Why Dementia patients need special Oral Care

January 29, 2019

Dementia is not a specific disease, but it is a term that describes a group of symptoms associated with the decline in memory or other thinking skills which reduce a person’s ability to perform daily activities which might include even brushing their teeth.

Tooth loss and dementia linked 

India stands second in housing most number of dementia patients. According to the “Dementia India” report published by the Alzheimer’s and Related disorders society of India, there are 4.1 million people suffering from it. Recent studies have found a link between tooth loss and dementia and Alzheimers disease. These studies conclude people with missing teeth were at a greater risk of developing dementia or cognitive decline.

Studies are still being carried out to know whether the number of missing teeth is linked with increased risk of developing dementia. For example, do more missing teeth lead to increased risk of dementia? Or with every missing teeth does the risk of developing dementia increase? Researches are yet to find out.

Symptoms of Dementia

  • Memory loss
  • Impaired communication and language
  • Inability to focus and pay attention
  • Altered reasoning and judgment
  • Impaired visual perception.

What causes dementia to occur?

Dementia is caused due to damage to brain cells. The damage interferes with the ability of brain cells to interact with each other. When the brain cells fail to communicate normally, thinking and behavior are altered.

While most of the changes in the brain that cause dementia are permanent and worsen eventually. The following conditions may worsen the diseases:

  • Depression
  • Medication side effects
  • Thyroid problems
  • Alcohol intake
  • Vitamin Deficiencies

 

Oral care for dementia patients 

People living with dementia have a high risk of having tooth decay and gum disease. This may be because they find it difficult to memorize and perform daily activities which might include improper brushing and taking care or their oral hygiene. Hence suffering from dementia require some sort of support to keep their oral hygiene intact. Others may not be able to express that they have tooth pain and hence the dental problems remain untreated.

Therefore, it is necessary to help dementia patients to keep their teeth and gums clean and 100% bacteria free. Here are a few tips which will help the patient’s guardian and caretakers to monitor and maintain oral care.

Sugar intake

If you are caring for someone with dementia, try to avoid too food items that are sweet, both between meals and at meal times. Give them tooth-friendly snacks like:

  • Vegetables
  • Bread with sugar-free spreads
  • Oats
  • Plain yogurt
  • Fruits

Remind to brush teeth

Always supervise your patient while they are brushing teeth. Instruct as needed. Don’t just plainly tell them to brush their teeth. Instead, give them a detailed instruction about holding their brush, placing toothpaste over it, holding the brush at 45 degrees to the gum line and give the right strokes. Teach them or brush for them using the right brushing technique. You may also use electric toothbrushes available in the market to make it more easy and convenient to brush for them. 

Nurses or guardians should brush the patient’s teeth who are unable to do it. Wearing of gloves is recommended to prevent the spread of infection. Toothpaste rich in fluoride is to be used in aiding caries prevention.

Wearing dentures

Recent studies also were done and suggested people who sought timely treatments for missing teeth with either dentures, bridges or implants showed less risk of developing dementia and other cognitive impairments. Hence it is in the best interest to get those missing teeth replaced at least by dentures to protect against dementia and Alzheimers.

Once replaced, it is also very important to keep the dentures clean and replace them if they become loose. If someone has recently received dentures, they might require support in cleaning dentures and keeping them in place. People suffering from dementia are very prone to dropping their dentures and misplacing them. Assist them with keeping their dentures clean and properly immersed in water when not in use. Help them wear and remove their dentures correctly in order to avoid any oral injuries. 

Oral care for reluctant dementia patients

Always supervise your patient whenever you are performing their daily brushing routine. Observe the patient for signs of discomfort. If the patient holds his face, struggle with ill-fitting dentures, frequent bleeding, or reacting to pain, consult the dentist immediately. Take them to the dentist every 6 months to get a teeth cleaning and polishing. You can also take them to hospital facilities  with dental care units for a teeth cleaning and polishing in case any dental emergency arises.

Highlights

  • Tooth loss and dementia are linked and studies suggest increased tooth loss can increase the risk of developing dementia.
  • Oral care for patients suffering from dementia is very important as they are more prone to dental diseases like cavities and gum infections.
  • Proper dental assistance and supervision is required to take care of their oral hygiene.
  • Dental diseases should be treated at the earliest to reduce the suffering and further complications.
  • Reduce the amount of sugar intake, daily reminders to brush their teeth,and helping them take care of their dentures should be done.
  • Reluctant patients must be taken for 6 monthly dental appointments for teeth cleaning and polishing by a dentist.

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Dr. Vidhi Bhanushali is the Co-Founder and Chief Dental Surgeon at DentalDost. A recipient of the Pierre Fauchard International Merit Award, she is a holistic dentist who believes that everyone should have access to oral healthcare, irrespective of class and geography. She strongly believes that tele-dentistry is the way to achieve that. Dr. Vidhi has also spoken at various dental colleges, addressing the dental fraternity about dental services and innovations. She is a keen researcher and has published various papers on recent advances in dentistry.
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