were found to have more caries, tooth mobility, gingival recession and periodontal pocketing than the control cohort. Additionally, the group with Parkinson’s disease reported less frequent tooth brushing and dental visits, and exhibited reduced salivary flow. [4]. Supporting this, a separate Japanese study showed more untreated caries and deeper periodontal pockets, leading to fewer natural teeth in persons with Parkinson’s Disease [2]. There is a significant population with Parkinson’s Disease, a condition that has been shown to have a negative impact on oral health. Increased caries and periodontal problems can lead to tooth loss and edentulism, a condition treatable with traditional or implant retained overdentures. Patient RM is a male with Parkinson’s disease. He is partially edentulous with six maxillary teeth and two mandibular teeth. ... ...100. [2] Hanaoka A, Kashihara K. Increased frequencies of caries, periodontal disease and tooth loss in patients with Parkinson’s disease. Journal of Clinical Neuroscience. 2009; 16: 1279-1282. [3] Heckmann SM, Heckmann JG, Weber H-P. Clinical outcomes of three Parkinson’s disease patients treated with mandibular implant ovedentures. Clin Oral Impl Res. 2000; 11: 566-571. [4] Muller T, Palluch R, Jackowski J. Caries and periodontal disease in patients with Parkinson’s disease. Spec Care Dentist. 2011; 31(5): 178-181. [5] Packer M, Nikitin V, Coward T, Davis D, Fiske J. The potential benefits of dental implants on the oral health quality of life of people with Parkinson’s disease. Gerodontology. 2009; 26: 11-18. [6] Welcome to Parkinson.org [Internet]. Miami (FL): National Parkinson Foundation; 2014 [cited 2014 Mar 7]. Available from: http://www.parkinson.org/.