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Northern California Northern Nevada Oral Health Problems and Dementia The leading oral diseases are tooth decay (dental caries) and gum (periodontal) disease. Both of these diseases can cause pain, which can exacerbate the confusion associated with dementia. Because people with dementia may not be able to recognize or express their discomfort, it is important for them to have regular oral health screenings – whether they have teeth, dentures or no teeth at all. Other dental problems that can be identified by a professional screening include infection or abscesses, loose teeth that could become dislodged and be inhaled, oral cancer, loose or poorly fitting dentures and drymouth. Gum disease can allow bacteria to enter the bloodstream, where they travel to the heart, lungs, kidneys and other parts of the body, increasing the risk for heart disease, stroke, diabetes, and other medical problems. Dry mouth (xerostomia) is the condition of not having enough saliva to wash away food and neutralize plaque. In addition to causing such problems as difficulty swallowing and speaking, burning sensations or loss of taste, dry mouth can also lead to rampant tooth decay, periodontal disease, oral infections and pain. There are more than 500 commonly prescribed medications that cause dry mouth, including antihistamines, diuretics, pain killers, NSAIDS, high blood pressure medications, antidepressants, antipsychotics and sedatives. There are several behavioral changes that may indicate that someone with dementia is experiencing a dental problem, including: • frequent pulling at the face or mouth • refusal to eat (particularly hard or cold foods) • refusal to wear dentures (that they were previously wearing) • increased restlessness, moaning, shouting or aggressive behavior • refusal to take part in normal daily activities For some people with dementia, a trip to the dentist’s office, the strange faces and the unfamiliar surroundings can exacerbate their confusion, making treatment difficult, if not impossible. You may need to locate a dentist who can make a home visit for an examination, and can treat your loved one under I.V. sedation or general anesthesia. Written by David M. Blende, DDS, Special Needs Dentist. For more, call the Helpline (800-272-3900).