Tips for Providing Dental Care to Patients With Alzheimer’s

By Greg Grillo, DDS

Providing top-notch care to elderly patients is a top priority. With some patients, this can be more difficult to achieve than for others. For example, patients with Alzheimer’s pose a unique challenge for dental care providers and require special consideration to provide proper treatment.

A diagnosis of Alzheimer’s disease doesn’t remove their right to receive quality dental care. And good dental care provides a large boost to their quality of life, so it’s the responsibility of all caregivers to be alert to oral health in older adults.

Following are techniques for providing quality dental care to patients with Alzheimer’s and what dental professionals can do to help provide that level of service.

Providing the Right Care
An elder’s dental needs are different from those of younger individuals and Alzheimer’s adds further complexities.

The first step is to constantly refine your understanding of the disease. Keeping an eye on current research will help keep your awareness at the highest possible level. Understanding how the disease affects people is key to being able to provide the empathy and treatment needed, even if circumstances are not ideal.

You’ll also want to be prepared with an array of strategies with which to assist patients with Alzheimer’s. In many cases, patience and the willingness to calmly explain the process are most important. Many Alzheimer’s patients will experience bouts of confusion, so being patient with them and walking them through what you’re doing can help them relax. Dentists can employ simple techniques to make the patients more comfortable and make the appointment go more smoothly.

Traveling dental services can significantly increase efficiency in dealing with patients with Alzheimer’s. Working with patients at their homes can go a long way toward helping them be more comfortable. Be sure to consider the pros and cons and recognize the limitations of mobile practice. Also, be mindful of any unique licensing laws governing your service area.

Tips for At-Home Care
After their appointments with a dental provider, it’s also important for patients and caregivers to understand how to provide proper care at home. This includes all the things that normally are associated with good dental care, but also aspects specific to Alzheimer’s patients. Patients with Alzheimer’s tend to struggle with their dental care routines, so imparting the knowledge about self-care is important.

Educate patients about proper at-home care with brushing and flossing. These are important for everyone, older adults and Alzheimer’s patients included. The longer they can maintain these habits, the better their oral health will be. This is a key, so always take the opportunity to reiterate its importance. Flossing, however, can be frustrating, and these patients may not have the dexterity to accomplish these tasks.

In most cases, you’ll want to provide simple, clear instructions for self-care. Breaking down a process into easy steps is generally a good idea. “Brush your teeth,” for example, might be too vague, while “grip the toothbrush” and “put toothpaste on the brush” are more likely to be understood. Keep this in mind when describing any sort of activity or procedure to help make sure it’s more easily understood.

If simple instructions don’t work, you can provide a demonstration, either performing the task on yourself or gently performing it on the patient. Gentle is the keyword here, as being too aggressive can cause more harm than good. When patients are prohibitively uncooperative, take some time for them to relax and try again later. Alzheimer’s is a very complex disease, and symptoms have been known to wax and wane very quickly throughout the day.

If the patient remains uncooperative, an easy technique is to suggest a change in the time or location of their dental routine. Sometimes that’s all it takes to help them understand what’s going on and thereby make them more likely to cooperate. It’s well documented that many Alzheimer’s patients’ symptoms are worse in the evening than they are earlier in the day, so performing a dental routine earlier rather than later can help.

In many cases, Alzheimer’s patients will not express pain and discomfort, which reduces their quality of life and can potentially lead to the worsening of their dental issues. That’s why it’s important to be proactive and talk to Alzheimer’s patients and explicitly ask them whether they’re having any mouth pain or discomfort. They’ll be much more likely to express issues when prompted.

Providing dental care for patients with Alzheimer’s can be a challenging yet rewarding prospect. The improvement to their quality of life through dental care cannot be overstated.

— Greg Grillo, DDS, of Washington state, has studied, practiced, and taught dentistry for decades.