One of the items often overlooked after a person has a hospital stay is possible dental problems.
This is especially true if there has been a long stay or a time when the patient was in a coma. There are some illnesses that may signal a challenge to the teeth as well. For example, I had a family member who recently underwent the onset of diabetes in a nasty crash from very high bold sugar. Because of the usually fairly long (several months) period of dehydration and the subsequent dry mouth that is part of all of that, there are often many cavities. After getting the medical condition under control, the patient should get a checkup from the dentist.
A comatose stay at the hospital often causes similar problems. The teeth are a small part of the problems the nurses and doctors have to look after when a person is in a coma. There are dental protocols that minimize problems with the teeth because of the comatose hospital stay, but it is still a time of significant challenge for the patient’s teeth. Again, this is often because of a period of very low salivary flow. As you likely are aware, just because the patient is “sleeping”, the bacteria are not taking the week or several weeks off. In fact, bacteria are often pretty undisturbed during this period leaving their tooth damaging acid output unchecked. People with a large amount of root structure showing are most at risk because root structure is much more susceptible to decay than enamel covered surfaces.
Other situations where the patient can be at quite a bit of risk may not be so obvious. For instance, if a person adds several new medications it is very likely one or more of them will cause dry mouth. Patients nearly universally greatly underestimate the amount of damage dry mouth can do and how fast things can fall apart. If a new medication or combination of medications is prescribed and you feel your mouth is dry now, you should see your dentist to get it checked out. On people with a lot of root structure showing, a delay of a few months when the mouth is really dry will almost certainly result in significant damage.
If you have a family member who is currently undergoing a long hospital stay or is comatose, there are things that can be done to minimize the damage that would be expected. If the person is coherent and is able to brush his own teeth, a high dose fluoride preparation like Prevident (a Colgate product) which you can obtain in Canada without a prescription will greatly reduce the damage of this stressful period. If your family member is comatose, a mouth sponge, kind of like a little chunk of sponge on a stick, can be used to swab a bacteria killing solution called Peridex on the teeth a couple of times a day. Even a very small amount of this product will do quite a bit to reduce the effect of the comatose period on the teeth. Ask the nurse whet is being done for the teeth because they may already be doing something that will suffice. If you have questions about what is being done, make sure you ask your dentist for advice, or even better, the dentist of your loved one who is in the hospital.
Hospital stays, the start of new diseases, or new medications don’t have to cause problems with the teeth, but they easily can if not handled properly. These are times of increased stress on all parts of the body, and the teeth are no exception. If you have questions about what to do after a recent hospital stay or the onset of a disease or condition and some medications to take care of it, be sure you ask your dentist what should be done to minimize the effects on your teeth and gums.
- This article was written by Dr. Mike Christensen and published in the Daily Miner and News, and Enterprise. Local Kenora News Publicatons (1998-2006)