Oral health care plays a pivotal role in preserving your general health. Thus, you must take proactive measures to protect your teeth from problems like cavities, infections, and toothache.
But what about people with dementia? Does this ideology apply to them as well?
The answer is Yes. Since, from a psychological perspective, it may become a tad bit difficult for people with dementia to guard their dental health against oral problems, special care, and attention need to be given to them.
This is because, due to their Alzheimer’s conditions, dementia patients may forget to maintain a proper and regular dental care routine. When this happens, they automatically become prone to serious tooth decay, infections, and gum diseases. Also, people with advanced cases of dementia may not be able to express their toothache and other pain from the mouth.
Read on to find out how dementia impacts or influences oral health.
What is Dementia & How does It affect Oral Health?
Dementia refers to the progressive state of cognitive impairment. So, let us first understand what cognitive impairment is.
This term refers to an individual’s disability to perform cognitive functions like remembering, focusing, learning, and even making sound decisions that impact their daily lives. A person with dementia may also be subjected to Alzheimer’s disease.
According to the longitudinal studies conducted by the NIA Intramural Research Program, dementia is commonly witnessed among older adults i.e., the aging population. They may require long-term care since dementia exposes them to various risk factors.
Some of these risk factors can also impact the oral health status of people suffering from cognitive impairment and dementia.
Dementia affects the oral hygiene of a person in multiple ways:
Increased risk of teeth infections and gum diseases
Since people with dementia are unable to follow a proper dental routine like brushing and flossing their teeth, due to poor cognitive functions, they are most likely to be prone to infections and gum diseases.
Reduced Saliva
Saliva plays an important function in maintaining a healthy mouth, and so, good oral health. It also helps to prevent the onset of tooth decay, plaque, tartar, and other oral diseases. However, since people with dementia succumbed to ingesting a plethora of medications, their salivary glands generate only less saliva, which makes them susceptible to these dental problems.
Medications
Speaking of medications, prolonged use of them can sometimes cause dry mouth amongst dementia patients. And, for those who are wearing dentures, it can cause difficulties in maintaining them.
Dietary Changes
Sucking on lollies, or consuming sugared tea can severely impact the teeth and gums. In addition to this, unstable diets, which are commonly witnessed amongst patients with Alzheimer’s because of dementia; can also be a leading cause of their poor oral health
People living with dementia frequently find it difficult to adequately express their teeth pain and discomfort. Hence, they need to rely on their families and caregiver to recognize any behavioral changes that could indicate dental issues, such as rejecting dental care and hygiene, avoiding food, or repeatedly pulling at the face.
Therefore, it is our responsibility as people of sound mind to support in providing dementia patients with proper oral care.
But how do we know if they are facing trouble with their oral health?
Let us find out!
Spotting Signs of Problems in Dementia Patients:
Since people who have dementia may find it difficult to communicate the dental issues they are facing, we need to remain mindful and watch out for the following indicators of pain and discomfort:
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Holding their face constantly -
They grimace while eating or drinking -
Exhibiting reluctance to consume hot/cold food and beverages -
If their gums bleed while brushing their teeth -
Look for dark spots in their teeth. (They may not let you look or clean their teeth) -
They frequently bite their inner cheek or lip -
Excessive drooling -
They may act aggressively and try to bite you or other objects -
They have swollen gums -
They have bad breath -
They have a white film on their tongue
If your loved one or a person you know is suffering from dementia and displays any or all these signs, take them to a dentist immediately.
Now let us look a some of the common dental problems that affect dementia patients.
Common Dental Problems:
The identification of any of these symptoms is essential to maintain the dental health of an individual. However, people with dementia need to maintain good oral health because it plays a vital role in impacting other parts of their bodies.
For instance, according to some studies furnished by “Clinical Oral Investigations”, researchers had discovered that, by maintaining healthy mouth care, the risk of pneumonia among dementia patients is significantly lowered.
Thus, you will need to look out for these (listed below) dental problems, to preserve the oral health of your loved one:
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Cavities: build-up of plaque and tartar on the outer layer of the tooth -
Broken teeth: Chipped enamel of the tooth or teeth -
Dental Work: fillings, crowns, and root canals that are chipped, or fallen out -
Abscessed Tooth: the tooth pulp gets infected -
Dry Mouth: Unable to taste food
Now that we are aware of the dental issues that a patient with dementia may experience, let us understand what specific type of dental care is best suited to treat their ailments.
Specialist Dental Care for Dementia Patients:
Since these patients have difficulty communicating their pain or at times cannot understand or consent to a specific dental treatment procedure, they may require the assistance of either a caretaker or a family/friend.
