Transcript
[Beginning of recorded material]
[Title card: Dementia Australia]
[Title card: Dementia Friendly Dental Care]
Kath: Hello, everyone. My name is Kopal Sinha. I'm one of the dementia counsellors at Dementia Australia. Today, I'm going to present a specialised video on dementia and dental care. I welcome you all in this latest video from Dementia Australia on dementia friendly dental care. In the spirit of reconciliation, I would like to begin today by acknowledging the traditional custodians of the land on which we gather, and pay my respect to their Elders past, present, and emerging. I also extend that respect to all Aboriginal and Torres Strait Islander people watching today. Progression of dementia can cause mild to severe changes in the brain. Changes to memory and thinking can impact person's ability to maintain dental care routines. There can be different experiences for people living with dementia. If you are in the caretaker role for a family member, it is important to learn what to expect from a person living with dementia.
In this video, we aim to gain insights on how we can enhance dental hygiene by following regular and basic dental care. Maintaining dental hygiene can pose a considerable challenge in the growing population, especially for older people. Those challenges are further aggravated in individuals with the diagnosis of dementia, the risk of which increases persistently with older age, especially from 65 years and above. People with dementia can be at greater risk of poor dental health. This might include people with conditions such as Alzheimer's disease, Vascular dementia, Parkinson's disease, or any other type of dementia.
The carer needs to consider if there is capacity for self-care for the person living with dementia, lack of insight resulting in resistance to dental care, fear of dental care, apathy, possibility of physical limitations. In this 20-minute video, I'm briefly going to explain how dementia can cause dental problems in people living with dementia. This video also offers families and carers some of the practical suggestions to support someone to maintain the best possible dental health.
In this video today, we are going to focus on three important questions. We'll be discussing some possible causes of dental problems, as well as practical advice for maintaining the best possible dental health. The questions include why someone will need your support, daily routine of maintaining dental health, negative effects of not maintaining your dental health. There are some basic steps to maintain good dental health. You may also call that management of dental hygiene that starts from brushing your teeth and tongue at least twice a day. Using fluoride toothpaste, floss every day, if possible, eat healthy, nutritious, and fibrous food, check your mouth regularly for any signs and symptoms of gum disease, visit your dentist regularly. People with dementia should continue to brush and floss their own teeth for as long as their ability to manually do so is not affected. If their ability to control a toothbrush to clean their teeth is affected, it is important for a family member or carer to provide help to care for their teeth and gums.
There are a range of techniques that a carer can use to brush their loved one’s teeth. There are some techniques for someone who lives with dementia, or the person with dementia to assist them to maintain good dental health, some daily routines of brushing your teeth, or someone who's going to assist a person with dementia. Brush teeth twice in a day, floss once a day and use mouthwash, avoid dark coloured or acidic drinks, avoid sugary food, clean dentures after every meal, drink plenty of water to avoid tooth decay. Quit smoking, and again, as I said earlier, visit your dentist regularly for full dental checkups.
Someone living with dementia may need your help with dental care because they can remember to look after their dental care, but may need your support to do it, may not remember how and when to take care of their teeth, may not be aware. They need your support to maintain dental health, may lose interest in brushing and using dental floss. Dental care may become daunting or tiring for them. Lack of insight often results in resistance to care, a failure to admit they need assistance, and refusal to accept it.
Most caregivers for people living with dementia might come across the problem of resistance to care at some point. Typically, in the early and middle stages of the disease, there are some general tips for someone who can provide or who provides assistance to the person living with dementia, that's called the cooperative technique. The cooperative technique will allow the comfort and the safe environment for both the carer and the person with dementia. You can do this by explaining dental care, by breaking directions into smaller steps. Brush your teeth may be too unclear to them while you maintain their respect and dignity. Prompt by saying, “Hold your toothbrush, put paste on the brush, brush your teeth.” There is a watch me technique which can also be referred as mirroring, allows you to show how to brush the teeth. Put your hand over the person's hand gently guiding the directions of the brush. If the person seems agitated or uncooperative, you can postpone brushing until later in the day.
Keep the teeth and mouth clean. Very gently, brush the person's teeth, gums, tongue, and the roof of the mouth at least twice in a day. Allow yourself plenty of time to find the comfortable position. If you must do the brushing yourself, gently place the toothbrush in the person's mouth at 45 degrees angle so you can massage gum tissues as you clean the teeth. Clean the dentures – if a person wears their dentures, rinse them with warm water after every meal, and brush them daily to remove food particles.
