Helping dementia suffers look after their teeth and oral health

The Alzheimer Society of Ireland has stated that there are over 64,000 people in the Republic of Ireland living with dementia¹, and these figures are expected to rise considerably across the next generation. By 2050, experts estimate that there will be 141,000 people in Ireland with dementia; approximately one in five people over the age of 80.

Dementia is a general term for a number of progressive syndromes which cause the decline of brain function, the most common of which is Alzheimer’s disease. This disease causes symptoms which include confusion, memory loss and difficulties with thinking clearly and problem solving. It also makes day-to-day tasks, such as adequate oral health care, a challenge for those living with the disease.

When you’re a carer for someone with dementia, ensuring good oral health in the person you’re caring for is an important aspect of their daily wellbeing. There are many ways to spot symptoms of dental and oral health issues in those suffering from dementia, and ways to assist with good oral health as the disease progresses.

The impact of dementia on oral health

Many people living with dementia find daily tasks we take for granted – including brushing their teeth and following a normal oral health routine – difficult to manage.

However, the results of poor oral health, and most notably tooth decay and gum disease, pose a serious risk to those living with dementia. This is because a lack of regular and thorough brushing can cause plaque to build up and result in damage to the surface of the teeth. Left unchecked, this can result in pain, sensitivity, more serious infection and tooth loss, all of which can make living with dementia even more difficult or uncomfortable.

Identifying when a person with dementia is experiencing issues with their oral health can be difficult, especially if they’re in the later stages of their illness. However, dentists with experience in treating patients with Alzheimer’s disease in Ireland have recommended looking out for a few tell-tale signs.

Spotting oral health issues in people living with dementia

While not every person living with dementia will struggle to think clearly or be able to articulate how they are feeling, it’s not uncommon for many to be unable to identify or express that they’re having issues with their oral health. It’s also quite usual for people living with dementia to find it difficult to maintain a regular oral health routine.

The Alzheimer Society of Ireland have identified a handful of typical behavioural signs that indicate an individual is struggling with their oral health, including:
• Problems with sleeping
• Reluctance to eat or loss of appetite
• Aggressive outbursts or acting as though they are in pain
• Constant touching their face or indicating pain in the mouth area

Many of these behaviours are symptoms of dementia and may not be connected to the oral health of the individual. However, if any of these symptoms develop quickly or seem out of character, speak to your local dentist for advice.

Taking care of oral health in the early stages of dementia

The earlier stages of dementia are generally typified by milder and often more manageable symptoms. However, the person you’re caring for will likely still need frequent reminders, help and guidance on how best to look after their teeth. This might include:
• Clearly explaining to the individual how best to brush their teeth. Use simple, short and easily-understandable steps, and provide frequent reminders to make it a part of their morning and evening routine
• Provide a demonstration on how to brush their teeth and ensure they have easy access to a mirror so they can see themselves doing it
• If necessary, gently guide their toothbrush for them or brush their teeth if they are not able to.

The importance of dentist check-ups for people with dementia

While maintaining a consistent at-home oral health routine is essential, it’s also important to ensure the individual you’re caring for has regular dentist check-ups, too. Many Smiles dentists are specially trained to provide care for those living with dementia – simply ask at your local dental clinic for guidance or a recommendation.

Not only will your dentist be able to check for signs of gum disease, tooth decay, poor dental hygiene and other oral health issues, they’ll be able to build a trusting relationship with the individual which will make dentist visits less stressful.

Taking care of oral health in the later stages of dementia

In the later stages of dementia and Alzheimer’s disease, people often lose the ability to adequately complete daily tasks by themselves. When this arises, carers may need to take a more active role in responsibilities such as brushing their teeth on their behalf.

It’s not uncommon for people living with later stage dementia to find someone brushing their teeth for them stressful or invasive, and it can cause them to become agitated. Should this occur, it’s important not to force the individual. Instead, consider postponing teeth brushing until later in the day or when they’re feeling calmer. If it becomes very difficult to brush their teeth, or if it frequently leads to outbursts of frustration or agitation, it may become necessary to seek out specialist care to make sure they have professional help in looking after their teeth.

Carers of people living with dementia often need support and guidance, or respite support to ensure they can continue living a fulfilling life. The Alzheimer Society of Ireland, along with other organisations, can help you find support in the community for dementia carers.

Maintaining good oral health habits for people with dementia

Making sure the person with dementia you’re caring for maintains good oral health habits is essential for their continuing wellbeing. It’s important to take a holistic view of their oral health and to understand that this goes beyond simply brushing twice per day, and can include the following:
• Taking good care of dentures by cleaning them after every meal with a soft toothbrush and toothpaste, and soaking them overnight to avoid drying out
• Keeping dentures in the same place all the time when they’re not being worn. People with dementia can struggle with memory loss and losing personal items, so ensuring important items like dentures are stored in the same place can make a difference
• Ensuring the individual has a healthy diet without too many sugar snacks, or replacing unhealthy snack foods with healthier sugar-free alternatives

If you’re seeking oral health advice for someone you care for or for yourself, contact your nearest Smiles dentist today.

Reference

1. https://alzheimer.ie/creating-change/awareness-raising/dementia-in-the-media/

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