3. Drugs and dental problems
People with dementia may be taking medication for a number of conditions. They may also be prescribed antidepressants or – less often – antipsychotics and sedatives. A dry mouth is a common side effect of these drugs. Saliva acts as a lubricant and also cleans the mouth and teeth. Lack of saliva can lead to a build-up of plaque and increase the risk of dental decay, gum disease and infection. A dry mouth can also cause problems with dentures, including discomfort and looseness. Denture fixatives and artificial saliva (a fluid to lubricate the mouth) can help some people with denture problems. The dentist will be able to offer advice to relieve discomfort and problems caused by lack of saliva or a dry mouth. Frequent sips of water throughout the day, especially at mealtimes, will help.
Some antipsychotic drugs can cause involuntary repetitive tongue and jaw movements, making it difficult to wear dentures, particularly in the lower jaw. In some cases, these movements will continue after the drug is stopped. If this occurs, the dentist may be able to advise on what can help, and how best to ensure that the person is comfortable.
If medication is syrup-based (for example lactulose), there is an increased danger of tooth decay. The doctor may be able to prescribe a sugar-free alternative if asked. The dentist may also be able to apply chlorhexidine and fluoride varnishes to help prevent decay at the necks of the teeth.