Oral Health Conditions Frequently Associated with AD

Patients diagnosed with AD routinely experience problems such as periodontal disease, caries, tooth loss, tooth mobility, orofacial pain, impaired swallowing, articular abnormalities in temporomandibular joints, difficulty wearing dentures, sores in mouth, cracked lips, coated tongue, and halitosis.1,68-74 These problems can cause discomfort, lead to behavioral changes, and ultimately decrease the patient’s quality of life.69,75,76 Additionally, oral problems can have a negative impact on eating, smiling, laughing, and self-esteem.77-79 Factors such as medications, dry mouth, nutritional deficiencies, and the functional deficiencies of AD itself contribute to developing these problems.

Understanding a patient’s oral health status can be complicated. Individuals suffering advanced AD may be unable to communicate when they are experiencing pain or if their removable appliance is not fitting properly.80 Care providers must be aware of behavioral changes that may indicate a patient is experiencing dental problems. Behavioral changes to look for are summarized in Figure 5. It is important to have a baseline understanding of each patient’s typical behavior in order to identify when these behaviors are atypical.75

Figure 5. Behavioral Changes that may Indicate Patient is having Dental Problems.74,75,77,81-83
  • Disturbed sleep
  • Refusal to eat (especially hot and cold foods)
  • Refusal to wear dentures in a previously compliant patient
  • Refusal to participate in daily activities
  • Aggressive behavior
  • Self-injurious behavior
  • Increased restlessness
  • Moaning or shouting
  • Pulling at face or mouth throughout the day
  • Increased drooling