Navigating Alzheimer’s and Oral Health
For your loved one, keeping their teeth healthy can grow more challenging as the disease progresses.
Does anyone really look forward to going to the dentist? We all know it’s good for us, and in the end, we are glad we have gone, but it can be an unpleasant, even scary experience for some people. So, imagine how maintaining good dental health, including dental visits, can be a challenge for your loved one suffering from Alzheimer’s.
For your loved one, keeping their teeth healthy can grow more challenging as the disease progresses. These challenges can come in a variety of ways:
Forgetfulness and Lack of Awareness: Your loved one may simply forget about the importance of keeping their teeth healthy and forget to brush their teeth.
Physical Difficulties in Maintaining Oral Care: Alzheimer's can lead to motor skill difficulties, making tasks like brushing and flossing challenging.
Behavioral Changes: Your loved one may become resistant to oral care because of fear, confusion, or discomfort.
Changes in Diet: Your loved one may find it more difficult to chew and swallow, which can lead to food buildup.
Side Effects of Medications: Some medications for managing Alzheimer’s lead to your loved one having a dry mouth, which can complicate their oral health.
Communication Issues: As your loved one’s ability to speak and communicate declines, it can be hard for them to alert you to oral health issues, such as mouth pain or a toothache.
These challenges can be met with a range of adaptations to your daily routine:
Set Regular Reminders: Set up a regular, preferred time for oral care, perhaps after a morning meal and after dinner and any orally administered drugs. Help your loved one by suggesting, step by step, how to perform the task, such as: “First pick up your toothbrush”; “Now put on some toothpaste”, and so on.
Get Adaptive Oral Hygiene Tools: Consider getting your loved one to use an electric toothbrush or obtain a toothbrush with a larger handle. One “hack” is to insert your loved one’s toothbrush through a tiny slit into an old tennis ball or a bicycle grip, which will give them a better holding surface. Give your loved one the option of choosing their own toothbrush design, toothpaste flavor, etc. to give them a sense of control and agency. Your loved one may find it uncomfortable to floss their teeth. Instead, try using an “interdental cleaner”, which is a tiny brush-like toothpick that can get between the teeth. When your loved one can no longer brush or floss their teeth themselves, caregivers can use swabs called "toothettes" to help with oral hygiene.
Create a Calm Environment: Soothe your loved one by playing music that they like and use verbal assurances. If necessary, let them do their oral hygiene in a favorite chair or some other favorite, comfortable space, instead of at the sink in a bathroom.
Monitor Their Diet: Make sure your loved one’s foods are easy-to-chew and swallow, and make sure they get abundant and regular hydration.
Keep an Eye Out for Changes and Problems. Pay attention to how your loved one eats, and any other signs of physical discomfort they might be having in their mouth.
Be Patient and Take Your Time: Don’t rush your loved one through their oral cleaning. Give them praise and reassure them that they are doing a great job, and that you are there to help. In some cases, you might need to step in and demonstrate yourself how to brush your teeth, or floss.
GOING TO THE DENTIST:
An important part of oral health is visiting the dentist on a regular basis. This can be challenging for your loved one, as it can represent a strange environment where practices and processes are confusing and concerning to them. As the disease progresses, the sounds and sensations of dentistry may become increasingly difficult for your loved one to experience.
Here are some tips:
Get to the Dentist As Soon as You Can: Schedule a dentist appointment as soon as you can after a diagnosis of Alzheimer’s, while your loved one is still capable of understanding what is transpiring. Ask your dentist if there may be problem areas for your loved one, such as an old filling, that could be addressed sooner rather than later, to prevent problems down the road, when a dental visit might prove more troublesome. Early on, keep up the appointments, frequently, to catch potential problems before they become serious.
Choose a Dentist with Experience: Consult with your loved one’s dentist about their own experience in treating patients with Alzheimer’s and ask if they want to recommend someone else who specializes in treating people with Alzheimer’s.
Schedule Appointments Strategically: Make your loved one’s appointments in a time frame during the day when they are calmer, less prone to agitation, and more cooperative. See if you can break up longer procedures into shorter segments spanning two or three sessions.
Come Prepared: Make sure your loved one’s dentist knows about their Alzheimer’s condition, and provide their medical history, medications, and any specific concerns related to their dental care.
Make Your Loved One Comfortable: Make the dental office environment as familiar and comfortable as possible for your loved one. This might include bringing along familiar items such as a favorite blanket or music they like to help reduce anxiety.
Over-communicate What Is Happening: As your loved one undergoes the dental examination, reassure them with explanations about what is happening, and what will happen next. You might say something like “Now they are going to tilt back your chair and turn on a bright light, so the dentist can get a better look at your teeth.”
Consider Sedation Dentistry: If your loved one’s Alzheimer’s has resulted in increased anxiety and agitation, you might consider having the dentist appointment conducted under some form of sedation. Discuss the options with your loved one’s dentist.
Going to the dentist is very important for everybody’s overall health, but for some people it can be challenging, and especially for someone suffering from Alzheimer’s disease. But with a calm, careful approach to oral hygiene and advanced preparation, you can make sure your loved one gets the care they need.
