Michael Watson discusses the changing needs of patients with dementia.
A visit to an excellent symposium at the Faculty of General Dental Practice UK on dementia and oral health opened my eyes to how little I knew about a condition that may well affect many of us as we grow older.
Much of our attention is centred on the oral health of children, rightly as the number referred to hospitals for extractions under general anaesthetic has reached almost epidemic proportions.
But we should also be looking at those at the other end of life, whose numbers are growing, some of whom will develop dementia perhaps in their late 70s and 80s.
Patients with dementia
Before the symposium I imagined most of these being in care homes or hospitals and only able to access dental care when it was too late to do anything other than extract.
But not always: many patients who have been diagnosed with dementia will still be living at home, often alone, but with a designated carer, often a relative.
Many of us also have an image of an older person, coming to see us with multiple restorations that are breaking down and need replacing.
Those who have the money and means to come and see a dentist and the mental capacity to understand a complex treatment plan are the fortunate ones.
Increasingly we will be seeing people who have difficulty doing simple things like making an appointment and remembering it, who find the atmosphere of our practices intimidating.
What they are going to need is practices that are ‘dementia friendly’, where the aim is to help them (and their carers) maintain as healthy a mouth as possible.
Dementia is not preventable, although living a healthy life in middle age and keeping the brain active helps.
To that extent it is different from caries in children.
But the challenge in both cases is similar, less reliance on treatment, more focus on helping the patient help themselves.