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World Alzheimer month is every September, and this is a good time to reflect on the relationship between it and gum disease.

Here’s a very basic description of what’s going on:

What we know is that “bad” bacteria found in the mouths of those with periodontal (gum) disease (bleeding/inflamed gums and bone loss-a chronic inflammatory disease) travel into the bloodstream and can also be found in the brain. It is suspected that when these bacteria are in the brain, they release an enzyme that harms brain cells.

The exact mechanisms of how the bacteria that cause gum disease also contribute to Alzheimer’s disease, and research is ongoing. Check out the new 2 year study that has started here: https://www.alz.org/co/news/oral-health-and-alzheimers-risk

Here’s how to care for ourselves to reduce the potential impact oral health may post on brain health: 

Even though the exact relationship hasn’t been proven (YET) we can all work towards overall health improvement by brushing twice a day, flossing/interdental cleaning daily, and seeing an oral health care professional. Proper daily oral self care habits are a part of our health journey (just like healthy eating) because it will also decrease the inflammatory burden on all our body systems which also has a positive impact on healthy aging, and who doesn’t want that?!

Here’s how to care for a loved one’s oral health to reduce the potential impact brain health if they have cognitive challenges:

  • Provide short, simple instructions. Explain dental care by breaking directions into steps. “Brush your teeth” by itself may be too vague. Instead, walk the person through the process. Say: “Hold your toothbrush.” “Put paste on the brush.” Then, “brush your teeth.”
  • Use a “watch me” technique. Hold a toothbrush and show the person how to brush his or her teeth. Or, put your hand over the person’s hand, gently guiding the brush. If the person seems agitated or uncooperative, postpone brushing until later in the day.
  • Keep the teeth and mouth clean. Very gently brush the person’s teeth, gums, tongue and roof of the mouth at least twice a day, with the last brushing after the evening meal and any nighttime liquid medication. Allow plenty of time and find a comfortable position if you must do the brushing yourself. Gently place the toothbrush in the person’s mouth at a 45-degree angle so you massage gum tissue as you clean the teeth. Use a brush with soft bristles, but experiment with different styles, such as a long-handled or angled brush if you find it easier to use than a standard toothbrush. Be aware that electric dental appliances may confuse a person with Alzheimer’s, although a sonic or rotary toothbrush can be helpful of the person is willing.
  • Clean between daily. If using floss is distressing to the person with Alzheimer’s or yourself, then try using a “proxabrush or interdental” to clean between teeth instead. When caring for a loved one in advanced stages, take care to monitor use of proxabrushes, softpiks, and toothpicks. There’s also “Stim-U-Dents” (triangular-shaped toothpicks). There are so many options to make it easier on everyone (I use a variety of these tools daily when working in continuing care)!
  • Sometimes high-dose prescription fluoride toothpastes may be helpful too (we sell Clinpro5000, but Prevident5000 can be purchased easily at stores or on Amazon). This helps prevent or slow down the progression of cavities and weakened enamel. Cognitively impaired people tend to be on more medications which means the impacts of dry mouth are noticed and that typically means more cavities.
  • For those who can use mouthwash, this can help keep gingivitis and cavity risk lower too, but watch to ensure they don’t swallow it; if they’re at risk to swallowing it, then we wouldn’t suggest that tool at all). Mouthwashes with alcohol tend to exacerbate dry mouth and its negative effects, and there’s a lot of alternatives for that.
  • Be aware of potential mouth pain. Investigate any signs of mouth discomfort during mealtime. Refusing to eat or strained facial expressions while eating may indicate mouth pain or dentures that don’t fit properly.

What if they had dentures? 

Well, teeth and dentures need to be cared for daily and sometimes multiple times (guess what, sometimes people have teeth and dentures and sometimes they have full dentures and no teeth); both situations require daily care and regular professional checks (what if they have pain or infection and can’t communicate that? That’s where regular professional checks help + they’d help with coaching on how to care for that person’s mouth).

Here’s how you care for dentures: 

Rinse them with plain water after meals and brush them daily to remove food particles. Each night, remove them and soak in a water or an approved cleanser (ask the denturist that made them). Then, use a DENTURE brush to clean the denture itself and a soft toothbrush or moistened gauze pad to clean the gums, tongue and other soft mouth tissues, and if there’s teeth follow the directions above.

Always reach out with questions or concerns, or if you’d like a mobile dental hygiene visit scheduled; that’s what we’re here for.

Here’s a link to some other information on how oral health and other systemic health conditions are connected: https://www.perio.org/for-patients/gum-disease-information/gum-disease-and-other-diseases/

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