Oral Hypofunction Unveiled during the Management of Periodontal Disease in a Patient with Dementia：A Case Report

Abstract

　Background：Oral health management for elderly patients with dementia presents a dual challenge：controlling the increased risk of periodontal disease due to declining self-care ability, and managing the decline in oral function. Dental professionals are now required to expand their role beyond conventional inflammation control to address this functional decline.

　Case Presentation：The patient was a 75-year-old male with Alzheimerʼs disease. He underwent initial periodontal therapy for severe periodontitis and then transitioned to Supportive Periodontal Therapy（SPT）. As a result, plaque control was well-maintained, and periodontal tissues remained stable. However, in stark contrast to this periodontal stability, oral function silently declined, leading to choking and subsequent aspiration pneumonia approximately one year after starting SPT. This critical event occurred despite suspicions of functional decline based on clinical observations during SPT.

　Conclusion：This case clearly demonstrates a critical limitation of current dental care：while periodontal stability is achievable in patients with dementia, this success alone does not prevent the decline of oral function. This experience suggests that dental professionals must evolve from merely managing inflammation to becoming“function managers”who detect functional decline early and collaborate with interprofessional teams. However, this case also highlights the importance of performing a baseline assessment of oral function at the initial stage of intervention, regardless of the chief complaint, and subsequently monitoring its changes longitudinally in collaboration with an interprofessional team.