How to Provide Oral Care for Someone with Dementia 

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Andrew Slavin, DMD, FACS

Andrew Slavin, DMD, FACS

June 23, 2019

As dementia or Alzheimer’s disease gets a firmer grip on a person, it often happens that the dementia causes that individual to forget about brushing their teeth, or even why it really matters. That makes it important that caregivers or family members help the dementia patient with their oral care, so that some semblance of good oral health can be maintained and chewing difficulties can be avoided.

Routine Oral Care 

During the initial onset of Alzheimer’s or dementia, dental care for a patient primarily focuses on prevention, meaning that teeth cleaning, regular checkups, and brushing and flossing should be attended to regularly. This will help to avoid the need for extensive oral procedures later, as the dementia progresses, and the dementia causes the patient to be less tolerant of dental care procedures.

That will change during the middle and later stages of Alzheimer’s or dementia, as oral healthcare becomes considerably more challenging. During these times, a patient frequently forgets what toothpaste is for, how to brush and rinse out their mouth, and they may even be resistant to a large extent on any kind of assistance from family members or caregivers.

Helping the Patient with Dementia

One of the most effective ways of helping patients with dementia with their dental care is to use simple instructions that are brief and clear. Instead of saying something like ‘brush your teeth’, it may be necessary to break the process up into steps, such as ‘hold this toothbrush in your hand’, ‘put this toothpaste on the brush’, and ‘move the brush back and forth on your teeth’.

If even these instructions appear to be too much for the patient, you can simply demonstrate how to do the brushing yourself. Another way to accomplish the same thing is to place your hand over the patient’s hand and guide them through each of the motions necessary to accomplish good brushing. If your particular patient reacts negatively to all this, it may be necessary to postpone brushing until later in the day, when they might be more cooperative.

If you are obliged to provide personal assistance, or actually do the brushing yourself, make sure you achieve a comfortable position beforehand, so that you’re able to adequately carry out the brushing function. Also be sure to clean the gums at the same time that you’re brushing the teeth, since food particles and bacteria can accumulate on the gums as well.

Things to Observe

When your Alzheimer’s patient uses dentures, these need to be rinsed with plain water after meals and brushed daily, so that food particles don’t get attached to them and form bacteria. Each night, make sure they are removed and soaked in some kind of cleansing agent, or perhaps a good mouthwash. In order to maintain good oral health, your Alzheimer’s patient should then have their gums, tongue, and other soft oral tissues brushed with a soft toothbrush or a moistened gauze pad.

In terms of the kind of toothbrush that you should use on your patient, it is advisable to avoid electronic toothbrushes, since they might frighten or confuse your patient. Even though it may be difficult, or it may be strongly resisted by your Alzheimer’s patient, you should make every attempt to floss regularly, because this is really the most effective way of removing particles between the teeth.

In some cases, a proxabrush can be effective, so you may want to try that. In all cases, you should try to be sensitive to what you’re Alzheimer’s patient is feeling, and you should look for any signs of discomfort or pain as teeth and gums are being cleaned. You should especially be on the lookout for obvious signs, like refusing to eat or expressions of facial strain, because these can be strong indicators of mouth pain, or possibly of dentures that have become painful to use.

Dementia Patients at the Good Samaritan Dental Implant Institute 

At the Good Samaritan Dental Implant Institute in South Florida, your dementia patient can receive the kind of oral care that will be non-threatening and totally effective for ongoing good oral health. If dental implant surgery is something that would benefit your loved one or patient, a consultation and good plan of care can be set in motion by expert specialist, Dr.  Andrew Slavin, DMD FACS.

 

Andrew Slavin, DMD, FACS

Andrew Slavin, DMD, FACS

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