Parkinson's disease: a review and recommendations for dental management.

Parkinson's disease is one of a group of extrapyramidal diseases characterized by rigidity and tremor. The disease affects about 1 million persons in this country, and is most common in persons older than 55. Parkinson's is disabling and usually progresses from mild to severe, often in less than a decade, and may preclude an individual from accomplishing many activities of daily living, even with current drug therapy. In addition to problems caused by age, dental complications arise from the inability of the individual with Parkinson's to accomplish routine oral hygiene, from changes in salivary flow and due to dysfunction in swallowing. Dental management of individuals with Parkinson's is a multifaceted challenge involving areas of preventive, restorative, and prosthetic dentistry. Support is also required for the psychosocial and behavioral aspects of this common progressive disorder.