Can someone with Parkinson's have implants? Dentures, care and medicine times

The NHS lists tremor and muscle stiffness among the main symptoms of Parkinson's; it writes that stiffness can also make facial expressions difficult. The same list also includes swallowing difficulties and drooling. For the mouth, this means that both cleaning your own teeth and keeping a removable denture in place with the cheeks, tongue and lips become harder. The Parkinson's Foundation writes that because of tremor and stiffness, about half of people with Parkinson's have difficulty with daily mouth care.

The medicines play a part too. Parkinson's UK explains that some Parkinson's medicines can cause dry mouth and some a burning sensation in the mouth, and that drooling can arise both from reduced swallowing and as a side effect of medicine. A dry mouth makes decay, gum disease and oral thrush more likely and makes a denture harder to control. The NHS writes that long-term use of levodopa can be associated with involuntary movements (dyskinesia); the Parkinson's Foundation adds that these movements can also affect the jaw and can lead to cracked teeth and tooth grinding.

Parkinson's UK's list of denture problems runs as follows: difficulty controlling the facial muscles, loss of muscle tone, dry mouth, saliva pooling in the mouth, and dentures that are old, worn, loose or do not fit the mouth. A loose denture can rub in the mouth and cause sores and infection, and it makes eating and speaking difficult. An implant intervenes at several links of this chain at once: it fastens the denture to the implant rather than to muscle strength.

On the evidence side, honesty is needed. A scoping review published in 2026 screened 634 records examining implants in neurodegenerative diseases, including Parkinson's, and none met the strict inclusion criteria. The 7 publications that fell outside the criteria indicated that implants improved chewing efficiency, quality of life and weight gain, especially in patients with Parkinson's. The authors write that there are promising results in early-stage patients, whereas suitability in advanced disease remains uncertain.

In one of these small studies, 9 patients with Parkinson's aged between 54 and 77 were given a fixed or removable implant-supported prosthesis. The success rate was 85% in the upper jaw and 81% in the lower jaw. On the other hand, eating and satisfaction with the prosthesis improved markedly at month 3, and this improvement was still continuing at month 12. In another series of 3 patients with a mean age of 75.7 and moderately advanced disease, dentures retained by implants in the lower jaw improved chewing markedly and the patients gained 2.2 kilos on average.

A review examining implants in movement disorders, based on 19 case reports and 11 case series, wrote that the rate at which implants stay in the mouth may be lower than expected, but that the losses were concentrated in the early rather than the late period. With fixed prostheses the need for maintenance was low; with removable implant-retained dentures, however, the attachments and the denture needed replacing more often. The review's conclusion is clear: an implant-supported prosthesis improves chewing and quality of life in these patients, but simple designs that are easy to maintain in the long term should be chosen.

There is also a case showing that the design decision can change over time. In one reported case, a fixed implant prosthesis in an 81-year-old patient with Parkinson's was converted to a removable implant-retained denture to make cleaning easier for the carers. When the patient became bedridden, they could not wear the denture, the exposed attachment caused a sore on the cheek and inflammation developed around the implant. This single case cannot be generalised, but it has an important lesson: the plan should be made with the reality of care a few years from now in mind, not today's.

That is also why timing matters. The Parkinson's Foundation says that as the disease progresses, the time during which the medicine works well gets shorter, and for this reason recommends that the replacement of old fillings, crowns, bridges and ill-fitting dentures is planned in the early period of the disease and that invasive procedures are also carried out as early as possible. It also notes that if a general anaesthetic is needed, recovery time can be longer in a patient with Parkinson's.

The distinction below is a framework. The final decision is made after the oral examination, the CBCT scan, the stage of the disease, the medicine routine and the care arrangements at home have been assessed together; if necessary, your neurologist's opinion is obtained.

For a patient with Parkinson's, safety and comfort are largely achieved through timing, communication and a simple design. The steps below show this framework.