Here are a few tips to work with a dentist considering these situations:
Finding the right dentist
The dentist you select must have proven experience working with dementia patients, or at the very least, senior patients. However, you must give the dentist written consent on the patient’s behalf before beginning any treatment.
Communicate everything
Before beginning any dental procedure, the patient’s caretaker or family must inform the dentist of their medical history, medications, list of doctors they are currently seeing, and any past dental treatments they have already completed.
Familiarity and Regularity
When dementia patients are placed in a familiar setting they are comfortable with, they will feel more at ease and be more cooperative with the dental treatments. Hence, it is important that the patient visit the same dentist for all their oral needs.
Daily Dental Care for Dementia patients
Providing short and simple instructions:
Since dementia patients cannot concentrate on specific and complex matters, dentists recommend that you should break down the dental care routine for the patient in simple steps. Also, it is important to avoid vagueness in these instructions.
For instance, instead of saying “brush your teeth”
You can say:
- “Hold your toothbrush,”
- “Apply the paste on the brush,”
- “Now brush your teeth.”
Using the “Watch Me” Technique
Even the most basic instructions might be difficult for people who have dementia. They need more guidance at this point. As a result, you may occasionally need to demonstrate to them how to clean their teeth. This approach will help eliminate feelings of agitation, confusion, etc., from their mind.
Do their routine for them
For patients with severe cases of dementia, they might often feel mentally lost, or have extremely limited awareness of their surroundings. When this happens, you will need to do their dental care routine for them.
For example, you will need to gently brush their teeth, gums, tongue and even the roof of their mouth, at least twice a day.
Monitoring their Sugar Intake
Sugar can easily impact the gums and teeth of a person. It can lead to the emergence of dental caries, decay, ad much more. Hence, you need to monitor the sugar intake of dementia patients.
Some of the ways to reduce their sugar intake are:
- Use artificial sweeteners in drinks and food.
- Consume sugar-free snacks and juices.
- For carbonated beverages, always use the “diet” version
Using Different Toothbrushing Techniques:
Sometimes dementia patients may depict a non-compromising attitude while brushing their teeth. They may tend to clench or spasm their lips and cheeks together, making brushing a difficult task. Hence, the dentist recommends a few brushing techniques to help solve this issue:
- Chaining: you may begin brushing the patient’s teeth. Then, let them take over and complete the process.
- Bridging: This technique focuses on improving the patient’s sensory connection. Here, the patient will be holding a toothbrush, while you brush their teeth using another brush.
- Hand-over-Hand: in this method, you will need to place your hand over the patient’s hand and guide them through the toothbrushing process.
What about Flossing? Do people with dementia require flossing?
The upkeep of oral hygiene is different for a normal person and a person with dementia. Although the dentist advocates flossing as a vital part of one’s dental hygiene, a patient with dementia does not require it.
This is because people with dementia often exhibit a reluctant attitude toward brushing their teeth. Thus, maintaining basic oral hygiene becomes more important than flossing. This allows dementia patients to remain consistent in their daily dental routines.
And by making the dental routine simpler, consistency can be ensured. Since dementia patients are unable to localize the problems with their teeth and gums, it is always important to remain minimal with instructions and guidance assigned to them.
Denture Care
If the dementia patient requires dental dentures, it is your (or the caretaker’s) responsibility to ensure that these dentures are removed from their mouth before brushing their teeth. Also, dentures need to be cleaned separately with a different toothbrush. Listed below are some of the tips to care for dentures:
-
Brush and clean the dentures daily -
Rinse dentures after every meal. You can use plain soap and water in this process -
When removed, always keep dentures in filled water, to prevent cracking -
You can also make use of denture-cleaning tablets. -
Do not soak dentures overnight. Ensure they are rinsed and dried -
Since these dentures are worn by dementia patients, they need to be marked for identification. -
Partial dentures cannot be advised for old people with dementia since their gum tissues are fragile.
Everybody deserves to have healthy teeth and a healthy smile. A person’s mental condition should not restrict them from maintaining proper hygiene. Therefore, whoever is responsible for looking after the dementia patient must ensure that their teeth and gums remain in good health at all times.
At Clinic Effect, we assure you of a friendly atmosphere, guaranteeing peace and support in dental care for you and your loved ones. Our dentists are qualified and trained to provide expert oral care to patients of all ages and dental needs.
To learn more about our services, visit our website
Reference List:
- https://www.nia.nih.gov/news/large-study-links-gum-disease-dementia
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748411/
