Objective: To determine if the oral health questionnaire (OHQ) devised could help to promote good oral hygiene in Parkinson’s disease (PD) while considering the potential for an MDT approach.

Background: PD is a progressive neurological condition with motor and non-motor symptoms that could impact on a person’s oral health. The OHQ was developed to explore oral health issues and consider opportunities for the MDT to engage in the specific needs of a person with PD. Risk factors recognised in PD oral health are multifactorial and include difficulty with cleaning teeth due to reduced manual dexterity, changes to saliva, and postural instability [1], which could affect accessing the dentist and getting in and out of dentist’s chair.

Method:
In this ongoing project, 3 Parkinson’s Disease Nurse Specialist’s (PDNS) from primary and secondary care will review 120 completed OHQ, undertaken whilst attending the nurse led clinic. Health records will also be reviewed to identify referrals to other members of the MDT to consider potential for intervention and support with issues identified.

Results: To date 10 patients 70% male, mean age 68.9yrs + 9.2 yrs, mean disease duration 11.9 yrs + 5.8 yrs, median Hoehn &Yahr 2.5 (range 2-4) have been reviewed. 50% had attended the dentist in the past year, but did not consider them part of the MDT, although 60% believed their PD affected ability with oral hygiene. 50% reported that their PD affected their ability to attend the dentist, and postural hypotension was identified in 20%. Dry mouth was reported in 70% with only 50% drinking at least 2 litres of fluid daily. Weight loss was reported in 20% and but none had a BMI less than 18.5 (n = 18.5-24.9) 50% had a BMI above normal. While 60% had attended speech and language therapy (SALT), 40% reported drooling and 10% complained of thick saliva. All patients had attended physiotherapy the past year, while review with the occupational therapist was 30%, and dietician was 10%.

Conclusion: The OHQ could increase awareness and referrals to the MDT for oral health related issues. While the dentist is crucial to the process, a collaborative MDT approach could address the problems attributable to motor and non-motor symptoms that affect ability with oral hygiene and dental procedures. Education and joint working could improve quality of life through greater understanding of the impact of PD

References: Batista L.M. et al (2015) Oral Hygiene in Patients with Parkinson’s Disease. Rhode Island medical Journal 35-37

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MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluation-of-an-oral-health-questionnaire-in-parkinsons-disease-to-facilitate-a-multi-disciplinary-approach-to-improving-care-through-education/