Alzheimer’s and Oral Health

Poor dental health has been linked to a fourfold increase in the chance of getting Alzheimer’s disease in the future. One of the few reversible risk factors for dementia as a result is keeping good oral health.

There is a known connection between your oral health and your whole health. There is fresh evidence from studies that links dental health to the likelihood of getting dementia, specifically Alzheimer’s disease, which is the most prevalent form of dementia. Alzheimer’s disease is a neurological condition with an unknown etiology that causes gradual memory loss and cognitive decline. The disease has three main stages: mild, moderate, and severe.

There are various behavioral and psychological signs associated with each stage. The continuous physical deterioration that goes along with them affects how well one can carry out daily tasks, such as performing dental hygiene, among other things. Oral health is crucial for eating, interacting with others, and avoiding health issues generally. The most important aspect of controlling oral infections is oral hygiene. 

Maintaining good oral hygiene lowers the risk of pneumonia, periodontal disease, and tooth decay. Supportive care for the family and/or carers is crucial when taking care of an Alzheimer’s patient. However, caregiving activities related to oral hygiene are frequently rejected by older adults with dementia.

Alzheimer’s and periodontal disease

The findings of a recent study add to the growing evidence that an infectious bacterium may bring on dementia and Alzheimer’s disease. Researchers examined brain tissue samples from deceased Alzheimer’s patients and discovered Porphyromonas gingivalis, the same bacteria that has been associated with chronic gum disease (P. gingivalis). 

Gingivalis was discovered in brain tissue samples taken from rats exposed to the same oral bacteria during clinical testing, together with several of the same biomarkers and proteins linked to Alzheimer’s disease. Furthermore, P. gingivalis was discovered in human brain tissue from individuals who had not yet received an Alzheimer’s diagnosis, indicating that P. gingivalis gum infection may have a role in the progression of cognitive disorder.

Common dental issues

Taking care of your mouth does more than just keep it healthy. Additionally, it lessens the likelihood that pneumonia will strike a person with Alzheimer’s disease. According to some research, poor dental hygiene contributes to as many as 50% of pneumonia infections among nursing home patients.

Older people with Alzheimer’s disease frequently experience the following dental issues:

 

·       Bacteria and food can build up in your mouth if you don’t floss or brush your teeth

The outer covering of the tooth, known as the enamel, can accumulate tartar from this bacterium and deteriorate over time. Cavities are created in the teeth as a result of this. These typically occur in pits and grooves on the teeth, where plaque and tartar collect. You could get a toothache if cavities spread further into the tooth.

·       Tooth decay or dental work

This can be mild or major. It’s just mild if the tooth enamel alone is chipped. However, if the fracture extends into the dentin or pulp the tooth’s interior you should take your loved one to the dentist as soon as possible. A severely fractured tooth might become infected if it is ignored. Dental work, including fillings, crowns, and root canals, can come loose or chip when older adults chew.

·       Teeth with an abscess 

This is an infection in the pulp of the tooth, which is the interior region of the tooth that is connected to blood vessels. The infection then spreads to the gums. It is typically brought on by a cavity penetrating too far into the tooth. As a result, microorganisms can enter the pulp layer. The pulp swells up as the tooth struggles to rid itself of the cavity, occasionally resulting in toothaches. The back teeth, or molars, are more likely to develop abscesses because they are more difficult to keep clean.

·       Dry mouth

Your mouth may get overly dry if you don’t produce enough saliva. It can also be brought on by medications for blood pressure, depression, allergies, and Alzheimer’s disease. A dry mouth can cause cavities, sores, and ulcers if it is not treated. Additionally, it may impair your ability to taste and cause you to experience digestive issues. 

·       Poor breath 

Foul oral hygiene, dry mouth, mouth infections, dental issues, medications, and specific meals are just a few of the factors contributing to bad breath. 

