Oral health-related quality of life in patients with Parkinson’s disease

Background: Parkinson's disease (PD) is a neurodegenerative condition affecting the quality of life. Due to a worsening of oral health in PD patients with the progression of the disease, oral health-related quality of life (OHRQoL) could be impaired as well. Objectives: To assess whether PD patients in The Netherlands experience worse OHRQoL than historical controls, and to investigate which factors are associated with OHRQoL in PD patients. Materials & Methods: In total, 341 PD patients (65.5 ± 8.4 years) and 411 historical controls (62.6 ± 5.3 years) participated. Both groups completed a questionnaire. The PD patients were asked questions regarding demographics, PD, oral health, and OHRQoL. The historical controls filled in demographic information and questions regarding OHRQoL. The latter construct was assessed using the Dutch 14-item version of the Oral Health Impact Profile (OHIP-14). Data were analysed using independent samples t-tests and univariate and multivariate linear regression analysis. Results: The mean OHIP-14 score was higher in PD patients (19.1 ± 6.7) than in historical controls (16.5 ± 4.4) (t(239) = 6.5; p <.001). OHRQoL in PD patients was statistically significant associated with motor aspects of experiences of daily living (B = 0.31; t(315) = 7.03; p <.001), worsening of the oral environment during disease course (B = 3.39; t(315) = 4.21; p <.001), being dentate (B = −5.60; t(315) = −4.5; p <.001), tooth wear (B = 2.25; t(315) = 3.29; p =.001), and possible burning mouth syndrome (B = 5.87; t(315) = 2.87; p =.004). Conclusion: PD patients had a lower OHRQoL than historical controls. Besides, PD-related variables and oral health-related variables were associated with OHRQoL

Developing a research diagnostic criteria for burning mouth syndrome: Results from an international Delphi process

Objective To develop a beta version of a preliminary set of empirically derived research diagnostic criteria (RDC) for burning mouth syndrome (BMS) through expert consensus, which can then be taken into a test period before publication of a final RDC/BMS.Design A 6 round Delphi process with twelve experts in the field of BMS was used. The first round formed a focus group during which the purpose of the RDC and the definition of BMS was agreed upon, as well as the structure and contents. The remaining rounds were carried out virtually via email to achieve a consensus of the beta version of the RDC/BMS.Results The definition of BMS was agreed to be 'an intraoral burning or dysaesthetic sensation, recurring daily for more than 2 hours per day over more than 3 months, without evident causative lesions on clinical examination and investigation'. The RDC was based upon the already developed and validated RDC/TMD and formed three main parts: patient self-report; examination; and psychosocial self-report. A fourth additional part was also developed listing aspirational biomarkers which could be used as part of the BMS diagnosis where available, or to inform future research.Conclusion This Delphi process has created a beta version of an RDC for use with BMS. This will allow future clinical research within BMS to be carried out to a higher standard, ensuring only patients with true BMS are included. Further validation studies will be required alongside refinement of the RDC as trialling progresses.</div

Effects of acute pain and strain of the periodontium due to orthodontic separation on the occlusal tactile acuity of healthy individuals

Objectives The aim of this study was to assess whether pain and strain of the periodontal ligament (PDL), induced by orthodontic separation, alter the somatosensory ability to perceive small thicknesses between occluding teeth (occlusal tactile acuity, OTA). Methods The OTA was tested at baseline (T0), using 9 aluminum foils (range 8-72 mu m), randomly placed between the molar teeth, and 1 sham test (without foil), asking the participants whether they felt the foil between their teeth. Afterwards, orthodontic separators were placed, and subjects were randomly assigned to one of the two experimental groups: Group Pain (GP: 18 males; 14 females mean age 25.22 +/- 2.28 years) had separators removed after 24 h; Group Strain (GS: 14 males; 17 females, mean age 24.03 +/- 3.06 years) had separators removed after 7 days. The OTA measurement was repeated in both groups immediately after orthodontic separators removal (T1). A within-group comparison (T1 vs T0) was performed for each testing thickness (ANOVA for repeated measurements, with Bonferroni correction for multiple testing) (p &lt; 0.005). Results GP showed statistically significant reduction of the OTA at T1, as compared to T0, for the thicknesses 24 mu m (p = 0.004) and 32 mu m (p = 0.001). No significant reduction was observed in GS (all p &gt; 0.005). Conclusions Acute periodontal pain tends to disturb the tactile ability of the teeth, while strain of the PDL in absence of painful sensation determines a return to OTA baseline values

