The relationship between oral/dental pain and behavioural and psychological symptoms of dementia (BPSD) among elderly residents in nursing homes

Oral care has been traditionally considered poor in nursing homes and increased dental problems have been associated in people with dementia. Whilst behavioural and psychological symptoms of dementia (BPSD) have been associated with pain in general, a link with dental pain has so far not yet been established. This study investigated the potential link between treatable dental problems (that might cause pain) and BPSD. Sixty five residents exhibiting BPSD were recruited in the study from three nursing homes in West Midlands. Patient cognitive and behavioural status was assessed using the Mini Mental State Examination (MMSE) and the Cohen-Mansfield Inventory (CMAI), and then subjected to dental screening using the Oral Health Assessment Tool (OHAT). The dental examination by a qualified dentist revealed no dental problems that required treatment or likely to cause pain in any of the participants. The results suggest that in this exploratory sample BPSD was not caused by dental problems or dental pain. More trials are necessary to establish whether dental or other types of pain are linked with BPSD and whether analgesic treatment versus antipsychotics will aid behavioural management