The importance of good dental health

People with Alzheimer’s disease may rapidly lose dental health if oral care is neglected, which can make it difficult for them to eat and lead to infections. Soon after diagnosis, a strategy for ongoing professional treatment should be created. Because they are frequently more challenging to treat as the disease advances, any current dental issues should be attended to in the early stages of Alzheimer’s disease. 

Additionally, the person with Alzheimer’s needs to follow a thorough oral hygiene regimen, including brushing, flossing, and regular trips to the dentist. They might be able to take care of their oral hygiene daily at first, but eventually, a caregiver will take over. For someone with Alzheimer’s disease, giving brief, straightforward instructions or showing them how to brush and floss their teeth may be useful. Poor dental hygiene, for example, raises the risk of developing bacterial pneumonia, a typical worry for elderly persons with impaired coughing or gagging reflexes, including those with Alzheimer’s disease.

Daily oral hygiene

Dental treatment for Alzheimer’s in its early stages emphasizes prevention. Regular dental cleanings, check-ups, and flossing might help avoid the need for more involved procedures later on, when the dementia patient may be less able to endure them. Oral health issues may worsen in the middle and late stages of Alzheimer’s. The person may misplace their toothpaste, not know how to rinse or be unwilling to accept help from others. Appetite loss may indicate mouth pain or improperly fitting dentures.

Try the following advice:

·       Utilize a step-by-step breakdown to describe dental care. Simply saying “brush your teeth” can be too general. Instead, guide the person through the procedure. “Hold your toothbrush,” you say. “Paste the brush with paste.” After that, “Brush your teeth.”

·       Use the “watch me” approach. Show them how to brush their teeth by holding a toothbrush. Alternatively, gently guide the brush by placing your palm over the person’s hand. Refrain from brushing if the person seems upset or resistant and wait until later in the day.

·       Maintain a healthy mouth and teeth. At least twice daily, with the final brushing being after the evening meal and any liquid medications taken at night, brush the person’s teeth, gums, tongue, and roof of the mouth very softly. If you must perform the brushing yourself, take your time and choose a comfortable position. Using a gentle motion, insert the toothbrush at a 45-degree angle into the patient’s mouth to massage the gums as you clean their teeth.

·       If the person has dentures, rinse them with plain water after meals, and brush them every day to eliminate food residue. Remove them and let them soak in a mouthwash or cleaner every night. After that, clean the tongue, gums, and other soft mouth tissues using a moistened gauze pad or a soft toothbrush.

·       Try using various toothbrushes. You could discover that a children’s toothbrush with soft bristles performs better than an adult brush with harsh bristles. Or, using an angled or long-handled brush is simpler than using a conventional toothbrush. Try different things until you discover the greatest option. Electric dental equipment should be avoided as it may confuse someone with Alzheimer’s.

·       Regularly floss. Most dentists advise using floss every day. Try using an interdental brushed to clean in between teeth if using floss distresses the Alzheimer’s patient.

·       Be mindful of possible mouth discomfort. If you have any mouth irritation when eating, look into it. Mouth pain or improperly fitting dentures may be indicated by an unwillingness to eat or strained facial expressions when chewing.

Collaboration with the dentist

·       Locate the ideal dentist. Get in touch with your local dental association to learn the names of specialists who have handled elderly or patients with dementia.

·       Give the dentist a list of all medical professionals who are treating the dementia patient, along with a list of all drugs. Certain drugs may exacerbate oral health problems, including dry mouth.

·       Maintain consistent dental care for as long as you can. This will aid in reducing discomfort, infection, and gum disease.

Conclusion

Follow the fundamental dental hygiene advice offered by the American Dental Association to maintain your loved one’s oral health. Use fluoride toothpaste twice daily to brush your teeth. Replace your toothbrush every three to four months, and for regions that are difficult to reach, use one with soft bristles and a small head.

Use floss or an interdental brush to clean regularly in between teeth. Drink fluoridated water. If they have dentures, make sure to clean them and remove them for four hours each day to maintain a healthy mouth lining. Get a dental exam once a year.



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