Oral and dental care are important with persons with Huntington's
Disease and as the disease progresses it becomes more of an issue. They have a high calorie diet and have a difficulty clearing
their mouths as swallowing becomes more impaired. They have increase in saliva production and a more difficulty swallowing
it.
After a meal you may notice food particles remain
in the mouth, thus an increase in bacteria stays within the mouth increasing the chance of cavities and increasing the chance
of the person swallowing or aspirating saliva with a higher bacteria count. This increases the chance of infection in the
mouth and in the lungs, possibly leading to aspiration pneumonia. They also can regurgitate their food which increases the
acid in the mouth.
As a person with Huntington's has chorea movements and cognitive impairments it is
difficult for them to clean their teeth properly. It is uncomfortable having someone putting a toothbrush in their mouth,
and even the use of toothpaste is difficult for the client to spit out as it is so thick. So brushing the teeth is important,
but you may need to modify it by using mouthwash instead of toothpaste on the toothbrush or even use toothlette sponges with
mouthwash.
It is important to do mouth care after each meal and
especially before bedtime to aid in reducing the chance of tooth decay. Always help the person relax prior to doing oral care
so it is a more comfortable experience. Their movements increase when they are stressed so the task would be more uncomfortable
and stressful for the client and caregiver. |
Another issue is that due to chorea movements a person with Huntington's
Disease may have an increase in grinding their teeth which too breaks down the tooth enamel and making the teeth more susceptible.
Dental checkups are important for everyone but with persons with
Huntington's Disease they should have dental checkups and cleanings done every three months.
Remember to aid the situation by helping with the positioning of
your client and helping them be more relaxed so as to decrease the movements at the time of a dental visit.
In relation to dental care issues, it is important to assess your
client for tooth and gum pain. These may be brought to a caregivers attention by the client verbalizing pain, but more times
than not due to difficulty in communication a client may not be able to verbalize their pain.
So then how do you know they are having pain ? You may notice simple
non-verbal cues such as them rubbing their mouth or drooling more, but most important is to investigate any increase in agitated,
irritable behaviors.
This type of behavior itself is usually always a sign that something
is bothering a person with Huntington's Disease, so remember to investigate it, and assess when, where and why their behavior
has changed.
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