What about pain, tooth loss and dementia?
Tooth loss is not just esthetics. It leads to decreased self-confidence, disrupting the vertical dimension of the jaw, which has pathophysiological implications. It affects nutrition, manifests as TMJ disorders, headaches, and orofacial pain. There are also broader reaching implications, such as neck and back pain and negative effects on overall posture and balance.
Especially with Alzheimer’s disease, research links neurodegenerative disorders and tooth loss. Then there’s dementia and care of the teeth, as the patient’s cognitive functions decrease, there follows the neglect of dental hygiene or substandard home care. As a preventive measure, there’s the need for proper oral health care, the need for adequate education for patients and caregivers, as well as training on the link between oral health and systemic conditions.
Then there is the Denture Debate.
We say that dentures should be removed at bedtime to prevent accelerated bone loss, gum inflammation and even aspiration pneumonia. It promotes better dental hygiene through adequate cleaning of the dentures and oral tissues. This is not to mention that the oral tissues can relax and become distressed.
However, there is an interesting caution. A study of seniors who are toothless/edentulous and who experience obstructive sleep apnea (OSA) found that when wearing complete dentures during sleep, the majority experienced an improvement in their condition. Again, there is a greater need for communication between medical and dental professionals with regard to denture-wearing seniors who experience or may be at risk for OSA. Without better communication, we risk patients being given conflicting information because of an incomplete picture of their health.
All of these issues and interactions point to the deep need for an interprofessional approach to geriatric patient care. There is a gap in the knowledge and training for caregivers. If the links between oral, physical, psychological, and social health are not obvious to patients or the caregivers, how can we expect them to give dental hygiene the care it deserves? Additionally, caregivers may feel inadequate in providing proper dental care. There’s a need to make sure that our family-member caregivers, nursing, and elder caregiving staff feel confident to carry out these tasks.
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