A pilot study by a team of nurses has now found a tailored approach to improve dental hygiene in dementia patients.
“Poor oral health can lead to pneumonia and cardiovascular disease as well as periodontal disease,” said Rita A. Jablonski, even though these illnesses are not usually associated with the mouth.
According to Jablonski, assistant professor of nursing, Penn State, persons with dementia resist care when they feel threatened. In general, these patients cannot care for themselves and need help.
Jablonski and her team introduced an oral hygiene approach called Managing Oral Hygiene Using Threat Reduction (MOUTh) specifically for dementia patients. Many of their strategies focus on making the patient feel more comfortable before and while care is provided.
“We have come up with 15 strategies — techniques to help reduce threat perception,” said Jablonski.
These strategies include approaching patients at eye level if they are seated, smiling while interacting, pantomiming, and guiding patients to perform their own care by placing a hand over the patient”s hand and leading.
Jablonski and her team conducted a pilot study with seven people who had either moderate or severe cases of dementia. The researchers used the MOUTh technique on the subjects for two weeks, recording the state of the patients” mouths and how the patients reacted throughout the study.
At the beginning of the study all seven subjects had poor oral health, as determined by the Oral Health Assessment Tool. Eight categories concerning oral health are scored between zero and two. The lower the score the healthier the mouth. The average score for the subjects at the start of the study was 7.29. By the end of the study the average score was 1.00.
“To my knowledge, we are the only nurses in the country who are looking at ways to improve the mouth care of persons with dementia, especially those who fight and bite during mouth care,” said Jablonski.
“Our approach is unique because we frame resistive behaviour as a reaction to a perceived threat,” added Jablonski.
The study has been published in the Special Care in Dentistry.