Oral health and chewing function in patients with Parkinson's disease

Author(s)

Giselle Rodrigues Ribeiro

• Document type: Doctoral Thesis
• Press: Piracicaba, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Odontologia de Piracicaba
• Defense date: 2016-02-29

Examining board members

Renata Cunha Matheus Rodrigues Garcia; Ana Carolina Pero Vizoto; Simone Saldanha Ignácio de Oliveira; Maria da Luz Rosário de Sousa; Celia Marisa Rizzatti Barbosa

• Advisor: Renata Cunha Matheus Rodrigues Garcia

Abstract

This study evaluated the oral health and masticatory function in older adults with PD during the good motor function (levodopa "on" period) and rehabilitated with new removable dental prosteses. Thus, it was divided into 4 articles. Articles 1 and 2, assessed before rehabilitation, included elderly patients with PD (n = 17, mean age = 69.59 ± 5.09 years) and a control group (n = 20, mean age = 72.00 ± 5, 69). Article 1 evaluated the oral health objective and subjectively, including the number of remaining teeth, decayed, missing, and filled teeth (DMFT), oral health index (OHI), salivary flow and conditions of prostheses (stability, retention, occlusion, vertical dimension and defects); and General Oral Health Assessment Index (GOHAI). Data were analyzed by t-test or X2 test (P <0.05). There was no difference in number of teeth, DMFT, OHI and salivary flow, but more defects in the upper prosthesis were observed in controls (P=0.037). The GOHAI was low for PD group and moderate for control (P = 0.04). We conclude that elders with and without PD have similar oral health, despite the more negative self-perception of oral health in the elderls with PD. Article 2 evaluated the removable prosthesis hygiene by the biofilm stained before and 7, 14 and 30 days after hygiene verbal instructions and positive reinforcement. Data were analyzed by t-test, Mann-Whitney U, ANOVA and post hoc Tukey test (P <0.05). There was a reduction in biofilm and, after 30 days, there were no differences between groups (P> 0.05). In conclusion, similar to the control, older people with PD are able to reduce the biofilm in response to verbal instructions and positive reinforcement. Articles 3 and 4 included elderly patients with PD (n = 17; age mean = 69.59 ± 5.09 years) and controls (n = 17, mean age = 70.71 ± 4.65). Article 3 evaluated the masticatory function after 2-month adaptation period with the new removable prostheses, by the range of the jaw motion, movements during Optocal chewing; masticatory performance (MP) and maximum bite force (MBF). Data were analyzed by t test (P <0.05). The PD group showed decreased range of jaw motion, longer duration and slower velocity of the masticatory cycle, worse MP, and lower MBF (P <0.05). We conclude that PD is associated with impairment of masticatory function. Article 4 evaluated the oral health related quality of life (OHRQoL) and masticatory efficiency (ME) before and 2 months after rehabilitation, using the Oral Health Impact Profile (OHIP-49) and Optocal chewing. Data were analysed by Wilcoxon sign or signed-rank tests; or paired t test (P <0.05). The groups improved OHRQoL and ME comparing before and after rehabilitation. After rehabilitation, elders with PD showed worse ME, but positive impact on OHRQoL, similar to controls (P <0.05). In conclusion, rehabilitation improves OHRQoL and ME in elderly patients with and without PD. In general, it can be concluded that elders with PD have similar oral health than controls, and that the PD impair the masticatory function during the levodopa "on" period (AU)

• FAPESP's process: 12/15223-2 - Oral health and chewing function in patients with Parkinson's Disease
• Grantee: Giselle Rodrigues Ribeiro
• Support Opportunities: Scholarships in Brazil - Doctorate