1. Dementia and Oral Health improving care for people with dementia
Angela Baker
Deputy Director, Health and Wellbeing
Public Health England, South East

2. What is the problem? Dementia is a growing problem
An ageing population with poor oral health
Increase focus on early diagnosis
Increase understanding of the causes of dementia
Estimates show that 850,000 people are living with dementia in the UK in 2014.
There is a link between Oral Health and Dementia, poor oral health is associated with increase risk of dementia, dementia invariably means poor oral health unless there is good care.
Dementia and Oral Health

3. Dementia prevalence in Thames Valley
Dementia and Oral Health

4. So what? Dentists role in dementia care
Number 1 – Prevention Dementia doesn’t have to be an inevitable part of ageing. People are more likely to live well in their older years if they live more healthily in earlier life, particularly during mid-life (40-65 years). Life expectancy is increasing, healthy life expectancy is not, we all have a role to play in prevention otherwise our systems will become unaffordable. (Delivering Better Oral Health) What’s good for the heart can be good for the brain: factors that increase the chances of developing vascular disease also increase the chance of developing dementia.
Reasons to be cheerful are
1, 2, 3….
Dementia and Oral Health

5. Prevention Actions Simple actions can reduce dementia risk:
Be physically active
Don’t drink too much alcohol
Eat a healthy diet
Give up smoking
Maintain a healthy weight
Join in
Be physically active: A lack of regular physical activity along with a sedentary lifestyle can increase the risk of developing vascular dementia, which is caused in part by problems with the circulation of blood to and around the brain.
  Don’t drink too much alcohol: Regularly drinking above recommended levels increases the risk of developing dementia. Drinking at high levels over time can directly cause a related condition called alcohol related brain damage.
  Eat a healthy diet: Diet is important for health. Eating a diet with less saturated fat, added sugars and salt will help reduce the risk of dementia, as well as reducing the risk of cardiovascular disease.
  Give up smoking: Smoking has an extremely harmful effect on the heart, lungs and vascular system including the blood vessels in the brain. This increases the risk of developing dementia – smokers are almost twice as likely to develop dementia as non-smokers.
Maintain a healthy weight: Obesity in mid-life is a risk factor for dementia, diabetes, heart disease, some cancers and other health problems. Eat well and keep active to achieve a healthy weight.
Join in: Staying socially active will help to improve your chances of delaying or avoiding the onset of dementia
Dementia and Oral Health

6. …and what can you do about it?
Our best estimates show that 10% of dementia cases may be avoided by improvements in public health. You can make a difference with brief interventions including Smoking Cessation services, Physical Activity and Weight Management Programmes. If you see early signs of other diseases refer as appropriate (such as dementia, hypertension and diabetes). Ensure your practices are environments for education and social opportunity!!
Dementia and Oral Health

7. Number 2 - The patient with dementia – oral health why bother?
People with Dementia still have teeth and mouths, still need to eat and drink and still need to be comfortable.
People with dementia are safest and most comfortable at home
Once a person with dementia is admitted to hospital they stay there longer and are less likely to get home again
Avoidable hospital admissions cost money
Dementia and Oral Health

8. An Example
Dementia and Oral Health

9. Oral Health impacts on all these reasons for admissions…
Dementia and Oral Health

10. Number 3 Dementia Friendly
 Health Education Thames Valley » New dental film highlights the needs of dementia patients
Dementia and Oral Health

11. Dementia friendly Dental Practice
Dementia and Oral Health

12. Dementia Friendly Training, we can’t afford it??
Can you afford not too?
Training for staff, level 1, 2 or 3
Ways of flagging notes
Care plans for patients
Carers to support patients
Practice lay out, simple things such as hand rails, door exits
Dementia and Oral Health

13. So…
You are key and important partners in the care of Dementia patients You have a role in Prevention You have a role in early detection/diagnosis You have a role in effective oral health treatment You can make your practices safe environments for these vulnerable patients The first stage is ensuring that you and your staff understand the patient with dementia. Training is available on line and free to access.
Dementia and Oral Health