NMDA Journal Summer 2018

10 New Mexico Dental Journal, Summer 2018 them to scream or growl so they will open their mouths. If this is done kindly and gently talking soothingly, the oldster actually begins to enjoy the attention. Manhandling using this technique will get you nowhere fast. Caregivers should keep dentures when they are not worn. Especially practicing vigilance at meal times and before the oldster goes to bed. • He is going to die anyway. When? That is an important question. It will be soon if they have a terminal disease. Unless the person is on hospice, they should be treated as if they are going to live for years. Remember—the longer one lives, the longer one will live. Eating, swallowing and diet are integral to the oral cavity. This is a no brainer. I can’t believe I wrote it. What do you bring an oldster for a present when you visit? Usually candy or flowers. They don’t need anything right? They eat high carbohydrate diets. They are on drugs that cause xerostomia. Changing drugs is almost impossible but you can talk to the geriatrician and see if you can make some headway. Their tongue doesn’t clean the food out of their mouths and they get vestibular food packing that can age for days. Have the care givers use their finger or a sponge on a stick to clean out the vestibule. No wonder they have so much decay. You already know how to prevent decay. Another problem is that some TIA’s (transient ischemic attacks) or strokes will cause the oldster to think they can’t chew but in reality, they can’t swallow. I give them a pistachio nut to chew and observe that it is almost always an inability to swallow. I use this nut because they don’t go rancid as fast as pecans or walnuts. Too many people have peanut allergies. Almonds are too hard. Pistachios are in their shells so I can also observe their manual dexterity. This becomes a speech pathologist’s problem not ours. They are retaught how to swallow and/or go on thickened liquids that covers the teeth and stays there. When you see this problem, make sure you have the patient rinse and spit with water or mouthwash like Listerine or Peridex after they eat. PRACTICE COMMON SENSE OFFICE BEHAVIORS SO YOU CAN ENJOY TREATING THIS POPULATION: • When scheduling know if you can trust the patient to schedule or find someone else to talk to who is responsible for getting them to your office. • Have the caregiver in the operatory at all times and even close to the oldster’s mouth so they can see all the plaque and debris while you remove it to get to the decay helping them understand that the bleeding is from the plaque and lack of care. Hopefully this will make them feel guilty and change their behavior. • Practice safely using a mouth prop, rubber dam, an Isolite, and gently restrain if necessary. • Stay calm, people pick up on your demeanor and will follow your mood just like a horse does when you are riding. • Touch them while you are talking to them. Always talk to the patient. The caregiver is listening. You never know how aware the oldster is and you want them engaged—not ignored or sidelined. These people are our parents, grandparents or even great grandparents. They are the ones who created us, and made our country the best place to live in the world. They deserve our care, respect and love. continued from page 9 Oldsters and Their Teeth 10 Warning Signs of Alzheimer’s disease Memory loss that disrupts daily life Challenges in planning or solving problems Difficulty completing familiar tasks Confusion with time or place Trouble understanding visual images and spatial relationships New problems with words in speaking or writing Misplacing things and losing the ability to retrace steps Decreased or poor judgment Withdrawal from work or social activities 1 9 8 7 6 5 4 3 2 10 Warning Signs of Alzheimer’s disease ©2009Alzheimer’sAssociation.All rights reserved. If you or anyone you know ex periences any of these warn ing signs, please see a doctor. For more information, call 800.272.3900 or visit alz.org/10signs. Memory loss that disrupts daily life Challenges in planning or solving problems Difficulty completing familiar tasks Confusion with time or place Trouble understanding visual images and spatial relationships New problems with words in speaking or writing Misplacing things and losing the ability to retrace steps Decreased or poor judgment Withdrawal from work or social activities Changes in mood and personality 1 10 9 8 7 6 5 4 3 2 f pts daily life or solving problems amiliar tasks place 10 Warning Signs of Alzheimer’s disease If you or anyone you know experiences any of these warning signs, please see a doctor. For more information, call 800.272.3900 or visit alz.org/10signs. Memory loss that disrupts daily life Challenges in planning or solving problems Difficulty completing familiar tasks Confusion with time or place Trouble understanding visual images and spatial relationships New p oblems with words in sp aking or writing Misplacing things and losing the ability to retrace steps Decreased or poor judgment Withdrawal from work or soci l activities Changes in mood and personality 1 10 9 8 7 6 5 4 3 2 ©2009 Alzheimer’s Association. All rights reserved. If you or anyone you know experiences any of these warning signs, please see a doctor. For more information, call 800.272.3900 or visit alz.org/10signs. Challenges in planning or solving problems Difficulty completing familiar tasks Confusion with time or place Trouble understanding visual images and spatial relationships New problems with words in speaking or writing Misplacing things and losing the ability to retrace steps Decreased or poor judgment Withdrawal from work or social activities Changes in mood and personality 10 9 8 7 6 5 4 3 2