A visit to the dentist is sometimes met with dread, but our mouths tell us more about our health than we may realize. I gained insight into the importance of oral health in my years as a caregiver for my parents.
Our family always had lousy teeth; some of my earliest memories are of going to the dentist. My dad avoided the dentist like the plague, but my mother dutifully spent many hours in the dentist’s chair. As a kid, I didn’t mind going to the dentist, because there was a huge chest of toys to choose from once the visit was over. At my mother’s dentist, there were homemade cookies! Through most of my adult years, my visits to the dentist were few and far between, but now I begrudgingly maintain regular visits, after suffering a chronic oral health issue and witnessing the complications oral health problems had on my parents.
A study published in the September 2016 edition of the Journal of the American Geriatrics Society found that periodontitis is associated with a greater risk of dementia. The study was of interest to me because I have periodontal disease and my father had Alzheimer’s. Because of Dad’s aversion to dentists, there is no way to know if he suffered from periodontitis, but he preferred to eat soft foods and seemed to have tooth and gum sensitivity. In the last months of his life, when dementia caused him to forget how to swallow, it made me realize just how much we take our mouths, and its many functions, for granted.
Oral health can be tricky to manage in dementia patients. Visits to the dentist, which already stoke fear in some people without dementia, can be disorienting and frightening to those with dementia. It can be difficult for those with dementia to follow orders, like keeping their mouths open or staying still for X-rays. But those with dementia need regular dental visits because they often cannot communicate when there is a problem. I know a woman who was shocked to learn that her father, who had dementia, had squamous cell carcinoma on the tongue. It went undetected at the assisted living facility, and took several months and multiple doctors to even reach a diagnosis. The issue went undetected even during an annual physical. Her father’s outward symptoms were weight loss, drooling and garbled speech. Her father was able to tell her that he was having trouble swallowing, but by then, the tumor had grown too big for treatment. He died just a month after diagnosis.
In the last years of her life, my mother had difficulty in getting her dental partial remade to conform to her shrinking gums and bone. While she was a trooper about it, she gave up healthy items she enjoyed eating, like raw carrot sticks, because of the ill-fitting dental device and her lack of remaining teeth. During my mother’s recovery from a colostomy, she developed serious blood clots that required her to be on blood thinners for several months. This can complicate some dental procedures that may cause bleeding. I was used to bringing a list of Mom’s medications to medical doctors, but I quickly learned that her medical history was equally important at the dentist.
When I was actively caregiving, I ignored my own health. I had to quit my job, and purchased a catastrophic-only health insurance policy, which was all I could afford at the time. I was grateful to have maintained decent health during my caregiving time, but knew there could be a price to pay afterwards.
I never experienced the common symptoms associated with periodontal disease, like gum bleeding and sensitivity. I had no symptoms whatsoever. The year before, I had undergone a root canal for a tooth problem that also caused no symptoms. After skipping the dentist for so many years, I was suddenly seeing a dentist, an endodontist, and a periodontist. I started out with some pockets of 7 millimeters in depth, so my periodontist took an aggressive approach to get it under control. I went through a scaling and root planing procedure, and now I get my teeth professionally cleaned a few times a year. I floss daily. The periodontitis is now under control, but I know it is a chronic condition that will require vigilance.
Every time I think about skipping a cleaning appointment, I think about how my parents suffered with their oral health. Most of these problems can be remedied with regular treatment. I have a job with good dental health benefits now. I have no excuses. We sometimes take our oral health for granted, but it is important for us to mind our mouths, and those of our loved ones who may not be able to actively participate in maintaining their own health due to conditions like dementia.
Photo by Marcelo Terraza/Freeimages
Joy Johnston is an Atlanta-based digital journalist who began The Memories Project blog in 2012 after her father died of Alzheimer’s. Her essays have appeared in best-selling anthologies, including Chicken Soup for the Soul: Living with Alzheimer’s & Other Dementias.