Salivation in Parkinson's disease: A scoping review

Objectives: We aimed to provide an overview of the available literature that includes both objective assessments (namely hypersalivation and hyposalivation) and the subjective experience (namely xerostomia and drooling) of salivary problems in patients with Parkinson's disease. Background: In patients with Parkinson's disease, there may be complaints of salivary problems such as xerostomia or drooling. This can have consequences for their oral health and quality of life. To date, systematic reviews have focused on drooling only. Materials and methods: A literature search in 4 databases was performed up to 12 February 2021. Two researchers independently assessed studies for eligibility. Results: In total, 63 studies were included. The prevalence of self-reported xerostomia ranged from 49% to 77%, and that of self-reported drooling ranged from 5% to 80%. Ten articles reported a significantly lower mean salivary flow in patients with Parkinson's disease than in controls. None of the articles with both a control group and a patient group reported a significantly higher salivary flow in patients with Parkinson's disease. When questioned about subjective salivary problems, a significantly higher prevalence of both xerostomia (7 studies) and drooling (14 studies) was found in patients with Parkinson's disease than in controls. Patients with Parkinson's disease have a lower salivary flow rate and higher prevalence of both xerostomia and drooling than controls. Conclusion: The complexity of salivary problems present in patients with Parkinson's disease necessitates a multidisciplinary approach in order to avoid mutually counteracting treatments from different healthcare professionals

Parkinson's disease, temporomandibular disorder pain and bruxism and its clinical consequences: A protocol of a single-centre observational outpatient study

Introduction A recent questionnaire-based study suggested that bruxism and painful temporomandibular disorders (TMD pain) may be more prevalent in patients with Parkinson's disease (PD) compared with controls. The presence of both bruxism and TMD pain may negatively influence patients' quality of life. The present study is designed to clinically and more objectively investigate the presence of bruxism and TMD pain in patients with PD. The secondary aim of the study is to identify factors associated with bruxism and TMD pain in patients with PD, such as disease severity and dopaminergic medication usage. Furthermore, the presence of tooth wear in patients with PD will be studied as this can be a major consequence of bruxism. Finally, deviations in saliva composition that may contribute to tooth wear will be studied. Methods and analysis This is a single-centre observational outpatient study at the Amsterdam University Medical Centres, location VUmc. All patients with a clinical diagnosis of PD will be eligible for inclusion. Participants will fill in a set of questionnaires. Subsequently, patients will be examined clinically for, among others, TMD pain, presence and severity of tooth wear, and deviations in saliva composition. Sleep-time registrations will take place for 5 nights with the GrindCare GC4 (ie, a portable, single-channel electromyographic recorder) to assess sleep bruxism and simultaneously by the use of the BruxApp for 5 days to assess awake bruxism. We will partly use data collected during standard clinical care to minimise patient burden. Ethics and dissemination The scientific and ethical aspects of this study protocol have been approved by the Medical Ethics Review Committee of the Amsterdam UMC, location VUmc; NL. 2019.143. Informed consent will be obtained from all participants. The results will be published in a peer-reviewed journal, if relevant presented at conferences, and published as part of a PhD thesis

Association between polysomnographic parameters of sleep bruxism and attrition-type tooth wear