1. 1

   Safety first: choking and swallowing

   If you have swallowing difficulty or a history of coughing or choking during meals, say so at the first consultation. The Parkinson's Foundation suggests asking for the chair to be kept more upright. If there is inability to breathe or choking during or after the procedure, call 112.

2. 2

   Medicine list and times

   Bring all your Parkinson's medicines, their doses and the times you take them in writing. Parkinson's UK asks you to tell your dentist your medicine times so that you can carry on taking the right dose during the procedure too. The Parkinson's Foundation stresses that MAO-B medicines such as rasagiline or selegiline must be mentioned, because they can interact with anaesthetics.

3. 3

   If there is a deep brain stimulator, a letter to the neurologist

   If you have had deep brain stimulation (a 'brain pacemaker'), say so. Parkinson's UK explains that in this situation the dentist writes to your specialist before the procedure to confirm whether antibiotics are needed and whether there is anything else to be careful about.

4. 4

   Planning the appointment around the 'on' period

   Do not change your medicine time to suit the appointment; arrange the appointment to suit your medicine. The Parkinson's Foundation recommends that appointments are made to fall in the morning and in the period when the medicine works best, and that several short appointments are planned instead of one long session. Settle the times together with your neurologist.

5. 5

   Choosing the design according to the reality of care

   Fixed or removable? With a fixed prosthesis the need for daily maintenance is low, but interdental cleaning calls for manual dexterity. With a removable denture cleaning is easy, but the attachments need maintenance more often and the denture has to be put in and taken out. The decision is made by thinking about who will be doing the care a few years from now.

6. 6

   Dry mouth and gum preparation

   Decay and gum inflammation in the remaining teeth are treated; if there is dryness, saliva substitute products and high-fluoride toothpaste are discussed. This step affects both surgical success and long-term care.

7. 7

   The carer taking part in the process

   It is helpful for the relative who acts as carer to come to the check-up appointments too and to learn the cleaning technique together with you. If you send the images and the medicine list through the assessment form in advance, the dentist prepares the session plan with this information.

Each option has its own side as far as Parkinson's is concerned. The right one is the choice that looks at both your situation today and how care will be carried out in the years ahead.

Most of the following can be reduced with the right planning. Read them bearing in mind that the evidence rests on small studies.

In a patient with Parkinson's, healing follows a similar path to other patients; the difference is keeping to the medicine times, monitoring nutrition and putting care on a set routine from the outset.

1. The day of the procedure

   Carry on taking your medicines at the times your neurologist has set. If you are asked to fast, settle in advance how your medicines will be taken. Have a relative with you for the journey home.

2. The first week

   Soft foods that are easy to swallow. If there is swallowing difficulty, adjust the consistency according to the advice of the speech and language therapist. Swelling and tenderness should go down; keep a close watch on the wound in the mouth.

3. The first months

   Because early implant loss is reported more often in this group, check-ups should not be skipped. The fit of the prosthesis, whether there are any rubbing marks on the cheek or tongue and any change in weight are monitored in this period.

4. The long term

   The Parkinson's Foundation recommends a check-up and cleaning every 3–6 months. As the disease progresses, the cleaning method and, if necessary, the design of the prosthesis are reviewed again.

Parkinson's disease does not directly change the fee for treatment. The items that determine the extent are these:

Session plan and duration

Sessions that are short and divided according to medicine times affect the number of appointments and the duration.

Type of anaesthesia

If sedation or a general anaesthetic is needed, the anaesthetic team and monitoring become part of the extent.

Prosthesis design

A removable implant-retained denture can be built on fewer implants but needs maintenance of the attachments; with fixed teeth, the number of implants and the superstructure determine the extent.

Preparing the mouth

Treatment of the remaining teeth, gum treatment and preventive measures directed at dry mouth can be separate items.

Long-term maintenance

A check-up every 3–6 months, replacement of attachments and a change of design when needed are among the long-term items.