The challenges and guidelines in caring patients with Alzheimer's disease in clinical dentistry

The occurrence and the development of progressive, symptomatic manifestations of dementia of Alzheimer's type (AD) are questions that researchers in different disciplinary and clinical fields must be concerned. This paper discusses the specifities of how the patients should be treated, both in the diagnostic phase and the treatment itself. The objective of this study was to identify ways of obtaining the cooperation of people with Alzheimer's disease during the odontological treatment; also the involvement of family/caretaker to achieve better results in clinical intervention. During 24 months between February 2004 and February 2006, 51 patients with AD - age group between 60 and 90 years old were examined/followed in the outpatient clinic (Hospital do Servidor Público Municipal de São Paulo) or at home. They were inserted in three distinct odontological treatment plans, according to the early, moderate or late stages of the disease, based on Alzheimer's disease guide from Associação Brasileira de Alzheimer (ABRAz). The results were: Treatment plan I - 39 patients all of them treated in the outpatient clinic with the optional presence of a family member/caretaker and no sedation; Treatment plan II - 8 patients all of them treated in the outpatient clinic with the presence of a family member in all appointments and no need for sedation; Treatment Plan III - 4 patients were assisted at their homes. In two of these cases, there were needs for sedation. The results showed that the effective participation of the caretaker; as well as the commitment to the relationship work with the patient, constitute an essential requirement for therapeutic success in all stages of the disease.