Alzheimer’s is a cruel disease. It makes the patient forget everything they’ve spent a lifetime learning – and this can be really tough for the patient, his friends and family. In the last stages of the condition, patients can slip in to complete submissiveness and ignore even basic sanitary needs. Everything suffers, and oral health in particular is completely neglected, leading to dental cavities, gum problems, foul mouth odour and tooth loss, among other challenges.
Relationship between Oral Health and Alzheimer
The actual cause of Alzheimer’s is not known but in the last few years, researchers have noted a few unusual facts regarding the disease and oral health. According to the researchers at the University of Central Lancashire, bad teeth and gum disease could be contributing to the disease or worsening the condition in an affected patient. The patient’s forgetfulness worsens the dental neglect and this results in a cruel circle in which the patient’s worsening mental condition exacerbates the oral condition as well. Another factor that contributes to poor oral health is Alzheimer’s medications. These medications can cause dry mouth and altered oral bacteria that can also contribute to poor oral hygiene and dental problems.
The Role of the Caregiver: Critical To Good Oral Health
Alzheimer’s patients require special dental care from expert caregivers. The caregiver will also have to slowly take on additional responsibility for the patient’s dental health as the condition worsensto ensure that the patient remains comfortable. Below is a short guide that should prove helpful.
Early stages of Alzheimer’s – During the early stages of Alzheimer’s, the patient can usually care for their teeth themselves. At this state, it is necessary to implement as many preventive dental care measures as possible. The patient and his caregiver are encouraged to visit the dentist 4-8 times a year for comprehensive dental care. The dentist will clean and polish teeth, fill any cavities, evaluate gum and periodontal health, apply topical fluoride as prevention, etc. To ensure optimum home care, the patient can use an electric toothbrush with a high fluoride-content toothpaste and a fluoride-impregnated dental floss.
Middle stages of dementia – During this stage, the patient is relatively healthy and the dentist will usually focus on preventive oral care measures. The dentist will also train the caregiver and the patient on basic oral hygiene measures like tooth brushing, flossing, dental care procedures, etc.
Later stages – During the later stages of the condition, the caregiver will have to take over most of the procedures required for oral hygiene. A dentist or hygienist can provide guidance or support on the correct way to clean the patient’s teeth. Some patients may not accept dental care and conscious sedation or general anaesthesia may be required to complete treatment.
Medications – The patient will usually be on strong medications like anti-depressants, anti-psychotics, and sedatives that alter the condition of the oral cavity and decrease oral saliva. This altered environment can cause oral ulcers, tongue ulcers, cracks in the corners of the mouth, etc. Patients may also find it difficult to wear their dentures due to the lack of saliva. To control these conditions, the dentist may provide denture fixative and artificial saliva to help the patient.
During the later stages of the condition, the dentist will work closely with the caregiver and family to provide dental treatment. Some dentists may also do home visits to care for patients that cannot travel.The dentist and dental hygienist will also reinforce basic oral care measures with the caregiver, family members and the patient
Dental care for Alzheimer’s patients is not difficult, but it requires a multi-pronged approach. Good quality preventive care in the early stages of the condition is critical for ensuring a stable oral condition. As the condition progresses, the responsibility for maintaining oral health will then shift over to a collaboration effort between the home caregiver and the dentist.