Radiotherapy to the salivary glands as treatment of sialorrhea in patients with parkinsonism (original) (raw)
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Sialorrhea and Xerostomia in Parkinson’s Disease Patients
Acta Clinica Croatica, 2022
Parkinson's disease (PD) is generally considered as a primary movement disorder, but the majority of patients also suffer from non-motor oral, salivary symptoms. The most common salivary symptoms, sialorrhea and xerostomia, have a considerable negative impact on the quality of life. Although these symptoms are completely opposite ones, both significantly impair oral health of patients. Sialorrhea is defined as an increased amount of the retaining saliva. It is related to salivary overproduction, or it may be associated with impaired clearance of saliva. Opposed to sialorrhea, xerostomia is subjectively defined as dryness of mouth and it is related to insufficient salivary secretion. Xerostomia promotes imbalance of oral microflora and oral pathology that often leads to malnutrition in PD patients. It is mostly related to autonomic dysfunction, or it might be considered as a side effect of dopaminergic or anticholinergic medication. In PD, different assessments are used for evaluation of sialorrhea and xerostomia, including validated scales for non-motor symptoms and standardized questionnaires on oral health. Consequently, treatment of salivary symptoms includes pharmacological and nonpharmacological approach, and surgical interventions. A multidisciplinary approach in clinical neurology and dental medicine, which includes accurate evaluation of salivary symptoms and effective treatment, indicates successful management of PD patients.
Sialorrhea in Parkinson's disease: A review
Movement Disorders, 2007
A significant number of patients with Parkinson's disease (PD) experience sialorrhea. This problem can cause social embarrassment, and because saliva pools in the mouth, may lead to aspiration pneumonia. Sialorrhea in PD is thought to be caused by impaired or infrequent swallowing, rather than hypersecretion. Oral medications, botulinum toxin injections, surgical interventions, radiotherapy, speech therapy, and trials of devices may be used to treat sialorrhea in PD, but few controlled trials have been published. This article reviews current knowledge regarding the frequency, etiology, assessment, and treatment of sialorrhea in PD. © 2007 Movement Disorder Society
Dysphagia and sialorrhea: the relationship to Parkinson's disease
Arquivos de gastroenterologia
Dysphagia and sialorrhea in patients with Parkinson's disease are both automatically accepted as dependent on this neurological disease. The aim were to establish if these two complaints are a consequence or associated manifestations of Parkinson's disease. Two Parkinson's diseases groups from the same outpatients' population were studied. Patients in the first group, with dysphagia, were studied by videofluoroscopy. The second, with sialorrhea, were studied by the scintigraphic method, Videofluoroscopic examination of the oral, pharyngeal and esophageal phases of swallowing showed that 94% of Parkinson's diseases patients present, structural causes, not related to Parkinson's diseases, able to produce or intensify the observed disphagia. The scintigraphic examination of Parkinson's diseases patients with sialorrhea showed that there is no increase of serous saliva production. Nevertheless, showed a significantly higher velocity of saliva excretion in the...
Evidence-Based Recommendations for the Oral Health of Patients with Parkinson’s Disease
Neurology and Therapy, 2021
Introduction: Patients with Parkinson's disease (PD) present a variety of oral disease that can be worsened by xerostomia and sialorrhea. The patients' physical limitations, for example rigidity and tremor, add to the difficulty of oral care by the general dental surgeon. The objective of the present review was to organize a list of evidence-based recommendations for the oral care of patients with PD. Methods: A systematic review of the literature was carried out by specialists who selected the relevant papers and created a list of recommendations based upon the literature. Results: Fourteen papers (data reported in 16 articles) were included in this review. Patients with PD had reduced quality of oral health and hygiene, and high prevalence of gingival recession, periodontal disease, dental calculus, tooth decay, tooth mobility and loss, drooling, xerostomia, dysphagia and temporomandibular disorders. Most studies offered class IV evidence, while one paper had class II evidence. Conclusion: Patients with PD present poor oral health with conditions that are mostly preventable.
