Huntington’s disease and oral health: dentists urged to adopt tailored care strategies
Oral health is a growing concern for people living with Huntington’s disease (HD), as new research highlights the significant barriers and complications faced in maintaining dental hygiene and accessing routine care. A recently published review in the journal Special Care in Dentistry provides crucial insights and practical guidance for dentists treating individuals with HD, underscoring the importance of disease-specific planning, preventative care, and interdisciplinary collaboration.
The paper, authored by Dr. Hanad Duble and Dr. Aviv Ouanounou, emphasizes that while HD is primarily a neurological disorder, its effects on muscle control, behavior, and medication response make oral health management especially challenging. This review consolidates years of professional experience and emerging evidence to support better dental care for HD-affected individuals and families.
Barriers to accessing dental care for people with HD
According to the review, people living with HD face multiple obstacles in seeking dental care and maintaining daily oral hygiene. These include:
- Fear and anxiety around dental visits, worsened by HD-related cognitive or emotional symptoms
- Financial limitations, often due to job loss and healthcare coverage gaps
- Mobility and motivation challenges, linked to chorea, apathy, and behavioral changes
- Oral muscle dysfunction, such as involuntary movement or stiffness, which complicates treatment
- Lack of training among dentists, many of whom may never have treated an HD patient before
These barriers collectively increase the risk of neglected oral hygiene and delay timely interventions.
Common oral health complications in HD
The review outlines several recurrent dental issues in HD patients, including:
- Tooth decay and gum disease, worsened by difficulty with brushing and dietary changes
- Dysphagia, or swallowing difficulty, which leads to food remaining in the mouth and throat
- Dry mouth and drooling, often side effects of medications like antidepressants or antipsychotics
- Communication challenges (dysarthria) that make it hard to report pain or consent to treatment
- Instability with dental prosthetics, due to facial muscle weakness
The impact of HD medications on dental care is also significant. Drug interactions, anesthesia risks, and side effects like dizziness or hypotension require special attention during appointments.
Recommendations for dentists treating HD patients
The paper provides several practical strategies for dental professionals, such as:
- Establishing long-term oral care plans early in the HD journey, including caregiver involvement
- Emphasizing prevention with fluoride varnish, xylitol products, and more frequent cleanings
- Customizing comfort measures, such as using upright dental chairs and specialized equipment
- Opting for less invasive treatments, like Silver Diamine Fluoride to halt cavity progression
- Using Glass Ionomer fillings, which release fluoride and are easier to place in challenging cases
Dentists are also encouraged to work closely with neurologists and caregivers, tailor treatment to individual needs, and focus on maintaining patient dignity and comfort.
Advocacy for early intervention, awareness
The review is a step forward in bridging gaps between neurology and dentistry. While HD patients may represent a small subset of dental practices, informed and compassionate care can significantly improve their quality of life.
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By initiating conversations early, adapting care techniques, and fostering stronger communication among providers, families, and caregivers, it’s possible to reduce discomfort, delay invasive procedures, and protect oral health even as HD progresses.
The authors emphasize that prevention and early planning are key. A collaborative approach that respects patient autonomy and anticipates evolving challenges is essential in managing oral health in Huntington’s disease.
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