Objective: To determine if the use of a dental mouthpiece affects motor functioning for people with Parkinson’s disease (PD).

Background: Several case studies have shown benefits from use of a dental mouthpiece among people with PD, including improvements in motor function, quality of life, grip strength, gait and balance measures, and sleep quality [1][2][3]. Current knowledge is limited by variation in mouthpiece design across studies and by the small number of participants studied thus far. We sought to determine whether a mouthpiece can affect motor functioning in a larger group of participants with PD.

Method: Twenty people with PD, average age 66.9 ± 9.75 SD, Hoehn and Yahr stages I-III, participated in this study. Motor tests included the Mini-BESTest to assess balance, handheld dynamometry to assess grip strength, manual measurement of handwriting metrics to assess fine motor control, and an electronic walkway mat to measure gait velocity. These measures were first conducted without a mouthpiece. A licensed maxillofacial surgeon fabricated and fitted a customized mouthpiece for each participant to fit over the mandibular teeth, and participants wore it for 25-30 minutes. Participants were then tested again while wearing the mouthpiece. Paired t-tests were used to compare performance with and without the mouthpiece (α= .05).

Results: Gait velocity significantly increased with the mouthpiece compared to without (t=2.432, p=.026). There were no significant differences for balance, strength, or fine motor control.

Conclusion: Though gait velocity increased slightly while wearing the mouthpiece, this increase may not be clinically meaningful. The difference in velocity between conditions (0.045 m/s) is slightly less than established minimal clinically important differences (0.05-0.22 m/s) [4]. The use of this dental mouthpiece does not appear to have an acute impact on balance, strength, or fine motor control for people with PD.

References: 1. Nomoto S, Nakamura M, Sato T, Hisanaga R. Occlusal treatment with bite splint improves dyskinesia in Parkinson’s disease patient: a case report. Bull Tokyo Dent Coll. 2013;54(3):157-161. doi:10.2209/tdcpublication.54.157 2. Lane H, Rose LE, Woodbrey M, Arghavani D, Lawrence M, Cavanaugh JT. Exploring the Effects of Using an Oral Appliance to Reduce Movement Dysfunction in an Individual With Parkinson Disease: A Single-Subject Design Study. J Neurol Phys Ther. 2017;41(1):52-58. doi:10.1097/NPT.0000000000000160 3. Durham TM, Hodges ED, Henry MJ, Geasland J, Straub P. Management of orofacial manifestations of Parkinson’s disease with splint therapy: a case report. Spec Care Dentist. 1993;13(4):155-158. doi:10.1111/j.1754-4505.1993.tb01467.x 4. Hass CJ, Bishop M, Moscovich M, et al. Defining the clinically meaningful difference in gait speed in persons with Parkinson disease. J Neurol Phys Ther. 2014;38(4):233-238. doi:10.1097/NPT.0000000000000055

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MDS Abstracts - https://www.mdsabstracts.org/abstract/examining-the-effects-of-a-dental-mouthpiece-on-motor-signs-in-parkinsons-disease/