Circadian rhythms and influencing factors of xerostomia among Parkinson’s disease patients

Barbe, Anna Greta; Ludwar, Lena; Scharfenberg, Isabel; Hellmich, Martin; Dano, Richard; Barbe, Michael T.; Noack, Michael

doi:10.1111/odi.12942

Cited by 12 publications

(23 citation statements)

References 47 publications

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“…Consistent with this suggestion, a previous study reported that patients with PD produced significantly less saliva and that decreased production of saliva correlated with the dose of levodopa [22]. Barbe et al also reported an association between subjective dysphagia and xerostomia and that LEDD increased the occurrence of xerostomia [23]. However, the direct effect of dopamine on the sympathetic innervations of the salivary glands that cause a decrease in salivation is unknown.…”

Section: Discussionmentioning

confidence: 72%

Impact of Progression of Parkinson’s Disease on Swallowing Ability and Oral Environment

Umemoto

Fujioka

Iwasa

et al. 2021

Parkinson's Disease

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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.

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Section: Discussionmentioning

confidence: 72%

Impact of Progression of Parkinson’s Disease on Swallowing Ability and Oral Environment

Umemoto

Fujioka

Iwasa

et al. 2021

Parkinson's Disease

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“…The dominant manifestations of oral symptom in PD presents salivary excretion, swallowing difficulties, dry mouth, tongue diseases [7], periodontitis and tooth decay [8].…”

Section: Oral Symptoms In Pdmentioning

confidence: 99%

Oral flora imbalance in Parkinson's disease

Pu¹,

Huang²,

Zhong³

et al. 2019

Arch Biomed Clin Res

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“…Furthermore, Parkinson's medication can cause xerostomia and hyposalivation, thereby contributing to impaired oral health. Barbe et al found that 50% of a PD study population reported xerostomia and up to 87% showed hyposalivation; 13 furthermore, PD patients might have a deviation in the circadian controlled salivary flow rates 14 . Thus, it is important that the dentists have insight into the mechanisms behind xerostomia and decreased salivary secretion and contribute to diagnostics and treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Secondary drooling is caused by disorders that affect the centres in the brain that initiate, control and regulate the swallowing process, as well as the motor neurons 16 . In PD, drooling is generally secondary and associated with reduced swallowing frequency and efficiency, and impaired orofacial and oropharyngeal muscle function 14–17 . Therefore, drooling in patients with PD can occur even when there are low salivary flow rates.…”

Section: Introductionmentioning

confidence: 99%

Effect of orofacial physiotherapeutic and hygiene interventions on oral health–related quality of life in patients with Parkinson’s disease: A randomised controlled trial

Baram

Karlsborg

Özhayat

et al. 2021

J of Oral Rehabilitation

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Background Parkinson's disease (PD) has a negative effect on oral health and orofacial function, but the subjective experience of orofacial symptoms and their impact on the quality of life is not fully investigated. In addition, knowledge of how to improve the subjective oral symptoms is lacking. Objectives To assess the self‐reported orofacial function and oral health in patients with PD. Furthermore, to investigate the effect of interventions for improvement of oral hygiene and function on oral health–related quality of life (OHRQoL). Methods A randomised controlled study with delayed intervention was conducted in 29 patients with moderate to advanced PD. Patients were instructed in a standardised exercise programme for the jaw and orofacial muscles and given an individualised oral hygiene programme. The effect on self‐reported orofacial function and OHRQoL was measured after 2 and 4 months using the Nordic Orofacial Test—Screening (NOT‐S), the oral health impact profile (OHIP‐14), self‐reported drooling score and subjective mastication ability. Results Self‐reported oral health and function before the intervention was significantly correlated to the severity and duration of PD. The NOT‐S and drooling score were significantly improved by the interventions after 2 months and the OHIP‐14 after 4 months. Conclusion The interventions improve the self‐reported orofacial function and OHRQoL. These simple interventions can be implemented in the allied multidisciplinary health care surrounding the PD patient.

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Circadian rhythms and influencing factors of xerostomia among Parkinson’s disease patients

Cited by 12 publications

References 47 publications

Impact of Progression of Parkinson’s Disease on Swallowing Ability and Oral Environment

Impact of Progression of Parkinson’s Disease on Swallowing Ability and Oral Environment

Oral flora imbalance in Parkinson's disease

Effect of orofacial physiotherapeutic and hygiene interventions on oral health–related quality of life in patients with Parkinson’s disease: A randomised controlled trial

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