When a loved one starts to experience advanced symptoms of Alzheimer’s and can no longer look after themselves, there are so many considerations in providing for them that it’s difficult to keep track of all the details. One of the most frequently overlooked areas of health for people living with advanced Alzheimer’s is oral health. With most adults only visiting the dentist briefly once or twice a year, a new caretaker may easily forget to schedule a dental appointment for their loved one with Alzheimer’s amidst the bevy of attendant health concerns. However, oral health can be a significant factor in quality of life for older people, and providing a positive dental experience for someone with advanced Alzheimer’s takes a little extra thought and planning.

Firstly, it’s important to understand that as Alzheimer’s progresses, it becomes more difficult for the person with Alzheimer’s to express their needs adequately. A person with Alzheimer’s may be in considerable ongoing oral pain but be unable to identify the source of their discomfort accurately, and instead lash out verbally or physically due as a result of that pain. Maintaining regular dental appointments and at-home dental hygiene can make a huge improvement in day to day quality of life for an Alzheimer’s patient by eliminating a common source of pain.

When scheduling a dental appointment for a person with Alzheimer’s, bear in mind that you will be disrupting their usual routines and taking them into a potentially frightening environment that they may have difficulty processing. With that in mind, here are some tips for caregivers to ensure a minimally disruptive dental visit:

• Speak with the dentist ahead of your visit and let them know what special needs your patient has
• Make note of your patient’s best times of day, when they are most lucid and able to process new information, and schedule their dental visit accordingly
• Ask for the office to be calm and quiet. This may mean scheduling at an uncommon time of day, or checking that potentially disruptive other patients such as small children are not scheduled around the same time.
• Make sure your patient uses the bathroom ahead of time
• Remain close at hand to provide reminders and reassurance to your patient throughout the visit if they become disoriented or afraid
• Handle as much paperwork as possible ahead of the actual trip to the office, such as making sure your patient’s insurance is accepted ahead of time
• Give your patient simple and brief instructions to help them know what to do throughout the appointment

You should also speak to your patient’s dentist and ask them to schedule more time than usual for your patient’s appointment, and to remain patient and calm throughout the appointment. Make sure they know they may need to repeat their instructions and reassurances frequently, and ask them to do what they can to keep the patient’s time in the chair to a minimum.

Outside of dental appointments, it’s also important to help people living with Alzheimer’s to maintain good oral hygiene to prevent discomfort and tooth decay. Depending on the individual’s needs, you can prompt them with visual cues to practice proper brushing technique. Brushing your teeth together can help an Alzheimer’s patient brush their teeth regularly twice a day, and watching your motions and instructions can help them practice best techniques. If they lack the coordination or focus to brush their own teeth, it may be necessary to gently brush their teeth and gums for them twice a day. Caregivers should also be on the lookout for bad breath and signs of pain or changes in behavior while eating, as these can be signs of deteriorating oral health, and should always consider oral pain as a possible factor if their patient shows sudden changes in behavior.