Parkinson Disease — ORE Part 1 MCQ

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ModerateHuman Disease & Dental ManagementParkinson DiseaseORE Part 1

A 70-year-old man with Parkinson's disease takes levodopa and has predictable periods of good motor control after each dose. He requires a restorative dental procedure under local anaesthesia. Which management plan is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Book a short visit during his usual period of best motor control

Explanation lettering: D = shown as A · C = shown as B · A = shown as C · B = shown as D

A is correct. Parkinson's symptoms may fluctuate with the response to levodopa. Dental treatment should therefore be planned for the patient's individual “on” period, when tremor, rigidity and bradykinesia are best controlled; a short appointment also helps accommodate fatigue and involuntary movements. B is incorrect because Parkinson's disease alone does not require universal avoidance of adrenaline-containing local anaesthetic. C is unsafe: metoclopramide is contraindicated in Parkinson's disease and in patients receiving levodopa/dopaminergic drugs. D is an excessive approach; routine dental care can usually be provided with local anaesthesia and appropriate planning. E is incorrect because fluoride toothpaste remains appropriate preventive care, particularly where oral hygiene may be impaired.

Reference: Electronic Medicines Compendium (eMC), Metoclopramide 5 mg/5 ml Oral Solution Sugar-Free – Patient Information Leaflet, section 2 “What you need to know before you take Metoclopramide oral solution”, current product information, https://www.medicines.org.uk/emc/product/13469/pil