Should Dentures Be Reinserted for Patients with Dementia and Weak Consciousness?

Should removable dentures be reinserted for patients with diminished consciousness due to dementia?

Hello, my mother is 83 years old and suffers from dementia, diabetes, and bile duct cancer.
After hospitalization and chemotherapy, her consciousness was extremely weak.
The family removed her removable dentures (she only has six natural teeth remaining) and fed her with a nutritional supplement.
After discharge, her consciousness has slightly improved, and we hope to increase her intake of porridge and semi-solid foods to supplement her caloric and nutritional needs.
We would like to reinsert her removable dentures to enhance her chewing function, but we are concerned about the risk of aspiration.

Mr. Wan, 50~59 year old female. Ask Date: 2016/10/18

Dr. Huang Zhicheng reply Dentistry

Dear Mr.
Wan,
Hello.
Generally, removable dentures are not easily swallowed; however, the design of removable dentures can vary among different healthcare facilities, and there may be size discrepancies.
If the dentures are too small, the possibility of accidental swallowing cannot be ruled out.
Additionally, the fit and stability of the dentures in relation to the teeth are also factors to consider regarding their likelihood of dislodging.
I recommend that you visit the dental clinic where your dentures were originally made or another healthcare facility for further examination and evaluation.
Thank you for your inquiry.
Wishing you safety and good health.
Sincerely,
Dr.
Huang Chih-Cheng
Attending Dentist, Department of Dentistry
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2016/10/18

More Info

When considering whether to reinsert dentures for a patient with dementia and weakened consciousness, several factors must be taken into account. Your mother's situation, with her advanced age, dementia, diabetes, and recent chemotherapy for bile duct cancer, presents unique challenges.
Firstly, it is essential to understand that patients with dementia often experience difficulties with oral health and hygiene, which can lead to further complications. The use of dentures can significantly improve the quality of life by enhancing the ability to chew and enjoy food, which is crucial for maintaining nutrition. However, in patients with cognitive impairments, there is a risk of mismanagement of the dentures, including potential choking or aspiration if the patient is unable to handle them properly.

In your mother's case, since her consciousness has been described as weak, there is a heightened risk of her not being able to manage the dentures effectively. This could lead to issues such as aspiration pneumonia, which is a serious condition that can arise when food or liquids are inhaled into the lungs instead of being swallowed into the esophagus.
Before making a decision, it is advisable to consult with her healthcare team, including her primary physician, a dentist familiar with geriatric care, and possibly a speech therapist. They can assess her swallowing abilities and overall cognitive function to determine if she can safely manage her dentures.
If the decision is made to proceed with reintroducing the dentures, it may be beneficial to start with short periods of wear to monitor her response. This gradual approach can help assess her ability to handle the dentures without compromising her safety. Additionally, ensuring that the dentures fit properly is crucial, as ill-fitting dentures can cause discomfort and lead to further complications.

Moreover, consider alternative feeding strategies that may not require the use of dentures. For instance, if her ability to chew is significantly impaired, pureed or soft foods can be offered that do not necessitate chewing. This can help ensure that she receives adequate nutrition without the risks associated with dentures.

In summary, while reintroducing dentures can enhance your mother's quality of life by improving her ability to eat, the risks associated with her weakened consciousness and dementia must be carefully evaluated. Consulting with her healthcare team will provide the best guidance tailored to her specific needs and condition. If dentures are deemed appropriate, a cautious and monitored approach should be taken to ensure her safety and well-being.

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