The Tooth & Nothing But The Tooth: Oral Health Care For People With Memory Loss

Anyone who's ever had a toothache will agree that it's one of the most agonizing things they've ever experienced.

They can't get to a dentist fast enough to have the offending tooth pulled or filled. Older adults with Alzheimer's disease or other memory disorders may also suffer from painful teeth or mouth but can't always tell their caregivers about their misery. For busy caregivers it's often easy to overlook a parent's daily oral health needs until he or she develops a painful problem. Understanding the signs, symptoms and causes of dental pain, its treatment and prevention will spare your older relative - and you - a great deal of pain.

SIGNS OF DENTAL PROBLEMS IN PEOPLE WITH MEMORY LOSS

It is important for people with memory disorders like Alzheimer's to maintain healthy teeth and gums. However, people with memory disorders can't always tell you that their mouths hurt.

Some signs that your older relative may be suffering from oral pain:

• Rubbing a cheek or jaw
• Moaning or whimpering
• Rolling or nodding the head
• Refusing hot or cold beverages and foods
• Refusing to wear dentures
• Sleep difficulties and restlessness

MANAGING TOOTH AND MOUTH CARE AT HOME

As memory loss progresses people may forget how to take care of their teeth. It's up to caregivers to help them manage daily oral hygiene and maintain healthy teeth and gums.

• Use step-by-step instructions: "Hold your toothbrush." "Put toothpaste on the brush." "Brush your teeth."
• Take your time. Wait until your parent completes each step before moving on to the next one.
• Don't give your parent mouthwash if he or she might swallow it.
• Make tooth care part of your parent's daily routine. Brush teeth at the same times every day. Clean dentures every night.
• Ask your dentist for suggestions for making tooth and mouth care easier for you and your relative.
• Check your parent's mouth regularly for any changes in teeth, tongue or gums.
• Continue regular dental check-ups as long as your parent is able to visit the dentist's office.

DEALING WITH DENTURES

Poorly fitting dentures can cause sore gums and make chewing painful. Dentures must be cleaned everyday – just like natural teeth. If your parent complains about her dentures or has trouble chewing, check her mouth for sores, inflamed or red gums. Because the structure of his mouth changes over time dentures won't fit properly and they may need adjustment or replacement. People with dentures also need regular dental visits for denture cleaning and a gum and tongue exam for oral cancer at least once a year.

PLANNING A DENTAL APPOINTMENT

Continue to see your parent's present dentist if you both are pleased with his or her services. Let him know in advance that your parent has been diagnosed with Alzheimer's and ask if he feels comfortable treating him. Schedule dental visits during the time of day when your parent is most alert, responsive, and at his best. Before you leave the house ask if he or she needs to use the bathroom. Bring a note pad along so you can write down any instructions the dentist gives you for any special care your parent will need at home. If your parent seems nervous about the appointment ask the dentist if you can sit with him during the exam, cleaning and other procedures. When the appointment is over write down the dentist's instructions for home dental care, any medications he or she may prescribe, and dates for future appointments.

PAYING FOR DENTAL CARE

Medicare does not cover routine dental services like cleaning, fillings, x-rays and dentures. However some community hospitals, dental clinics and dental schools offer discount or sliding scale oral health services to older patients. Contact your local Office on Aging or dental society for additional information.

THE TOOTH SHOULDN'T HURT

Caregivers of older adults are often so caught up in the diagnosis, treatment and day-to-day management of their relative's physical and mental health conditions that it's easy to overlook the importance of oral health. Understanding the relationship between oral and physical health will help your older family member maintain healthy teeth that will contribute to the overall health of his body.

Love conquers all things except poverty and toothache —Mae West