Restoration of the habit of routine tooth brushing teeth in patients with severe dementia

Abstract

Purpose-related activities are often lost in severe dementia, including oral hygiene habits such as brushing teeth. The aim of this study is to investigate whether patients with severe dementia can be induced to develop an oral hygiene routine through an occupational therapy approach and whether routine training in oral hygiene habits can reduce dental or denture plaque. Six female inpatients in the same room, who had been given diagnosis of multiple cerebral infarction and dementia. The project design included 4 periods a, b1, b2, and c, a and c were observation periods, while b1 and b2 were general approach periods. In the approach periods we held meetings, and made the program for oral hygiene, planning and problem-solving. In the b2 period both direct intervention by the dentists, dental hygienists and occupational therapists reinforced the habit of brushing teeth in subjects and educated care approach guidance. No patient completely resumed routine habit of brushing teeth, but an improvement in brushings was found in four subjects, one case had no change, and in one case brushing deteriorated. The state of oral hygiene showed improvement in periods b1 and b2. Although the adherence of dental plaque decreased in period b2, it increased in period c. Despite the improvement in performance, sufficient improvement in oral disease prophylaxis was not recognized, suggesting the necessity of professional oral health care by dental staff, and of a disciplinary team approach.