Q: As a Neurologist treating patients with neurological diseases, how can a Prosthodontist be a valuable part of the treatment team for my patients?
A: Dementia is the broad category given to a range of brain diseases that affect a patient’s memory and ability to think. These neurocognitive disorders include Alzheimer’s disease, vascular dementia, Lewy body dementia and fronto-temporal dementia.
Dementia affects 36 million people worldwide. About 10 percent of the population will develop the disease during their lifetime and the risk increases with age. The incidence of this disease by age group is estimated to be 3 percent for those aged 65–74 years, 19 percent in those aged 75–84 years, and approximately 50 percent in those over 85 years old.
While there are available medications such as Namenda or Aricept that may slow the disease process, the evidence is still not convincing. However, there are other challenges for the older patient with dementia (and their caregivers) in that patients usually have a long list of medications for multiple medical issues, and these medications often — either individually or collectively — cause xerostomia.
Medication-induced xerostomia, coupled with the diminished ability to provide self-care, can result in gross decay of the teeth such that the dentition is not restorable. In cases like this, the only remaining option is to consider complete dentures. Having grossly carious teeth removed and a well-fitting set of dentures made will greatly reduce the risk of oral infection, endodontic pain and candidiasis. Conventional dentures are also easily cleaned by the caregiver.
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