Proper oral care is important to prevent tooth decay and gum disease. Good dental health contributes to a person’s overall self-esteem, dignity, and socialization. Poor dental health will affect a person’s ability and willingness to eat.
Additional sources of information:
Approaches for Oral Care: Interventions for Residents in Long-Term Care with Responsive Behaviours, Communication or Functional Impairments.
Tips for oral care
- In the early stages, she will be able to brush her own teeth. You may need to provide reminders or supervise her or show her what to do.
- Remind him to brush twice a day with a soft-bristled toothbrush and fluoridated toothpaste.
- Give step-by-step instructions, or try "hands-on" guidance or gestures.
- Try fluoride swabs if he refuses the toothbrush.
- Try an electric toothbrush if manual dexterity is a problem and he can tolerate the noise and vibration.
- In the later stages, you may need to take over the task. Ask your dental hygienist or dentist for tips on how to clean another person’s teeth. You may find it easier to have him sitting down in a chair, with you behind him, cradling his head with one arm.
- Remove partial dentures before cleaning natural teeth.
- Remove dentures at bedtime and clean with a firm brush. Place them in water overnight.
- Make sure dentures are well identified to prevent misplacement. To prevent damage when cleaning, make sure the sink is filled or the drain is closed and the toilet lid is shut.
Because someone with dementia may not let you know if there is a problem, and may not clean her teeth as well as she used to, it’s important to have regular mouth checks. This is true whether she has her own teeth, dentures, or no teeth. A mouth check can reveal a small problem before it gets worse, such as a small ulcer, poorly fitting dentures, dental decay or even oral cancer.
It is wise to have a complete dental examination early in the disease, to help prevent both gum disease and tooth decay. These can both lead to pain and infection.
Gum disease can cause swollen and bleeding gums, receding gums, loose teeth and bad breath. Good oral hygiene can prevent these problems. Tooth decay is caused by bacteria attacking the tooth. This can be prevented by restricting the amount of sugar intake and providing good oral hygiene. Ask your dental hygienist or dentist if you are concerned about gum disease or tooth decay.
When scheduling visits to the dentist, ask for appointments at times when there will be no delay at the office. Ask the dentist if there’s anything that can be changed in the environment to lessen anxiety, such as reducing the noise or the number of people in the room.
If dental treatment is needed, try to lessen any anxiety by accompanying her. Staying in sight may help with other unfamiliar faces and strange equipment and sounds. Holding her hand may also help calm her.
Medications and dental disease
Some medications, for example, antidepressants and sedatives, can cause dry mouth. This can lead to problems with dentures and promote gum disease and tooth decay. Other medications may be syrup-based, which also can increase the likelihood of tooth decay. Ask about alternatives, and pay special care to oral hygiene. If he develops a dry mouth, try sugarless candies or gum to increase the flow of saliva. The dentist may also consider fluoride or other treatments.
Signs of oral care problems
A person with dementia may not be able to tell you that there is a problem. Here are some signs to look out for:
- Refusal to eat, especially hot or cold foods
- Tugging at the face or mouth
- Refusal to wear dentures
- Changes in restlessness, moaning or shouting
- Changes in sleep
- Refusal to participate in daily activities
- Aggressive behaviour