A diagnosis of dementia is a life-altering event.
And as Australia ages over the next 30 years or so, it will be an increasingly common one for many people with an estimated 900,000 people expected to be living with dementia by 2050. As with many major life events, it can be challenging to make the necessary changes needed to ensure a high quality of life is maintained. But it is possible, and in the case of dental care, a vital one given the close links between the health of a person’s teeth and gums and their overall wellbeing. The key is maintaining good oral hygiene, which may require different approaches depending on the stage of dementia:
• Early to mid: Generally no support is required.
• Mid-stage: Some help and support may be needed.
• Late stage: Oral healthcare needs to be provided by a carer.
Prevention is best
A focus on preventative dental health practices such as brushing, flossing and regular trips to the dentist is necessary for anyone but it is particularly important for a person living with dementia since cleaning teeth plays a major role inhibiting the growth of diseases such as aspiration pneumonia. This means that whether the person has their own teeth or partial dentures, an increasingly common occurrence for people over 75, or full dentures, extra attention must be paid to brushing and flossing.
You will need to ensure that the dignity of the person with dementia is respected and that, where possible, many of their old routines such as brushing their teeth, continue to be performed by them as long as this doesn’t compromise the health of their teeth and gums.
It is likely as dementia advances that a person living with it may lose the ability to brush their teeth on their own.
In these instances, there is a range of techniques you can employ that use a cooperative approach to brushing.
• Chaining – The carer begins brushing and the person with dementia takes over.
• Bridging – the individual holds the brush while the carer brushes the teeth
• Hand over hand – The carer’s hand is placed over the person with dementia’s hand to guide brushing.
• Yawning – Yawn facing the person and hopefully stimulate a yawn in return so they will open their mouth.
You should also keep the teeth and gums hydrated to combat dry mouth (a lack of saliva production), a side effect of many dementia medications. This condition can be a major problem since saliva plays a key role in reducing the occurrence of tooth decay. Additionally, the daily use of an anti-bacterial rinse or spray is a good idea, as is limiting the consumption of sugary drinks, snacks and desserts.
Visiting the dentist
At a time when everything is changing for a person with dementia, continuing to visit their long term dentist provides a comforting point of familiarity. Their regular dentist will be well-versed in their oral health care needs and will be able to talk to them about treatment plans in a way that will put the person with dementia at ease.
When you’re booking an appointment for a person with dementia, request a morning time slot when most people with dementia are more alert. Ensure that the dentist is aware of the dementia diagnosis and any pertinent medical records and medications.
Thanks to a partnership between the Australian Dental Association and Alzheimer’s Australia, dentists are increasingly aware of the best ways to treat a person living with dementia and how to ensure this person continues to enjoy not just optimal oral health but an overall high quality of life.