Case Report: Prosthesis (Complete Denture) for Communication and Behavioral Impaired Dementia Patient
Aims: To describe the procedures for complete denture fabrication in dementia and behavioral impairment patient and how to manage the case holistically.
Methods and Results: The patient was a 77-year-old woman diagnosed with moderate dementia, Alzheimer’s disease with Behavioral and Psychological Symptoms of Dementia. The patient lost her previous complete dentures. She had signs of agnosia, communication problems and behavioral control. These aspects increased the difficulty in her daily life activities and in providing dental treatment. Our goal was to restore her oral function and to improve her overall general health by fabricating new complete dentures. An online consultation was used to oversee the behavioral management, adaptation in posture, and techniques in prosthodontic procedures between the postgraduate dental student providing this treatment and the prosthodontic specialist in an academic institute while they were in different places. The dental treatment in this case was provided holistically and patient-centered, the dental treatment outcomes were achieved through the follow-up visits.
Conclusions: This case study revealed that a dementia patient could receive appropriate dental treatment in cooperation with the care team to maintain her oral health function. Behavioral management could be performed using non-pharmacological methods. After delivering the denture, the patient’s nutritional status and the quality of life largely depends on the caregiver when the dementia progresses.
1. Korolev IO. Alzheimer’s disease: a clinical and basic science review. MSRJ. 2014;4(1):24-33.
2. Bird TD. Alzheimer disease overview. GeneReviews®(Internet). 2018.
3. Bränsvik V, Granvik E, Minthon L, Nordström P, Nägga K. Mortality in patients with behavioural and psychological symptoms of dementia: a registry-based study. Aging Ment Health. 2020:1-9.
4. Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer's disease prevalence. Lancet Neurol. 2011;10(9):819-28.
5. González‐Salvador MT, Arango C, Lyketsos CG, Barba AC. The stress and psychological morbidity of the Alzheimer patient caregiver. Int J Geriatr Psychiatry.
1999;14(9):701-10.
6. Mahoney FI, Barthel DW. Functional evaluation: the barthel index. Md State Med J. 1965;14:61-5.
7. Rovner BW, Folstein MF. Mini-mental state exam in clinical practice. Hosp Pract (Off Ed). 1987;22(1a):99-110.
8. Rockwood K, Fay S, Theou O, Dykes L. Clinical frailty scale. Halifax, NS: Geriatric Medicine Research, Dalhousie University. 2009.
9. Kocaelli H, Yaltirik M, Yargic LI, Özbas H. Alzheimer's disease and dental management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(5):521-4.
10. Fisher JE, Carstensen LL. Behavior management of the dementias. Clinical Psychology Review. 1990;10(6):611-29.
11. Winkler S. House mental classification system of denture patients: the contribution of Milus M. House. J Oral Implantol. 2005;31(6):301-3.
12. Critchlow SB, Ellis JS, Field JC. Reducing the risk of failure in complete denture patients. Dent Update. 2012;39(6):427-36.
13. Morita H, Hashimoto A, Inoue R, Yoshimoto S, Yoneda M, Hirofuji T. Successful fitting of a complete maxillary denture in a patient with severe Alzheimer's disease complicated by oral dyskinesia. Case Rep Dent. 2016;2016:4026480-.
14. Chalmers JM. Behavior management and communication strategies for dental professionals when caring for patients with dementia. Spec Care Dentist. 2000;20(4):147-54.
15. McGrath C, Bedi R. The importance of oral health to older people's quality of life. Gerodontology. 1999;16(1):59-63.