Oral Health for Persons with AD
Oral health can become compromised at all stages of Alzheimer’s
disease (AD) and other dementias. There are many reasons for this.
For people with dementia, it becomes progressively difficult to independently
maintain good dental habits. Early on, dental appointments may be
forgotten, and in later stages one may forget why and how to brush their
teeth or how to use their dentures properly. Often the diet of a person
with AD contains food and drink that may increase the risk of dental
disease. Additionally, some of the commonly prescribed medications
to treat anxiety and depression that can be associated with AD cause xerostomia,
or dry mouth due to lack of saliva.1 Normally, the flow of saliva
helps prevent plaque formation and gingival inflammation. People with
AD also become unable to report pain or symptoms of oral disease.
The breakdown of simple sugars by the bacteria (plaque) in the mouth
into enamel dissolving acid is a major cause of tooth decay. Virtually all
foods contain some type of sugar, but some are more detrimental
than others. Generally, foods with added sugars such as, soda, sweetened
fruit drinks, candy, pastries, are of greatest concern. Also, when sugar
remains in the mouth for longer periods of time,more acids are produced,
worsening decay. Sticky foods, or foods that can get packed in the teeth
like chips, will stay in the mouth longer causing more harm.
It can be a challenge to maintain good oral health for people with AD.
In addition to an increased reliance on the caregiver to perform daily
dental hygiene procedures, changes in eating habits may also occur.
Common situations include an increased selection of sweets, eating more
snack foods because they can be managed independently or because a
person may no longer be able to participate in larger, traditional meals.
All of these issues can lead to less than optimal preventative oral care.
For people with AD, poor oral health can cause a change in eating habits,
negatively affecting a person’s diet, quality of life and cause a decline in
overall health.2
However, there are dietary adjustments that caregivers can make in
order to help prevent tooth decay. What, when and how foods are eaten
can play a role in promoting good oral health. To the right are some tips
to consider. In addition to these, caregivers should also maintain good
daily dental hygiene and monitor for signs of oral pain.
Increase Flow of Saliva
- Chew sugarless gum or eat sugarless candies—if able to do safely.
- Sip water throughout the day, limit caffeine intake, use alcohol free mouth rinses.
- Speak to the dentist about dry mouth management.
Type of food
- Some foods are protective because
they increase saliva flow and
neutralize acids. Better choices
include: cheese, chicken, meat,
nuts, vegetables, and milk.
- More harmful foods include:
candy, cookies, soda, cakes,
cracker, pretzels, muffins,
chips and dried fruit.
Timing of meals
- Limit snacking if possible, if not,
choose from the list below—also
limit sipping on sweet drinks
during the day.
- If sweets are consumed, try to
eat them with meals when the
saliva flow can help push away
the food.
- Good snack substitutes include
fruit, cheese, nuts, popcorn, and
vegetables, (if the person can eat
these safely without choking.)
— Lisa Zullig, MS, RD, CDN
God's Love We Deliver
This is the 6th in a series of articles on the nutritional and feeding needs of persons with AD.
Lisa Zullig is the Director of Nutrition at GLWD, a non-profit agency in NYC. It provides meals to men, women and children affected by HIV/AIDS, cancer, AD and many other serious illnesses who are unable to shop or prepare meals for themselves. The agency’s team of experienced nutritionists also provides nutrition education, information and counseling in individual and group sessions to clients, their caregivers and other service providers. In partnership with GLWD, the NYC Chapter is pleased to offer this service to persons with dementia and their families. For information, please call the Chapter’s 24-hour Helpline at 800-272-3900.
To obtain more individualized nutrition information, the nutrition department of GLWD can be reached at 212-294-8103 or 800-747-2023 or by visiting www.glwd.org.
1 Little. General Dentistry. Jul-Aug 2005;53(4):289-296.
2 Fiske et al. Gerodontology.2006 Dec;23(supp 1):5-32.
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