Dental care for dementia patients

Dental Care Tips for Dementia Caregivers

September 22, 2022

Updated September 2022. Published May 24, 2016

Dementia is a general term for the loss of memory, thinking, and reasoning skills that affects nearly 55 million people across the globe. It often presents itself as forgetfulness, poor judgment, or confusion, and can cause difficulty speaking, expressing thoughts, or reading and writing.

If you’re a caregiver for someone with dementia, it’s important to understand how dementia affects oral health and know dental care tips to help ensure you keep your loved one’s smile healthy.

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How Does Dementia Affect Oral Health?

Dementia greatly impacts a person’s daily life and overall health–including oral health. Some studies even suggest that gum disease could increase the risk for developing Alzheimer’s disease and related dementias, especially vascular dementia.

After all, good oral care doesn’t just keep the mouth healthy. Studies show that good oral care even lowers the chances that someone with Alzheimer’s will get pneumonia, and reduces the risk of developing malnutrition, dry mouth, and dysphagia.

For those living dementia, oral health care might be something that’s neglected over time. That’s because, as dementia progresses, a person might not understand the importance of practicing good oral health care, or may forget how to practice good oral hygiene habits that they’ve been doing most of their life–like brushing and flossing daily as well as making regular visits to the dentist.

Those with dementia may also lose the ability to communicate that they’re dealing with pain–including pain resulting from oral health issues like cavities and gum disease. As a caregiver for someone with dementia, oral health pain signs may include:

  • Wincing when chewing
  • Avoiding hot or cold foods
  • Drooling
  • Acting aggressively to trying to bite you, their inner cheek or lip, or other objects
  • Having bad breath even with proper brushing and flossing
  • Developing a white film on the tongue
  • Not letting you help clean or look at their mouth

If you’re caring for someone with dementia, be sure to take them to the hospital or call a healthcare professional if you notice swelling in the face or jaw, fever, or trouble breathing or swallowing. It’s also a good idea to call their dentist if you see that a tooth has become a darker color than those around it, or they’re having pain when eating or pressing on the tooth.

Dementia and Dental Health Care Tips

Abbie Goudarzi, DDS, one of Delta Dental’s of Washington’s consultants, has a parent with dementia and knows what a challenge it can be to help a loved one maintain good oral health. As a caregiver and dentist, she knows there’s a lot you can do to ensure your loved one’s smile stays healthy despite their dementia diagnosis.

Here are Dr. Goudarzi’s tips on caring for loved ones with dementia:

•Use short instructions. “Brush your teeth” seems simple, but it may be too much. Walk through each step of the process—hold the brush and put toothpaste on it. Breaking up instructions into mini-steps can make commands easier to understand. Be aware that a person with dementia may need a toothbrush with a different handle design that is easier to grip or one with softer bristles. 

•Do it together. Take the lead—brush together in the bathroom mirror. The demonstration will show the person firsthand how to brush.

•As dementia progresses, you may find that you have to do the brushing and flossing for your loved one. The time and place are not important. Do it when you are both most relaxed and where it is most comfortable. It does not need to be done in the bathroom. It can be done with the person sitting in a chair with you positioned behind them. Flossing is also very important. It may be easiest to use a proxabrush or a floss holder. 

•When brushing and flossing is difficult, a wet gauze may be used to wipe out the mouth.

•Dry mouth can be an issue for many people with dementia, especially due to many medications that they are taking which can decrease their saliva. Drinking plenty of water and limiting snacking is important.

•For those who have dentures, it is important to remove the dentures at bedtime, clean them and soak them overnight.

•Look for clues. Make sure you’re on top of daily care routines and monitor them closely. For example, if you notice strained facial expressions while eating, this may indicate dental pain.

•Remember dental appointments. Routine checkups are key for your loved one. Seek out a dentist who has experience working with dementia patients. It may be necessary to be have exams and cleanings more frequently. Dental procedures can become more difficult as the disease progresses, so work to encourage a good oral health routine.

These tips are a great starting point. Dr. Abbie also wants you to remember that your loved one’s dentist is your best ally. Talk with them. They’re happy to show you how to care for your loved one’s oral health.

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