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Dental Care for Alzheimer’s Patients (Part 2)

In Part 1, we covered the causes of dental care issues for Alzheimer’s and dementia patients. In Part 2, we’re covering how each stage of Alzheimer’s affects the person suffering from this debilitating disease’s reaction to dental treatment. Plus; how to tell if that person has a dental issue if the person can’t speak or communicate what the problem is.

Ways to tell if someone has a dental issue

Sometimes a person with dementia or Alzheimer’s will have pain or discomfort in the mouth, but will be unable to tell someone. So below are some changes in behavior that may indicate mouth pain or a painful tooth:
  • If the person refuses to eat; especially if the food is either hot or cold.
  • If the person is frequently pulling at the mouth or at the face.
  • If the person stops wearing dentures that were previously being worn.
  • If the person has started to moan, shout or has been restlessly moving.
  • If the person is suddenly having disturbed sleep.
  • If the person is refusing to partake in usual daily activities.
If there aren’t any other reason for the behavioral changes, then arrangements to see a doctor and a dentist to identify what the issue is should be made.

Stages of dental care treatment for dementia sufferers

When a person has dementia in the early stages, dental care is still possible. The dentist which is used should plan the treatment with the idea in mind that the person with dementia in the later stages will be unable to do dental care properly though. So at this point, important teeth should be restored and measures taken in preventing decay and further gum disease. If another person is willing to take on the responsibility of seeing that the dental care of the dementia patient’s teeth; then crowns, implants and bridges can be considered. During the middle stages of Alzheimer’s or dementia, the person may be pretty healthy physically, but could have lost some of cognitive abilities. At this point, dental hygiene will be based on prevention of further dental issues. Depending on the person, sedation may or may not be used. Furthermore, the decision will be decided upon based on whether or not the individual will cooperate, the general type of dental treatment and the health of the patient. It’s at this point that a need for a consent for treatment document may be needed. Finally, during the later stages of dementia, the person’s thinking usually isn’t clear. There may be problems with reasoning and memory. Plus; there may be physical frailty as well as other complex medial issues. So treatment during this stage of the disease is mostly about maintaining oral comfort, focusing on preventing dental diseases; and if emergency treatment would be needed, how to handle this. In addition, each treatment plan should be formulated to the individual person’s needs based on the risk of dental diseases and the assessment of dental care issues. When deciding the treatment plan, consideration should be about the thinking abilities, co-operation level, any physical impairments and the level of independence of the person also. Further, considering any dental problems or symptoms that the person may be experiencing in this; especially as listed in the bulleted points should be considered along with the person’s ability to give informed consent.

Consent to treatment

If the person with Alzheimer’s or dementia can understand, then the opportunity should be given for input on the dental treatment. In simple terms, the dentist should explain what is going to be done and the reason for it. This way the person can answer yes or no if asked for a reply. If the person cannot give an informed consent; however, then the caregivers or family members need to be involved in the dental care decision. If there’s a disagreement among the caregivers or family members, then the dentist may ask for a second opinion. To conclude, by continuing good dental care, an Alzheimer’s or dementia patient should be pain free and have good dental health.  

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