The 5 “W’s” of Oral Care for those living with one of the Dementias
Submitted by Dr. Joy Poskozim DDS FSCD CDP
Founder of Joyful Dental Care – House Calls, Advocate, & Presenter
Geriatric House Call Dentist for over 15 years, Dr. Joy Poskozim speaks to Long-term Care Facility Administrators, Nursing Staff, Caregivers, and loved ones on the importance of oral health care as we age. Her goal is to share as much dental information as possible, thereby making it easier to communicate to traveling dentists on what oral health problems residents may have.
Learn how to best maintain oral health and why it is so important to our overall health.
Maintaining a healthy smile for all of us is a form of self-care
Monitoring daily oral hygiene for all of our clients, patients, and loved ones is extremely important not simply for health, but for social reasons as well.
No one wants to be at the dinner table where one is afraid their denture will come out while chewing, or is visibly missing teeth. Not having a smile that one feels comfortable with can lead to social anxiety and ultimately isolation.
WHO is affected?
ANYONE who eats. Seriously. As long as we are eating, we need to keep ahead of bacterial growth that comes from eating certain “foods” such as processed and ultra-processed snacks that are often available at senior living facilities.
Those that are beginning to experience apathy in their daily appearance with an intolerance of bathing will also start to skip oral care as well.
Over 85% of bacteria in bacterial pneumonia is ORAL bacteria.
No one should be breathing in/aspirating their own dental plaque.
Brushing keeps all of us ahead of oral bacterial growth, thereby preventing tooth loss, cavities, and certain medical issues.
WHAT can we do about poor oral hygiene?
For those that we are caregiving, starting out with simple reminders to brush our teeth after breakfast and immediately after dinner truly helps if done daily.
Monitoring their brushing — and making sure they are brushing all of their teeth — is extremely important.
Brushing their teeth for those in late stages of one of the dementias is another way we can make sure teeth and gums stay clean.
When is the best time to be able to get oral hygiene done?
An activity followed by another activity is one way to help maintain focus and engagement.
I am told the hardest time to brush one’s teeth is at night, either due to sundowning or simple fatigue.
Keeping a consistent schedule with strong routines also reinforces the importance of oral care.
Where is the best place to accomplish these goals?
ANYWHERE!
As a girl in Girl Scouts, I learned to think outside the box.
Following the last meal of the day with brushing teeth does not necessarily have to be done in the bathroom.
For example, after one’s last bite and drink, drinking water, then giving their familiar toothbrush either with toothpaste on it or having them apply their own toothpaste sitting at the kitchen table allows for independence and autonomy while achieving what needs to be accomplished.
Or, if in their comfy chair watching tv, bring their toothbrush and toothpaste to them!
Why do we need to continue this “chore” if they are no longer doing it themselves?
Due to what I consider overcrowding, oral bacteria over time will migrate past the blood-brain barrier, helping to create plaque deposits in our Alzheimer’s clients/patients.
Oral bacteria can also migrate to our hearts causing endocarditis — inflammation in the inner layer of our hearts.
We also see an increase in tooth loss due to chronic gingivitis or gum disease.
For those wearing partial dentures, the most vulnerable teeth to tooth mobility are the ones being used as anchors holding these dentures in place.
Even if at late-stages and all we can do is brush the outside of the teeth and/or even if all we can do is brush their teeth with their partials in place something is better than nothing.
No one should suffer from a toothache due to neglecting oral care for those who cannot do it themselves.
No one should lose a tooth, therefore no longer be able to use their denture.
No one should get sepsis from a dental abscess and potentially die.
Contact me with any questions/concerns/comments you may have! I would love to help show you how this can be achieved, even if one is now in hospice.
Submitted by Dr. Joy Poskozim DDS FSCD CDP
Founder of Joyful Dental Care – House Calls, Advocate, &Presenter
Geriatric House Call Dentist for over 15 years, Dr. Joy Poskozim speaks to Long-term Care Facility Administrators, Nursing Staff, Caregivers, and loved ones on the importance of oral health care as we age. Her goal is to share as much dental information as possible, thereby making it easier to communicate to traveling dentists on what oral health problems residents may have.
