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Alzheimer`s Disease/Grinding of teeth in Alzheimer's patients

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Question
Hello-
My mother is in the end stages of Alzheimer's disease after battling it for the past 10 years.  She has been in a full time care facility for over 5 years and has started grinding her teeth continually.  She has broken off 2 teeth and displaced a crown the covered a root canal.  Do you know of any causes for this grinding.  How is dental care viewed for the advanced patient? Is she is pain?  Is there anything we can do? The facility brought in a specialist to evaluate, but we have never heard anything back regarding results after repeated inquires.
We just want her to be comfortable.  
Thank you for any advise you can offer.

Answer
Hello Jan:  It must be very frustrating for you and your family to deal with this new problem with your mother.  I'm glad the facility brought in a specialist and you need to be able to have access to the report.  Unless there is a very good reason, the facility should be telling you the results of the report.  Asking them frank questions such as "Do you have the report back yet, and if not, please tell me the name and phone number of the specialist so I may contact them directly."  Then, I would call them DAILY (either the administrator, or the specialist's office) for that information. Be that squeaky wheel and you will get an answer quicker.   
Dental care is still important for elders with dementia in that infections or cavities can lead to heart problems and systemic illnesses.  That being said, it's difficult to accomplish oral care with many of these elders.
It may be that the damage in her brain is now affecting the area that controls the impulses to her mouth and that stimulation is causing the grinding.  If that is the case, then this behavior will eventually go away as the damage progresses.  If she's also having problems with eating, chewing or swallowing, then that would point to the AD as the likely cause.  It's hard to know for sure, but the specialist may have some suggestions.  It's always a guessing game with elders with dementia because they cannot tell you what the problem is.  Her physician may wish to try something like a very low dose of either a sedative or muscle relaxant to see if that helps.  Even trying something simple like round the clock doses of Tylenol just in case she's grinding because of an irritation or pain.  Has the facility tried to give her something to chew on?  I'm thinking of something like those baby teething rings that you put into the freezer. You wouldn't necessarily need to give it to her frozen in case that would cause further discomfort, but having something soft and "chewy" to chew on could help reduce the wearing down on her teeth. Another option might be to try to constantly have something in her mouth--it sounds awful, but here I'm thinking of something like a larger pacifier or something similar that would alter her ability to grind the molars if she has something in her mouth.  I would try the teething ring first though.  
This is a real dilemma for you Jan, and I hope you find some answers very soon for your dear mother.  She's lucky to have family who care for her enough to look for answers.  Cindy  

Alzheimer`s Disease

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Cindy Keith, RN, BS, Certified Dementia Practitioner

Expertise

As a nurse and dementia consultant, I can answer most questions on all types of dementia. If I cannot answer your question, I will attempt to find someone who can. My passion is to help caregivers of people with dementia, which in turn helps all those wonderful elders with dementia live better lives. When caregivers are better educated, they are able to better care for themselves and their loved ones, so education is key to decreased stress levels and healthier, happier families.

Experience

I have worked as a nurse in various disciplines of nursing for over 20 years, most of which was with the elderly. I was a health care coordinator in a dementia dedicated assisted living facility for 4 years before I started my own business (M.I.N.D. in Memory Care) as a dementia consultant six years ago. As a dementia consultant, I help families nationwide through phone conference calls as they struggle to care for their loved ones with dementia.

Organizations
Alzheimer's Foundation of America Geriatric Interest Network Sigma Theta Tau International

Publications
Published "Love, Laughter, & Mayhem - Caregiver Survival Manual For Living With A Person With Dementia" which is a collection of stories about people with dementia I have known, loved and worked with. Every story has a lesson to teach and this book gently teaches family caregivers lessons about how to better care for their loved one, as well as themselves during their caregiving journey. Published "Love, Laughter, & Mayhem In Eldercare Facilities: The Master Key For Dementia Training" Created "Bringing Nurturing To Memory Care" staff dementia training video Created Ebook: "Hair Stylist's Helpful Tips For Working With People With Alzheimer's & Other Dementias"

Education/Credentials
Registered Nurse with Bachelor's degree in Nursing; Certified Dementia Practitioner; Author of 2 books and an ebook

Awards and Honors
Sigma Theta Tau National Honor Society of Nursing

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