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Oral health care considerations for patients with Alzheimer’s disease:

  • It is important to assess a patient’s capacity to consent. Identify a legal guardian/care taker if necessary.
  • Document available support networks.
  • If removable prostheses are fabricated, be sure to label them with the patient’s name. Also, keep original casts in order to fabricate additional prostheses, as these patients have a tendency to misplace items.
  • Avoid removable prosthesis in patients with poor oral hygiene, and/or dexterity difficulties.
  • Be aware of oral dryness.
  • In case of swallowing difficulties, place the patient in a slightly more upright position. Use a rubberdam and high evacuation suctioning.
  • Address patient’s ability to perform oral health care independently.
  • Recognize that patients’ aggressive and even threatening behavior is part of the disease and not personal.
  • Aggression and agitation may be associated with pain.
  • Approach patients in a non-threatening way. Stress, fear and embarrassment may stimulate aggressive behavior in a patient.
  • Apply a tell-show-do approach. Determine each patient’s communication skills and avoid an infantilized approach.
  • Avoid introducing novel oral hygiene devices or methods.
  • Recognize that patients’ ability to seek outpatient dental care diminishes over time.
  • Recognize that a patient’s cooperation will diminish over time.
  • Try to perform as much oral health care as possible during the earliest stages of Alzheimer’s disease.
  • Lack of appropriate spatial perceptions may result in inability to carefully sit down or stand up from a dental chair (“transferring” difficulties).
  • Schedule short appointments.
  • Recognize possible abuse and neglect.