The Importance of Oral Care in Parkinson’s Disease

By: Lindsay Arena, MA, CF-SLP

Swallowing dysfunction is frequent in Parkinson’s disease (PD) and is commonly associated with aspiration pneumonia, which is the leading cause of death in PD. Aspiration pneumonia is a bacterial infection in the lungs that occurs when saliva, food, liquid, or regurgitated material enters the lower airway (trachea-lungs).

Poor oral hygiene results in increased harmful bacteria in oropharyngeal secretions. Without a daily oral hygiene routine, those who are experiencing dysphagia with PD may be at a higher risk of developing aspiration pneumonia, due to the increased potential for bacteria to enter the airway.

Therefore, maintaining a daily oral care routine is crucial in reducing your risk of developing aspiration pneumonia. Regardless of your dental status (teeth, dentures, no teeth), you should use a toothbrush to brush your teeth/gums and tongue at least 2x/day. This is the most effective way to create the friction required to remove bacteria from your mouth. Flossing, using a water flosser, and/or using alcohol-free mouthwash are other great additions to utilize in your oral care routine. Regular visits to the dentist at least every 6 months is also recommended.

It is important to note that while oral hygiene is one preventable risk factor in developing aspiration pneumonia, there are a number of other risk factors. Other risk factors associated with the development of aspiration pneumonia include: dependency upon others for feeding, reduced overall physical health, and mental health.

Resources

If you have questions or concerns regarding your oral hygiene, reach out to your local Speech-Language Pathologist or physician.

References

• CanadaQBank (2015). Aspiration Pneumonia [Picture]. Retrieved from: https://www.youtube.com/watch?v=HcBKvqlg1Nc

• Chang, Y., Yang, C., Hu, K., Chao, A., Chang, Y., Hsieh, K., … Lim, S. (2016). Risk factors for pneumonia among patients with Parkinson’s disease: a Taiwan nationwide population based study. Neuropsychiatric disease and treatment 2016; 12: 1037-1046. doi: 10.2147/NDT.S99365

• Langmore, S., Terpenning, M., Schork, A., Chen, Y., Murray, J., Lopatin, D., & Loesche, W. (1998). Predictors of aspiration pneumonia: How important is dysphagia? Dysphagia 13(2): 69. doi:10.1007/PL00009559

• Martinez-Ramirez, D., Almeida, L., Giugni, J., Ahmed, B., Higuchi, M., Little, C., … Okun, M. (2015). Rate of aspiration pneumonia in hospitalized Parkinson’s disease patients: a cross-sectional study. BMC Neurology 15:104. https://doi.org/10.1186/s12883-015-0362-9

• Yoon, M. & Steele, C. (2007). The oral care imperative: The link between oral hygiene and aspiration pneumonia. Topic in Geriatric Rehabilitation (23) 3, pp. 280-288. doi: 10.1097/01.TGR.0000284771.24711.6a