Disorders of the Oral Cavity in Parkinson’s Disease and Parkinsonian Syndromes
Parkinson's Disease, 2015
Awareness of nonmotor symptoms of Parkinson's disease is growing during the last decade. Among these, oral cavity disorders are, although prevalent, often neglected by the patients, their caregivers, and physicians. Some of these disorders include increased prevalence of caries and periodontal disease, sialorrhea and drooling, xerostomia, orofacial pain, bruxism, and taste impairment. Though many of these disorders are not fully understood yet and relatively few controlled trials have been published regarding their treatment, physicians should be aware of the body of evidence that does exist on these topics. This paper reviews current knowledge regarding the epidemiology, pathophysiology, and treatment options of disorders of the oral cavity in Parkinson's disease patients.
International Archives of Otorhinolaryngology, 2016
Introduction Dysphagia is a common symptom in Parkinson's disease (PD) and it has been associated with poor quality of life (QoL), anxiety, depression. Objective The aim of this study was to evaluate the quality of life in individuals with PD before and after SLP therapy. Methods The program consisted of four individual therapy sessions. Each session comprised guidelines regarding food and postural maneuvers (chin down). The Quality of Life in Swallowing Disorders (SWAL-QOL) questionnaire was applied before and after therapy. Results The sample comprised of 10 individuals (8 men), with a mean (SD) age of 62.2 (11.3) years, mean educational attainment of 7.5 (4.3) years, and mean disease duration of 10.7 (4.7) years. Thirty percent of patients were Hoehn and Yahr (H&Y) stage 2, 50% were H&Y stage 3, and 20% were H&Y stage 4. Mean scores for all SWAL-QOL domains increased after the intervention period, with significant pre-to post-therapy differences in total score (p ¼ 0.033) and domain 4 (symptom frequency) (p ¼ 0.025). There was also a bias significance for domain 5 (food selection) (p ¼ 0.095). Conclusion Patients exhibited improvement in swallowing-related quality of life after a SLP therapy program. The earlier in the course of PD, greater the improvement observed after therapy.
International Journal of Dental Hygiene, 2018
Objective: The aim of this study was to analyse quality of life (QoL) pretreatment and up to 24 months post radiation therapy (RT) in patients with head and neck (H&N) cancer. Methods: 29 patients (19 men and 10 women) with a mean age of 59±8 years were included. The stimulated salivary secretion was measured and the patients completed the European Organisation for Research and Treatment of Cancer Quality of Life questionnaires (EORTC QLQ-C30 and H&N35) and the Hospital Anxiety and Depression scale (HADS) pretreatment and at 6, 12 and 24 months post RT. Results: At all time-points after RT (6, 12, and 24 months), patients with hyposalivation (stimulated secretion rate ≤ 0.7 ml/min) reported clinically significant differences (> 10 points) regarding insomnia, swallowing, social eating, dry mouth and sticky saliva. Statistically significant differences were found for emotional functioning and insomnia at 12 months (p<0.05 for both) and for sticky Accepted Article This article is protected by copyright. All rights reserved. saliva at both 12 and 24 months (p<0.05 and p<0.01). The number of clinically significant differences increased from 10 at both 6 and 12 months post RT to 14 functioning/symptom scales and single items at the 24 months follow-up. At 24 months post RT, 21% of patients with hyposalivation had HADS scores suggesting anxiety problems compared to 7% for those with stimulated salivary secretion rates > 0.7 ml/min. Conclusion: Patients with hyposalivation showed deterioration in health related quality of life (QoL) at 24 months compared with 12 months post RT. Most pronounced were problems with insomnia, swallowing, social eating, dry mouth and sticky saliva.
The Quality of Life for People with Parkinson’s Disease in Relation to Their Oral Health
Open Journal of Stomatology, 2018
The present study aimed to evaluate the correlation between the oral health status and the quality of life for people with Parkinson's disease. The Decayed, Missing, Filled (DMFT) index and the quality of life questionnaire for people with Parkinson's disease (Parkinson's Disease Questionnaire-39) were used as evaluation instruments. Sixty-two people with a clinical diagnosis of Parkinson's disease between stages 1 and 3, age between 46 and 86 years, of both sexes, with an average time of disease evolution of 7 years, participated in the study. Data were evaluated using the Pearson's correlation test, and one-way ANOVA (p < 0.05). The mean DMFT obtained was 23; there was no correlation between the DMFT values and the total score of the Parkinson's Disease Questionnaire-39 neither in its domains, nor between the DMFT and the stages of Parkinson's disease (p = 0.61). We found that the oral health of parkinsonians is deficient due to the high number of missing teeth, but their perception of quality of life is favorable despite their motor limitations related to mobility, and activities of daily living.