Background: Clinically, sleep bruxism is considered to be associated with the presence of tooth wear, but strong evidence is still lacking. Objective: To examine whether an association exists between polysomnographic parameters, recorded from patients with possible sleep bruxism and tooth wear. Methods: Sixty-three possible sleep bruxers (19 males and 44 females, mean ± SD age = 38.5 ± 11.4 years) were recruited among patients attending the Clinic for orofacial pain and dysfunction of the Academic Centre for Dentistry Amsterdam (ACTA). The incisal/occlusal tooth wear was recorded for each tooth clinically, using a 5-point ordinal scale. Subsequently, all patients underwent an one-night ambulatory polysomnographic recording, during which the number of bruxism episodes per hour of sleep (Epi/h), the number of bruxism bursts per hour of sleep (Bur/h), and the bruxism time index (BTI) were recorded and analysed. Logistic regression analysis was performed using the presence of tooth wear as the dependent variable, the polysomnographic recordings as independent variables, and corrected for age and gender. The Bur/h and BTI were removed from the analyses due to collinearity with the Epi/h. Additionally, the polysomnographic recordings were also tested for possible association with self-reported grinding of the teeth during sleep. Results: No significant correlation was found between tooth wear and Epi/h (P = 0.381). In addition, the presence of tooth wear was not associated with self-reported parafunctions. Conclusion: Clinically measured tooth wear and self-reported parafunction seem not be related to the polysomnographic parameters of possible sleep bruxism

Towards a standardized tool for the assessment of bruxism (STAB) - overview and general remarks of a multidimensional bruxism evalution system

The aim of the present paper was to give an overview of the general project and to present the macrostructure of a comprehensive multidimensional toolkit for the assessment of bruxism, viz. a bruxism evaluation system. This is a necessary intermediate step that will be detailed in a successive extended publication and will ultimately lead to the definition of a Standardized Tool for the Assessment of Bruxism (STAB) as the final product. Two invitation-only workshops were held during the 2018 and 2019 General Session & Exhibition of the International Association for Dental Research (IADR) meetings. Participants of the IADR closed meetings were split into two groups, to put the basis for a multidimensional evaluation system composed of two main axes: an evaluation Axis A with three assessment domains (ie subject-based, clinically based and instrumentally based assessment) and an aetiological/risk factors Axis B assessing different groups of factors and conditions (ie psychosocial assessment; concurrent sleep and non-sleep conditions; drug and substance use or abuse; and additional factors). The work of the two groups that led to the identification of different domains for assessment is summarised in this manuscript, along with a road map for future researches. Such an approach will allow clinicians and researchers to modulate evaluation of bruxism patients with a comprehensive look at the clinical impact of the different bruxism activities and aetiologies. The ultimate goal of this multidimensional system is to facilitate the refinement of decision-making algorithms in the clinical setting

Is Myofascial Pain in Temporomandibular Disorder Patients a Manifestation of Delayed-onset Muscle Soreness?

WOS: 000330536800008PubMed ID: 23343773Objective: In a study to the possible role of overuse of the jaw muscles in the pathogenesis of jaw muscle pain, we used a protocol involving concentric and eccentric muscle contractions to provoke a state of delayed-onset muscle soreness (DOMS) in the jaw muscles of healthy individuals. We tested whether the accompanying signs and symptoms would yield the temporary diagnosis of myofascial pain according to the research diagnostic criteria for temporomandibular disorders (RDC/TMD) in these individuals. Methods: Forty persons (mean age +/- SD = 27.7 +/- 7.5 y) performed six, 5-minute bouts of eccentric and concentric jaw muscle contractions. Before and immediately after the exercise, and 24 hours, 48 hours, and 1 week later, self-reported muscle fatigue and pain, pain-free maximum mouth opening, pressure-pain thresholds, and the number of painful jaw muscle palpation sites were recorded. Results: Significant signs and symptoms of DOMS in the jaw muscles were found, which all had resolved after 1 week. In 31 (77.5%) of the participants, these signs and symptoms also gave rise to a temporary diagnosis of myofascial pain according to the RDC/TMD. Conclusions: The results of this study demonstrate that an experimental protocol involving concentric and eccentric muscle contractions can provoke DOMS in the jaw muscles and the temporary diagnosis of myofascial pain according to the RDC/TMD. The results observed strengthen the supposition that the myofascial pain in TMD patients may be a manifestation of DOMS in the jaw muscles.European Union Marie Curie Chair Project (GenderReflex) [MEX-CT-2006-040317]; Turkish Scientific and Technical Research Organization, Ankara, Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [107S029-SBAG-3556]Supported by the European Union Marie Curie Chair Project (GenderReflex; MEX-CT-2006-040317) and Turkish Scientific and Technical Research Organization, Ankara, Turkey (TUBITAK; 107S029-SBAG-3556). The authors declare no conflict of interest