The following is a question and answer column with ASCC and Dov Glazer, DDS on oral hygiene and a person living with Alzheimer's disease.

ASCC: What would be say, 5, basic steps to good oral hygiene for older folks?

Dr. Glazer: The mouth is the gateway to the body. It is through the oral cavity that we bring in food and water for nourishment, through the tongue we verbally connect by articulating our thoughts and ideas, from the salivary
glands we can spit to express disgust, and through our lips we kiss to
express affection. Keeping the mouth healthy is imperative to good general
health and well being.

The first step in maintaining good oral health is to eat foods that are
healthy and nutritious. Fruits, vegetables, and nuts are at the top of the
list. Using utensils to make small bite size portions and then thoroughly
chewing the food, not only enhances the digestive process to squeeze out the
maximum amount of nutrients, but also increases the pleasure of eating.
Eating the right foods not only provides the satisfaction of healthy
nourishment, but also cleanses the teeth.

While chewing, in and of itself will scrub the outer surfaces of the teeth,
cleaning between the teeth is extremely important. The new sonic brushes
will shake up some of the dental plaque and debris that is hidden between
the teeth, the most effective way of getting to these area is with a soft
toothpick or better yet, with dental floss.

The tongue can also harbor undesirable bacterial colonies, so scraping the
tongue with a soup spoon once a day can keep the mouth healthy and fresh
feeling.

There is one thing to avoid. For good oral health, do not use mouth wash.
These products, which contain alcohol and other harmful chemicals, can
temporarily reduce bacterial count, but within a matter of minutes the
bacteria return.

And of course, the tooth brush is an important tool in keeping the mouth and
teeth healthy and clean. Brushing after dinner is most important, while
cleaning the teeth in the morning creates a fresh feeling for the rest of
the day.

ASCC: Given the delicate situation of reminding an adult to brush their
teeth, what can a caregiver do optimize good oral hygiene?

Dr. Glazer: It is desirable to coordinate tooth brushing with other routine daily
activities. It can be linked to the evening meal as the "desert" following
dinner, or have the tooth brush available in the tub or shower, right next
to the soap or shampoo.

ASCC: What can be done to combat bad breath due to poor oral hygiene?

Dr. Glazer: There are many causes for oral malodor. Tooth decay, gum disease, sinus
infections, gastrointestinal disorders, growths and tumors can all be
contributing factors to halitosis. It is imperative that the cause of the
bad breath be identifies by the patients physician and dentist. More
frequent professional cleaning may be indicated if no pathology is noted and
the client has difficulty maintaining optimal oral hygiene.

ASCC: What are the signs to watch out for that indicate a dental problem?

Dr. Glazer: Pain, bleeding and swelling are the clear indicators of the presence of dental problems. Since pain is usually the first symptom, it is important to determine the location, intensity, and duration of the pain. To assist with the diagnosis, it is desirable to determine if the pain is constant or
intermittent, stimulated by cold, heat or pressure upon chewing.

ASCC: Any suggestions on oral health maintenance when dealing with dentures?

Dr. Glazer: Within any 24 hour period, the dentures should be left out of the mouth for 2 to 4 hours. For good jaw support, it may be desirable to leave the dentures in the mouth during sleep. The denture should be immersed in a cleaning solution while out of the mouth, and the mouth should be thoroughly rinsed prior to inserting the dentures in the mouth.

ASCC: As a dental professional, what would you suggest caregivers tell you beforehand about their loved one with AD who's coming to see you?

Dr. Glazer: Be frank and thorough. It is most helpful for the caregiver to write a concise narrative about the patient. E-mailing the information to the doctor prior to the appointment is very helpful and will prepare doctor and staff for the visit.

Trust this is helpful,

Yours for better health,

Dov Glazer, D.D.S.
3525 Prytania St., Suite 312
New Orleans, LA 70115
Office: 504.895.1137
Fax: 504.897.8010
www.glazers.net