ORAL HYGIENE

Dirty Mouths Lead to Broken Hearts

"Poor oral health can lead to pneumonia and cardiovascular disease as well as periodontal disease," even though these illnesses are not usually associated with the mouth. According to persons with dementia resist care when they feel threatened. In general, these patients cannot care for themselves and need help.

IDA team introduced an oral hygiene approach called Managing Oral Hygiene Using Threat Reduction (Mouth) specifically for dementia patients. Many of their strategies focus on making the patient feel more comfortable before and while care is provided, the researchers report in the current issue of Special Care in Dentistry.

"We have come up with 15 strategies -- techniques to help reduce threat perception,". These strategies include approaching patients at eye level if they are seated, smiling while interacting, pantomiming, and guiding patients to perform their own care by placing a hand over the patient's hand and leading.

People with dementia are often no longer able to distinguish low or non-threatening situations from highly threatening situations. This happens when the parts of the brain that control threat perception -- particularly the fight, flight or freeze responses -- begin to deteriorate. The amygdala is the part of the brain that houses the fear response. The hippocampus and cerebral cortex receive and send messages to the amygdala, telling it how to react.

"Think of the hippocampus, cerebral cortex and amygdala as being in the woods,". "In a person with dementia, the path in the woods is blocked with tumbleweeds and the message from the cortex and hippocampus can't get to the amygdala." In turn, patients with dementia often react to something as intimate as a nurse brushing their teeth as a perceived threat.

In the past 30 years the number of nursing-home residents who still have their own teeth has risen significantly. Many of these people need assistance with their dental hygiene, as well as with other hygiene.

Team conducted a pilot study with seven people who had either moderate or severe cases of dementia. The researchers used the Mouth technique on the subjects for two weeks, recording the state of the patients' mouths and how the patients reacted throughout the study.