Oral Health and Alzheimer's Disease
Early tooth loss has been linked with increased risk for Alzheimer’s disease, according to Mayo Clinic. Those who experience tooth loss before age 35 are at increased risk for Alzheimer’s disease, meaning dentists must proactively recognize this symptom and recommend testing. If you have experienced early tooth loss, talk to your dentist about other potential risk factors related to oral health and Alzheimer’s disease, such as a family history of the condition.
A study published in the October 2007 edition of The Journal of the American Dental Association examined 144 participants in the so-called “Nun Study,” a landmark study concerning aging and Alzheimer’s disease. The study followed the dental records of the Catholic sisters from the School Sisters of Notre Dame, who ranged in ages from 75 to 98. The study found those with zero to nine teeth were at an increased risk for experiencing dementia than those with 10 or more teeth.
The researchers were uncertain if tooth loss was a side effect from dementia or if the tooth loss contributed to dementia. However, they did speculate that poor dental health could result from conditions such as poor nutrition, infection or chronic disease, which may affect the brain and lead to cognitive decline.
Alzheimer’s Disease and Dental Care
Because Alzheimer’s is a progressive disease, there may come a day that you or a loved one is unable to remember to brush regularly or engage in other protective measures for good dental health. You can manage this issue as much as possible during the early stages of Alzheimer’s-related dementia. For example, ability to grip or use your hands may decrease, making an electric toothbrush preferable over a manual toothbrush. You may find you need reminders or assistance in brushing to best care for your teeth.
In dementia’s later stages, motor functioning may be severely affected, which can keep you or a loved one from being able to effectively brush your teeth. A caregiver can often provide dental care by brushing the teeth with a soft toothbrush or washcloth and a high-fluoride toothpaste.
Oral Health and Alzheimer’s Medications
Not only does Alzheimer’s affect the ability to care for your teeth, but the medications prescribed to minimize or delay symptom onset can increase the risk for dental issues. For example, Alzheimer’s patients are often prescribed a set of medications, including antidepressants, antipsychotics and/or sedatives to reduce symptoms. A chief side effect of these drugs is dry mouth. A lack of saliva in your mouth can contribute to tooth decay because saliva helps to wash away harmful bacteria in your mouth. Without enough saliva, Alzheimer’s patients may have difficulty wearing dentures effectively and can experience increased risk for dental injury and cavities.
Bringing a list of medications to your dental visit can help your dentist troubleshoot issues that could arise from Alzheimer’s-related medications. For example, your dentist may apply a protective varnish to vulnerable teeth to prevent decay or recommend a high-fluoride toothpaste to render the toothpaste more effective.
Talk to your dentist about the appropriate number of visits a year for you given your condition. Some dentists may recommend more frequent visits to proactively manage decay.
“The best way to specify how many dental visits you need is to look at how high-risk you are, looking at genetics, diet and home care because different patients have different susceptibilities to tooth decay,” says Charles V. Ankar, DDS, a dentist with a private practice in Chattanooga, Tenn. “As dentists, we try to focus less on insurance and more on what a patient needs.”