Alzheimer’s disease is the most common cause of dementia. The word dementia describes a set of symptoms that can include memory loss and difficulties with thinking, problem-solving or language.
As dementia is a progressive condition (it gets worse over time) it is important to establish a good dental care programme to improve oral health and reduce the risk of developing poor oral and dental health. Maintaining oral health brings benefits in terms of self-esteem, dignity, social integration and nutrition. Poor oral health can lead to pain and tooth loss, and can negatively affect self-esteem and the ability to eat, laugh and smile.
There are two main types of dental disease: gum disease and tooth decay. Both of these can cause discomfort or pain and can lead to infection. Both pain and infection can worsen the confusion associated with dementia.
How to Maintain Good Oral Health
A healthy diet, good oral hygiene, and the use of fluoride toothpaste will help prevent tooth decay.
Restricting the intake of sugar to two to three times a day, preferably at mealtimes, is important in preventing tooth decay. It is the number of times that sugar is eaten during a day, rather than the total amount of sugar consumed, that is important in reducing the risk of decay. This includes hidden sugar in food and drink, as well as sugar added to food or drinks. Always have a look at the labels on food packaging if you are unsure.
High-energy food supplements contain high levels of sucrose (a form of sugar). If they are used on a regular basis, it is important to keep the mouth clean to minimise the risk of decay. Gum recession increases the chances of decay occurring at the necks of teeth (where the tooth meets the gum) unless oral hygiene is excellent and dietary sugars are controlled.
Food supplements may be prescribed to a person with dementia who is having difficulties with eating. When food supplements are prescribed for a person with natural teeth, it is important to get advice on prevention from your hygienist or dentist.
Brushing can be a challenge at times, encourage self-brushing for as long as able to maintain dignity, this can be supervised, but when self-brushing becomes difficult assisted brushing may be necessary, this is often helped by use of an electric toothbrush. Always use a fluoride containing toothpaste and encourage ‘spit not rinse’ to allow the fluoride to maintain in contact with the teeth for longer. An alcohol free fluoride mouthwash can be used in addition at an alternative time to tooth brushing, perhaps using after lunch.
People with Alzheimer’s may be taking medication for a number of conditions. A dry mouth is a common side effect of these drugs. Saliva acts as a lubricant and also cleans the mouth and teeth. Lack of saliva can lead to a build-up of plaque and increase the risk of dental decay, gum disease and infection. A dry mouth can also cause problems with dentures, including discomfort and looseness.
Denture fixatives and artificial saliva (a fluid to lubricate the mouth) can help some people with denture problems. Your hygienist, dentist or pharmacist will be able to offer advice to relieve discomfort and problems caused by lack of saliva or a dry mouth. Frequent sips of water throughout the day, especially at mealtimes, will help. Try to avoid sipping sugary drinks.
In any stage of Alzheimer’s dental care is important, including regular dental examinations and hygienist visits. Here at Arden House we are a Dementia Friend and can ensure that either yourself or your loved one can be treated compassionately despite any difficulties and will offer you appropriate advice in order to maintain dental care at home between visits.
Diploma in Dental Hygiene, Member of British Society of Dental Hygiene and Therapy. GDC Reg No: 6419