Our mouth – so important for so many reasons – seems overlooked, dismissed, ignored in its role in overall health and well-being.
Consider the work we expect from our mouth: in addition to the vital task of eating (and all that’s required from lips, tongue, teeth, cheeks), there’s the impact of talking, coughing, sneezing and even breathing when the nose isn’t properly working.
Anyone’s who’s had a toothache, cold sore, tender gums, dry mouth, canker sore knows the buck stops at the mouth. Add age, medications and their side effects, chronic conditions such as Alzheimer’s, mental decline and there’s a world of trouble brewing.
From “Impacted Nurse“:
“Just yesterday we had an elderly lady who we just could not keep any oxygen masks or nasal prongs on. She just kept swiping across her face and knocking them off. After trying everything, I thought, as a long shot, I would give her some mouth care. Her mouth was dry as Mars. And guess what? After a freshen-up and a little Vaseline to her lips, she slept like a baby.”
“There are groups of patients that are predisposed to mouth hygiene problems such as those with chronic obstructive pulmonary disease (due to persistent mouth breathing), patients that are nil by mouth and those with physical injury or intellectual impairment.”
For those in ICU or emergency, intubated patients are at increased risk of ventilator-acquired pneumonia if a mouth full of incubating oral pathogens migrate to the lungs.
Medications such as antibiotics, steroids, antihistamines and antidepressants can all depress the normal protective flora of the mouth, resulting in bacterial growth or infection.
For a dentist, there’s much to consider in oral health for the elderly infirm. Like how to get to their mouths when they’re in a wheelchair. When Dr. Natalie Archer was asked to design the dental clinic at Runnymede Healthcare Centre in Toronto’s west end, she did so with the elderly who are challenged physically or mentally in mind.
“We have a specialized dental chair that operates on air, and can be easily moved to anywhere in the room, which allows us to accommodate wheelchair bound patients easily. We also have specialized ceiling lifts to allow us to safely transfer any patient from their wheelchair to the dental chair with ease.”
Two strategies to help with oral health
They contain an enzyme called ananase, which cleanses the mouth and have been suggested for use by radiotherapy patients with mouth problems.
They contain an enzyme called papain, which breaks down the protein of saliva and can be useful in patients with thick or “ropey” secretions clogging up their mouth.
Studies have shown that mouthwashes containing greater than 20 percent ethanol may cause keratosis, mucosal ulceration, gingivitis and most recently, an increased risk of oral cancers with prolonged usage.
The Canadian Dental Association has tips for caregivers. Click here
Reprinted with permission of Kathy Kastner; this post was originally published at ability4life “Caring for Aging Parents”
For more info, tips and strategies specific to dentist and the dementia patient, go to our story: This Won’t Hurt a Bit