Related topics: •  Alzheimer's and Bathing •  Caring for Someone With Alzheimer's •  Clothes Contact: Helping an Alzheimer's Patient Get Dressed

With all of the difficulties facing people with Alzheimer's disease -- not to mention their caregivers -- oral hygiene may seem like a trivial issue. Getting a person clean and dressed is hard enough. Who has time to worry about a few cavities or slipping dentures?

As it turns out, you do. Investing that time can be one of the most important things you do for your loved one.

Oral hygiene may often be overlooked, but it's a crucial part of keeping Alzheimer's patients as comfortable and healthy as possible. Older people in general tend to have dental problems that cause pain or make it hard to chew, swallow, and speak. Such problems become even more common when a person forgets how to use a toothbrush or how to keep her dentures clean.

And for Alzheimer's patients, dental trouble can actually be dangerous. A patient can easily choke if he can't chew properly. He may also have trouble getting enough nutritious food to eat, and a shortfall in nutrition has the potential to hasten the progress of the disease. He could also suffer excruciating pain from cavities -- pain that he might not be able to communicate.

If a person still has teeth, make brushing a part of her daily routine. If she has forgotten how to brush, you can jog her memory by brushing your own teeth in front of her. You may also need to guide her hand while she brushes. If she has trouble gripping the brush, find one with an extra-thick handle.

As the disease progresses, your loved one may not be able to recognize his toothbrush, let alone use it properly. Now it's your job to put that foreign object into his mouth without upsetting him. Pick a time of the day when he's most cooperative and move slowly and calmly. If he puts up too much of a fight, try again later. And if he refuses to unclench his teeth, clean the outsides; it's better than nothing at all. Flossing his teeth is also a good idea, if he doesn't mind. (Use the larger part of your hand to gently hold his mouth open, because if you have only a finger or two inside, you may get a painful bite if your loved one closes his jaw unexpectedly.)

If the patient wears dentures, make sure they fit absolutely perfectly. Ill-fitting dentures can irritate the gums and interfere with chewing. And if dentures fit well, you may not have to fuss with adhesives. Dentures must be removed and cleaned every day. If you have never used dentures, talk to your loved one's dentist for advice and instructions.

And be sure your loved one sees the dentist regularly (ideally twice a year) to be checked for cavities. If these visits are difficult, ask for a referral to a geriatric dentistry specialist with experience caring for Alzheimer's patients. In the event that X-rays are needed, special examination techniques may be used; in addition, geriatric dentists are also more apt to pay attention to appropriate oral hygiene and to notice lesions that can cause pain and malnutrition.

-- Chris Woolston, M.S., is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was the staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education. His reporting on occupational health earned him an award from the northern California Society of Professional Journalists.

Further Resources

Alzheimer's Association 800/272-3900

http://www.alz.org

Michael Castleman et al. There's Still a Person in There: The Complete Guide to Treating and Coping with Alzheimer's. Putnam Publishers, 2000.

Howard Gruetzner, M.Ed. A Caregiver's Guide and Sourcebook. John Wiley &Sons, 1992.

Nancy L. Mace, M.A., and Peter V. Rabins, M.D., M.P.H. The 36-Hour Day. Johns Hopkins University Press, 1999.

Lela Knox Shanks. Your Name Is Hughes Hannibal Shanks: A Caregiver's Guide to Alzheimer's. The Penguin Group, 1999.

Carol Simpson. At the Heart of Alzheimer's. Manor HealthCare Corporation, 1996.

References

Last updated February 25, 2009
Copyright © 2000 Consumer Health Interactive

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