Looking after your oral hygiene when you have Parkinson's

• Brush your teeth twice a day with a toothpaste containing at least 1350 ppm fluoride. Ask your dentist if you're not sure about the level of fluoride in your toothpaste – they may be able to prescribe you a toothpaste with a higher concentration of fluoride.
• Use a daily fluoride mouthwash at a different time to brushing.
• Brush last thing at night and 1 other time during the day.
• Try not to rinse your mouth after spitting out your toothpaste.

Your dentist may also advise a fluoride mouth rinse or gel to use when you're not brushing your teeth. This is important if you have a dry mouth as you are more likely to get tooth decay. They may also apply a fluoride varnish to your teeth, which strengthens the enamel.

• It's important to clean all parts of your teeth, especially the area where the tooth leaves the gum. Don’t forget to clean both sides of your teeth as well as the biting surface.
• Use whichever technique you find easiest. Your dentist or hygienist can show you some aids to help you clean between your teeth.
• If you find cleaning your teeth difficult or tiring, you could clean one part of your mouth in the morning and another part in the afternoon.
• Ask your dentist for help on choosing the best toothbrush for you. They'll also be able to help you find the best way to clean your teeth and the gaps between them.
• Your dentist may advise you on toothbrush handle adaptations which can help improve your grip. You may find it easier to use a three-sided toothbrush or one with an angled head. A small head may also help you reach all your teeth.
• Consider an electric or battery-operated brush, as the extra weight may help to reduce hand and arm tremors.
• If you're cleaning someone else's teeth, you may find it easier to stand behind them like dentists do. Or you could clean one side of their teeth standing behind them and the other side while standing in front of you. This can help you use your strongest, writing hand to reach all the parts of their teeth. 

The bacteria in plaque changes sugar into acid, which attacks your teeth. Cutting down on sugar in your diet can reduce tooth decay.

• Try not to have more than 30 grams of sugar (7 sugar cubes) per day.
• Try not to eat or drink sugary things more than 4 times a day. How often sugar is in contact with your teeth can be more damaging than the amount.
• Choose sugar-free snacks, such as cheese or vegetables. 
• Try and restrict sugary drinks to meal times. Drink water or sugar-free tea or coffee between meals.
• Cut down on foods such as biscuits and cake.
• Be aware of the sugar in fruit juice, smoothies, honey and syrups (like maple and golden) as these foods and drinks can also lead to tooth decay.

Plaque can build up on dentures, just as it does on natural teeth, causing irritation to the skin on the roof of your mouth, cheeks and gums. It may help you to do the following things.

• Removing your dentures will help you clean all the surfaces more easily.
• Always clean dentures over a sink full of water. That way, if you accidentally drop them, you can avoid breaking them.
• Soak your dentures overnight in water and then brush them gently under water.
• Never use toothpaste on dentures because it’s too abrasive. Denture pastes are available, or cleaning your dentures with a nailbrush and soap and water is as effective.
• If you use a soaking solution for your dentures, follow the instructions carefully. Leaving dentures in the solution for too long or it being too hot can damage the denture plastic. Avoid using a soaking solution if you have metal dentures. Don't use bleach.
• If you find persistent stains, ask your dentist to remove them.

Ask your dentist for advice if you have specific problems with your dentures.