Abstract

This study investigated the impact of the severity and treatment of Parkinson's disease (PD) on the swallowing ability and oral environment of patients. Swallowing dysfunction increases the aspiration risk and may lead to poor oral health among patients with PD. We investigated the influences of PD progression and drug treatment on the swallowing ability and oral environment using simple noninvasive screening measurements. We recruited 87 patients with PD (mean age, 71.9 ± 8.0 years; mean Hoehn and Yahr score, 2.9 ± 0.9). The PD condition was assessed in each patient using the unified Parkinson's disease rating scale (UPDRS) part III, diet type and oropharyngeal function using the swallowing disturbances questionnaire (SDQ), maximum bite force (MBF), tongue pressure (TP), and oral bacterial count (OBC). Levodopa equivalent daily dose (LEDD) was also calculated for 56 participants. Based on an SDQ score of ≥11, 29.5% of patients were dysphagic, but almost all were still on a regular diet. The SDQ score was positively correlated with disease duration (rho = 0.228, p=0.047) and UPDRS part III score (rho = 0.307, p=0.007) but was negatively correlated with OBC (rho = −0.289, p=0.012). OBC was significantly higher among patients with an SDQ score of <11 (nondysphagic) (p=0.01), and the SDQ score was lower in patients with higher OBC requiring professional oral care (p=0.03). However, OBC was also negatively correlated with LEDD (rho = −0.411, p=0.004). These results indicated low self-awareness of dysphagia among the participants and an association between dysphagia and PD progression. Moreover, the oral environment could have deteriorated with swallowing dysfunction. Patients and clinicians should be aware that higher LEDD can increase xerostomia and associated deficits in oral health.

Highlights

  • Swallowing function deteriorates with the progression of Parkinson’s disease (PD), necessitating careful adjustment of diet and monitoring of oral health

  • Few studies have investigated the influence of physical dysfunction in patients with PD on diet or oral care ability. is study investigated the impact of PD severity and treatment on the swallowing function and oral environment by examining the associations among swallowing disturbance questionnaire (SDQ) scores, unified Parkinson’s disease rating scale (UPDRS) part III score, multiple measures of oral environment and function, and levodopa equivalent daily dose (LEDD)

  • oral bacterial count (OBC) was significantly higher in the subgroup with an SDQ score of

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Summary

Introduction

Swallowing function deteriorates with the progression of Parkinson’s disease (PD), necessitating careful adjustment of diet and monitoring of oral health. Swallowing dysfunction (dysphagia) among patients with PD is often evaluated using video fluoroscopic swallowing study (VFSS) or fiberoptic endoscopic evaluation of swallowing (FEES), and VFSS in particular provides detailed information on the oral and pharyngeal stages of swallowing dysfunction [1, 2]. These tests are costly and often not available to primary care clinicians. Is study investigated the impact of PD severity and treatment on the swallowing function and oral environment by examining the associations among SDQ scores, unified Parkinson’s disease rating scale (UPDRS) part III score, multiple measures of oral environment and function, and levodopa equivalent daily dose (LEDD) Few studies have investigated the influence of physical dysfunction in patients with PD on diet or oral care ability. is study investigated the impact of PD severity and treatment on the swallowing function and oral environment by examining the associations among SDQ scores, unified Parkinson’s disease rating scale (UPDRS) part III score, multiple measures of oral environment and function, and levodopa equivalent daily dose (LEDD)

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Conclusion

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