Laura Argello DHIII Alzheimers Disease June 26, 2013

1. What is the disability? a. Alzheimers is an idiopathic form of irreversible dementia that is divided up in two parts; early onset and late onset. It is defined as a progressive brain disorder that gradually destroys memory and the ability to reason, to learn to make judgments, to communicate, and to carry out daily activities. 2. History of the disability: a. Alzheimers disease was first recognized by Dr. Alois Alzheimer in 1906 when he identified altered brain tissue in an individual who died of an atypical mental illness. 3. Predisposing factors of the disability: a. The Alzheimers Foundation of America noted age, inflammation of the brain, traumatic head injuries, family history/genetics, and neuron damage associated with free radicals, and environmental factors as the predisposing factors. b. Symptoms can range from difficulty remembering recent events, names of familiar people, disorientation, problems with language, impaired decision making, to difficulty solving basic math problems. 4. Whom does the disability effect? a. The disability can affect anyone. 5. When is population effected?

Laura Argello DHIII Alzheimers Disease June 26, 2013

a. It depends on the type of onset, early or late onset. Early onset Alzheimers effects individuals before the age of 60. Late onset is more pronounced in individuals between 70-80 years of age. 6. How does the disability affect the body? a. As the disease progresses, so do the physical impairments. Individuals may experience changes in personality and behavior, such as anxiety, suspiciousness or agitation, as well as delusions or hallucinations. In advanced and terminal stages of the disease, there is profound comprehension difficulty, aggression, inability to recognize family members, physical immobility, dysphagia (difficulty swallowing), mutism, and unawareness of environment. b. Individuals muscles grow rigid not allowing them to smile or support their head up. These patients will also need help with daily personal and hygiene care like eating or using the restroom. 7. Medications that affect the disease: a. The medications given to address behavioral problems are antidepressants, antianxiety and antipsychotics. 8. Do medications affect the body? a. Yes, patients are prescribed cholinesterase inhibitors to slow the progression of the disease by temporarily improving cognitive function and providing some improvement in behavioral symptoms.

Laura Argello DHIII Alzheimers Disease June 26, 2013

9. Is the disease progressive and does it have a state of remission? a. It is a progressive disease; it does not have a state of remission. The progression of the disease of categorized into 7 different stages; no impairment, very mild cognitive decline, mild cognitive decline, moderate cognitive decline, moderately severe cognitive decline, severe cognitive decline, and very severe cognitive decline. 10. How does disability affect the oral cavity physically? a. There is no significant sign or symptom that arises from having Alzheimers disease, but oral hygiene should be supervised to reassure adequate care. 11. Caries or periodontal considerations: a. Patients should be monitored closely because the disease shows a decrease in interest of oral hygiene and personal care. 12. Medications effect on the oral cavity: a. Some side effects of the medications include; Xerostomia, glossitis, coated tongue, alteration of taste, dizziness, sedation, and orthostatic hypotension. 13. Use of a caretaker. a. Alzheimers patients require a caretaker when they no longer can do day to day activities on their own and may need assistance or supervision. This would be around stage 5.

Laura Argello DHIII Alzheimers Disease June 26, 2013

14. Toothbrush modifications: a. A power toothbrush may be advised to improve dental biofilm removal. 15. Dental aides: a. Topical fluoride application should be done with a fluoride varnish. 16. Appointment modifications: a. Three month intervals are recommended to provide proper maintenance.

Laura Argello DHIII Alzheimers Disease June 26, 2013

References

Wilkins, Esther M. (2013). Clinical Practice of the Dental Hygienist. Philadelphia. Lippincott, Williams, and Wilkins.

Prajer, R., Kacerik, M. (2006). Treating patients with alzheimers disease. Dimensions of Dental Hygiene, 4(9). Retrieved June 21, 2013 from
http://www.dimensionsofdentalhygiene.com/ddhnoright.aspx?id=922&term=alzheimers

Hebl, L. (2013) Dental Hygiene III Class Notes. Kirkwood Community College.