According to the Public Health Agency of Canada, research suggests that there appears to be a link between poor oral health and dementia but the exact nature of the relationship is still unknown. However, evidence shows that older adults living with dementia may:
Have more cavities than older adults without dementia
Be less likely to visit an oral health professional compared to older adults without dementia
Have difficulty chewing their food
Experience pain in the mouth and they may not be able to communicate this issue to others
Need assistance cleaning their dentures and dental implants
Have generally poor denture hygiene
Dry mouth is also more common among older adults with dementia than those without dementia, and those who are wearing dentures may have red and swollen gums more often than older adults without dementia.
When older adults require the help of someone else like a home care provider or caregiver, they may face barriers in receiving or accepting getting oral care. Older adults may:
Feel uncomfortable with the caregiver's technique of physical closeness
Feel some anxiety or fear, either because of past negative dental experiences or attitudes toward oral care
Not be able to afford dental treatment or to physically attend those appointments because of transportation issues
Have to rely on some caregivers who are hesitant to provide oral care because of a lack of skill, time or understanding of how important oral health really is
These barriers are even more challenging for older adults with dementia, who can show some resistance to necessary care. Good oral health is important throughout life for overall health and well being
Oral Health and Dementia
Poor oral hygiene can:
Increase the risk of developing respiratory infections like pneumonia
Make it harder to control blood sugar levels in people with diabetes
Increase the risk of heart attack and stroke
Lower self-esteem, reduce social interactions and lower quality of life
Oral health and dementia
Older adults with dementia have more cavities than those without dementia
Older adults with dementia are less likely to visit an oral health professional compared to older adults without dementia
Research suggests that there may be a link between poor oral health and dementia but the exact nature of the relationship is still unknown
As dementia progresses, more support will be needed
Oral care is a complex task with many steps
As dementia progresses, oral care becomes more difficult to complete and the level of support needed increases
Signs that more support may be needed
Does the toothbrush look like it is not being used
Has it been a while since the tube of toothpaste or container of floss has been replaced
Is there ongoing bad breath
Does the person have difficulty chewing food
As not all people can express pain, are there signs of dental pain such as frowning or grimacing when chewing food or drinking hot and cold fluids
Supporting an Older Adult with Dementia
Recognize that assisting or directly providing oral care to an older adult living with dementia is not an easy task and it may be uncomfortable.
Be prepared for some resistance when assisting or directly providing oral care. Further information on tips for communicating with a person with dementia.
Start by finding routines that are familiar to the older adult living with dementia and identify routines you are both comfortable with-such as brushing teeth together, in the same place and at the same time of day.
As dementia progresses, some individuals may have trouble identifying their oral care tools. Consider labelling them in a way that is easy to identify (for example, name, colours, placing dental tools and supplies in familiar places).
Be prepared to provide reminders and prompts to help orient the older adult living with dementia that it is time to complete their oral care.
More tips for caregivers can be found at:
Partnering with an oral health professional
Try to book appointments with an oral health professional who is familiar with the older adult living with dementia, especially in the later stages of the condition.
Inform the oral health professional of a dementia diagnosis, even in the early stages, so that informed and appropriate treatment decisions can be made.
Work with the oral health professional to identify strategies that can help you to better provide support and care at home.
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