General

1. Monitor vital signs at every appointment because of cardiovascular side effects.

2. Have the patient sit up slowly and remain seated for at least two minutes after being supine in order to minimize the risk of orthostatic hypotension.

3. Decreased saliva flow can put the patient at risk for dental caries, perio-dontal disease, and candidiasis.

4. Shorter appointments may be necessary because of the effects of Parkinson's disease on muscle.

5. Determine the presence of movement disorders such as extrapyramidal symptoms, tardive dyskinesia, or akathesia. They may interfere with the ability of the patient to perform oral health care or they can complicate dental treatment.

6. A semisupine position for the dental chair may be necessary to help minimize or avoid GI adverse effects.

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