Each night, remove the denture and soak it in the cleanser. Dementia can cause dental problems for several reasons. Dementia can cause changes to memory and thinking, which can impact the person's dental care routines. Taking medications changing, or changes in the brain function caused by dementia, can reduce saliva production. Saliva is essential to maintain a healthy mouth and prevent tooth decay, mouth ulcers, and sores. Sugar-based medications, if taken long-term, can lead to tooth decay, dry mouth, and difficulties using dentures. Changes to eating habits, such as replacing main meals with snacks, sucking lollies, or drinking sweetened tea can cause dental problems.
Now, let us find some of the subtle ways to help with maintaining regular dental care routine. Set yourself a daily reminder to clean your teeth with the steps of brushing, using dental floss, and finally, using mouthwash. Consider either writing the steps down or using a picture chart, and putting it up by the bathroom basin. Ask a family member or a friend to help if you need any sort of assistance. Consider using mouth rinses and gels containing fluoride and antimicrobial agents to help reduce dental decay and gum disease. These are available from the chemist. Consider the use of artificial sweetness in drinks and snacks, but if you have diabetes, check this with your doctor. Try having sugar-free snacks, drink water or soft drinks that are sugarless and have reduced sugar. If you have tooth decay or are at risk of developing decay, discuss and monitor this with your dentist.
The pictures here simply shows the basic steps of dental care for people living with dementia. Use a soft bristle toothbrush or medium soft bristle toothbrushes, which are considered idle for people living with dementia, especially for elderly people. This is absolutely crucial as older people are more susceptible to gum recession, which can further expose the root of the teeth, leaving the teeth more sensitive. Fluoride toothpaste or mouth washes can help building off the plaque formation. It can also help restore the lost enamel. Dentist recommends flossing regularly and daily. Flossing can help removing dental plaque and food particles from between the teeth and the gum line, flossing helps in avoiding gingivitis, which in common terms is inflammation of the gums, causing swollen and irritated gums, redness, and can easily bleed.
What are the negative effects of not maintaining your dental health? Tooth decay, including multiple caries, can be gum disease, loss of bone, high blood pressure, inflammation of the blood vessels, blood clots, social anxiety, or maybe depression. Poor dental health can affect person's overall physical and emotional health. Taking care of dental health can prevent many health problems. The above mentioned negative impacts are few to name. There are some serious impacts of not maintaining dental health. The diseases may include some of the debilitating diseases such as heart and lung disease, diabetes, stroke, hardened arteries, and can even trigger dementia symptoms. If you suspect any mouth related disease, contact your dentist as soon as possible to avoid any serious consequences.
There are many advantages and disadvantages of keeping dental health. These are not just limited to these ones, such as good dental hygiene, which can lower the risk of cavities, prevent bad breath, keep bright smile. On the other hand, poor dental hygiene can cause heart and lung risk, stroke blood infections. Did you know that the dental health is strongly linked to the overall health? There is considerable research which says that insufficient dental care impacts overall wellbeing. This happens when due to poor dental care, bacteria start to build up on the surfaces of the teeth, bacteria can gain entry through the mouth into the bloodstream and affects the lining of the heart. The infection caused by this can be very serious even leading to death. Remember that eating healthy, nutritious food, including fibrous food, drinking plenty of water and fluids, visiting your dentist can prevent tooth decays and gum diseases. Allow your dentist to find early signs and symptoms of dental problems, if any.
There are some additional reading and resources which can be found on dementia.org au. Dementia Australia Dental Help Sheet can provide information on dementia and dental care. For any further information or support regarding dementia, such as post-diagnostic support, counselling, dementia education, please contact Dementia Helpline number. The National Dementia Helpline is available 24 hours a day, seven days a week, every day of the year. It is a free service that provides information and advice to people living with dementia or mild cognitive impairment.
People concerned about changes to their memory and thinking, family, friends, and carers of the people living with dementia, as well as people working in the health and aged care sectors. The helpline can provide emotional support and guidance, connect you to Dementia Australia services and programs, as well as government and community support. I would like to thank you all for taking out some time to watch this video. I'm hoping that this video has provided some basic strategies to follow good dental care. Please remember, dementia can be managed with proper support and cooperation. Thank you so much.
[Title card: Together we can reshape the impact of dementia]
[Title card: Dementia Australia. 1800 100 500. Dementia.org.au]
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