Dental status in outpatients with Parkinson's disease

Abstract

Dental health status of patients with Parkinson's disease (PD) is thought to be poor due to difficulty in brushing. However, a previous study examining a small number of patients with PD indicated quite good dental health in these patients. In order to determine whether the dental status of patients with PD, a cross-sectional survey was performed for the decayed, missing, and filled teeth (DMFT) in a larger number of patients with PD and the results were analyzed for their relationship with sex, age, salivary flow, salivary pH, tooth-brushing and other eating habits. The dental status of 31 consecutive outpatients with PD who were 60 years old and over, and who visited a university hospital in 1999, was examined. The subjects consisted of 17 males (mean age 71.1, range 61-78 years) and 14 females (70.2, 60-84). Their unstimulated saliva was collected for 5 minutes, and information concerning their tooth-brushing and eating habits was ascertained. The total number of DMFT, as well as the number of remaining teeth were calculated. Sex- and age-specific numbers of DMFT and remaining teeth were compared with the corresponding figures obtained in the National Dental Diseases Survey (NDDS) in 1993. These indices were also examined for their relationship with sex, age, salivary excretion, salivary pH, tooth-brushing and other eating habits. In total, DMFT for the PD patients was 19.3 +/- 1.5 (mean +/- standard error) and the number of remaining teeth was 16.5 +/- 1.7. The expected numbers from the NDDS were 24.3 for DMFT and 10.2 for remaining teeth. Both indicated a healthier than average dental condition among patients with PD. This finding was confirmed for site-specific values, and in each sex and age category, except in males aged 70 years and over. Salivary flow of the patients was 2.2 +/- 0.2 ml/5 min, and pH was 6.5 +/- 0.1. The proportion of the patients who brushed their teeth 3 times a day or more was 68 percent (21/31), while the expected proportion from the NDDS was 19 percent. Spearman's correlation coefficients of DMFT with probable risk factors indicated a significant correlation: r = 0.54 with age, -0.39 with salivary flow, -0.39 with salivary pH, and -0.47 with the number of brushings per day. Male patients aged 70 years and over, and who had a higher DMFT, showed a lower salivary pH. A smaller proportion of them (36%) brushed their teeth three times a day or more, and a greater proportion of them (64%) had a habit of eating between meals. The present result suggest that PD outpatients with mild symptoms generally keep good dental health. They were, however, still subject to conventional caries-associated factors. One of the reasons for their overall better dental status may be partly related to their better salivary characteristics and tooth-brushing habits.