Caregiver's Corner
Tips and Techniques for Daily Dental Care:
When to See the Dentist

The dental needs of people with Alzheimer's are often overlooked. Even if proper care had been maintained throughout their life,a person can end up with rampant decay and aggressive periodontal disease that dramatically threaten their medical health within the span of a year or two. This disastrous condition is the result of one or more of the following reasons: 1) the person's forgetfulness results in unintentional dental neglect; 2) cardiac, antidepressant and other medications, as well as advanced age, can cause chronic "dry-mouth" (reduction of the healthy flow of saliva) and an increase in decay; 3) dental needs are forgotten, or problems go unnoticed, as they are hidden by the lips; and/or 4) people often lose contact with their dentist during this period because they are focused on other issues.

Discomfort from neglected and decaying teeth can lead to pain and unmanageable behavior, and result in extensive, costly dental treatment. Good dental health can make eating and digesting food easier, and improve a person's overall quality of life. Assisting your loved one with brushing and flossing can be a daunting task. Here are some tips:

1. Brushing teeth - twice a day

   • Use a brush with a "small" head so the back teeth can be reached and with soft bristles which are gentler for the gums.
   • If a vibrating sensation can be tolerated, a "Sonicare"-type toothbrush can be used.
   • Larger-handled brushes are typically easier to use. A tennis ball can be helpful in adapting a toothbrush to have a larger, easier to use handle.
   • Toothpaste is not necessary and omitting it may be more comfortable.
   • Ask a dentist about using a fluoride gel or rinse to keep the tooth enamel strong.

2. Flossing teeth - once a day

   • It can be easier for the person to use a floss holder or for the caregiver helping him or her with flossing to use a floss holder.
   • An inter-tooth cleaner such as a small "Proxabrush"- a tiny little brush with anti-microbial solution on it that can fit between the teeth and gums - is a good alternative for assisting people who keep their teeth clenched.
   • Ask a dentist about using an anti-microbial solution like Peridex to protect the gums.

3. Cleaning dentures: Remove and clean the dentures after every meal. Use a toothbrush with soft bristles to gently brush the gums and roof of the mouth.
   
   
4. Visually inspect the person's teeth and gums: at least once a month. Work with a dentist to know which spots to watch. If the tissue appears dry, swollen ,or red, contact the dentist.
   
   
5. Maintain an updated list of the person's medications for all doctors and healthcare workers, and ask the dentist which medications on the list cause xerostomia, or dry mouth.
   
   
6. Visit the dentist for an exam and cleaning: upon diagnosis of Alzheimer's and then every six months

Additional signs that your loved one may need to see a dentist: refusal to eat; chewing appears painful or difficult; or bad breath.

If the person is unable to cooperate, comprehend, or comply, the Alzheimer's Association in your area should be able to help you find a special needs dentist who can treat them.