Objective: To determine if the Oral Health Assessment Questionnaire (OHAQ) devised by 2 Parkinson’s Disease Nurse Advanced Practitioners (PDNAP) could facilitate a healthier mouth to optimise the potential for current and future treatment options in Parkinson’s disease (PD).

Background: PD is a progressive neurological condition, with management of motor and non-motor symptoms dependant on dopamine replacement treatment.  Disease progression impacts manual dexterity, and saliva changes and problems chewing and swallowing results in food and medication  residue in the mouth causing significant problems. Looking into the mouth is not routine practice in the movement disorder clinic and oral hygiene is often not addressed [1]. This is increasingly pertinent given emerging treatments including inhaled and sublingual medications, to address unpredictable and disabling motor fluctuations. While these medications  are classed as non-oral, they rely on a healthy mouth to facilitate delivery and limit potential side effects.

Method: In this on-going project, the PDNAP’s will review 80 completed OHAQ undertaken in the nurse led clinic. Data gathered during routine reviews, will consider oral health status and potential suitability for emerging treatments with a proactive approach to oral health.

Results: To date 30 patients 60% male, mean age 69.8 years ± 8.3, mean disease duration 13.2yrs ± 5.2, median Hoehn & Yahr 3 (range 2-4) have been reviewed. Visual inspection of oral cavity 90% with 27% having difficulty opening their mouth. Difficulty lifting tongue to roof of mouth 13% and difficulty keeping mouth closed 13%. Dental plaque was noted in 40%. broken teeth 30%, and coated tongue 33%. Mouth ulcers were seen or reported by 17%, irritated gums  27% and pain in the mouth experienced by 27%. Dentures worn by 33% and problem with fit experienced by 13%. Difficulty cleaning teeth 57%, dry mouth 30%, and drooling in 54%, with 43% reporting use of mouthwash. Following oral inspection 63% were recommended for review with dentist or dental hygienist.

Conclusion: The OHAQ could help to determine issues earlier and promote good oral hygiene. This could potentially help to optimise treatment suitability throughout disease progression.  This includes non-oral treatments that by-pass gut absorption through sublingual absorption but still depend on a healthy oral cavity.

References: Auffret M, Meuric V, Boyer E, Bonnaure-Mallet M, Vérin M. (2021) Oral Health Disorders in Parkinson’s Disease: More than Meets the Eye. J Parkinsons Dis. 11(4) 1507-1535

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MDS Abstracts - https://www.mdsabstracts.org/abstract/considering-oral-health-to-optimise-the-potential-for-current-and-future-treatments-in-parkinsons-disease/