Dental care

2. Dental disease

There are two main types of dental disease: gum (periodontal) disease and tooth decay (dental caries,more commonly known as cavities). Both of these can cause discomfort or pain and can lead to infection. Both pain and infection can worsen the confusion associated with dementia.

Gum disease

Gum disease can cause inflamed and bleeding gums, gum recession (where the gum tissue is reduced so the roots of the teeth become exposed), loose teeth and bad breath. It is caused by the build-up of dental plaque (a combination of food debris and bacteria). Plaque leads to gum disease if it is not removed by daily efficient brushing and flossing. Using a tooth gel or mouth rinse containing chlorhexidine (an antiseptic and disinfectant agent) can help to control gum disease for a person who is experiencing bad breath and bleeding and inflamed gums.

Tooth decay

Tooth decay is caused by the action of dental plaque on the teeth when food and drinks containing sugar are consumed. Plaque and sugar together produce acid, which attacks the tooth, causing decay. Restricting the intake of sugar to two to three times a day, preferably at mealtimes, is important in guarding against tooth decay. It is the number of times that sugar is eaten during a day, rather than the total amount of sugar consumed, that is important in reducing the risk of decay. This includes hidden sugars in food and drink, as well as sugar added to food or drinks. A healthy diet, good oral hygiene, and the use of toothpaste or a mouth rinse containing fluoride will also help prevent tooth decay.

High-energy food supplements contain high levels of sucrose – a form of sugar. If they are used on a regular basis, it is important to keep the mouth clean to minimise the risk of decay. Gum recession increases the chances of decay occurring at the necks of teeth (where the crown of the tooth meets the root at the gum) unless oral hygiene is excellent and dietary sugars are controlled. Food supplements may be prescribed to a person with dementia who is having difficulties with eating. When food supplements are prescribed for a person with natural teeth, it is important to get advice on prevention from the dentist.