Dental Treatment Effect on Deep Brain Stimulation System in Parkinson's Disease.

Parkinson's disease (PD) is a highly prevalent, long-term neurodegenerative disorder that is sometimes treated by deep brain stimulation (DBS), which significantly reduces the need for dopaminergic drug therapy and improves quality of life. Such patients are cautioned, however, that dental instruments such as a dental turbine or ultrasonic scaler may adversely affect the functioning of such a system. Here, we report dental treatment for right maxillary tooth pain in a 65-year-old woman undergoing DBS for PD. The diagnosis was occlusal trauma. After verification with occluding paper each time, treatment comprised milling of the high contact points of tooth #17, followed by scaling with an ultrasonic scaler. This treatment was spread out over 3 visits, and its course was uneventful. To our knowledge, there are no previous reports on the interaction between dental instruments and DBS systems. Although no interference with the DBS system was observed here, we believe that the dentist should be aware of the potential for such, especially with the use of devices used to measure root canal length, dental lasers, and electrical scalpels.

A Case of Buccal Abscess from an Impacted Wisdom Tooth in an Elderly Person with Malnutrition.

We report a case of buccal abscess caused by an impacted wisdom tooth in an extremely elderly person with malnutrition. The patient was a 94-year-old man, who complained that he had found it hard to open his mouth and that his cheek had been swollen for the previous 2 weeks. He had a shallow oral wound caused by an improperly fitting denture; however, the wound became infected. We performed incisional drainage of the abscess under local anesthesia. The swelling disappeared and he was able to open his mouth 55 mm. The elderly have a high risk of healing failure of injuries and it has been reported that infection in a host in a compromised state is severely intractable. This elderly patient was in a compromised state because of malnutrition. Cases such as this one will increase as the elderly population increases. Dentists need to consider the quality of life of patients with a longer life expectancy and should offer patients several treatment options before their general condition deteriorates.