While looking after your teeth seems straightforward enough, for a person living with dementia maintaining healthy teeth and gums may require some assistance from you, their carer. We all know how important it is to floss and brush twice a day, limit sugary food intake, get regular dental check-ups, and make a special appointment when we feel we may have a cavity.
But how do you know when your parent, or partner, living with dementia has a tooth ache, or other oral issue that requires a dental examination? And, how do you help your loved one keep their teeth and gums healthy?
It is well documented that poor oral hygiene can cause teeth and/or gum pain, loss of teeth, and gum disease, and can make eating, even smiling or talking, difficult. So, how can you ensure that your loved one is not suffering the pain of tooth decay or gum disease? For a person living with advancing dementia this type of pain and discomfort can exacerbate feelings of confusion or stress. They may not be able to tell you “my tooth hurts” or “I think my roots are infected”. Therefore, putting a simple dental plan in place for your loved one is a must, as you want to minimise any distress that they may be experiencing in their lives.
Signs to look out for that there might be dental problems:
- Your loved one living with dementia may suddenly refuse to eat certain foods, especially if the food is very cold or hard to chew
- They may keep taking their dentures out, or stop wearing them at all
- They may constantly be touching their mouth or teeth
- They may experience increased aggression, especially when an activity involving the teeth, or mouth, is concerned
- They may not be sleeping well
- They may not want to participate in activities that they normally enjoy
These above items should cause you, as the carer, to want to investigate further.
- When helping someone brush their teeth always face the person directly and gently explain what you will be doing, or what you would like them to do
- Gently rubbing their check with the back of your hand can be a lovely way to communicate to them that you will be assisting them with teeth brushing or denture care
- Ensure the bathroom is warm, and ensure the person is warm
- Only use room temperature water for brushing and rinsing. Do not use water that is too hot or too cold
- Only apply fluoride toothpaste if your loved one is able to spit it out and rinse. If they are not able to spit and rinse you are best to find a non-fluoride/herbal toothpaste, or just use plain water
- You may need to cover the bathroom mirror, or set up teeth brushing in another room – mirrors can be very disturbing for some people living with dementia as they may not be able to recognise themselves, causing aggitation as to who the stranger in the room is
- If the bathroom fixtures and fittings are all-white, your loved one with dementia may not be able to clearly identify the floor from the cabinet from the sink. Maybe place a coloured washcloth in or next to the sink and use a coloured toothbrush
- Ensure you have a clean glass, or cup, of warm or room temperature water in the bathroom to use for sipping, drinking, or swishing, before brushing commences if your loved one has recently eaten – this will help remove some of the food before brushing
Keeping teeth and gums healthy:
- Limit sugary foods, snacks and drinks (eliminate all together if possible)
- Build up a regular twice daily brushing routine with your loved one living with dementia. Establishing a regular pattern will help them to become more familiar with the routine
- Hydration is important. Bacteria can form more easily in a dry mouth, so ensure your loved one has regular sips of water throughout the day. If they are not able to drink/swallow please talk to your doctor or dentist about other methods that you can employ that may help to keep their mouth moist. Don’t use your standard alcohol-based mouthwashes as they can dry out the mouth.
The Dental Health Service of Victoria will come out to your home if it is not possible for you to attend a clinic. This service is free to pensioners, health care card holders and DVA Gold card holders:
Western Special Needs Dentistry provides dental care for people living with dementia, MS, cerebral palsy, stroke, MND, Parkinson’s disease and acquired brain injury. They are a fee-for-service clinic. They accept DVA Gold card holders. They are located in Newport, an inner western suburb of Melbourne:
Below are some links to YouTube videos that discuss how to approach someone, and what you should prepare, before you start assisting them with brushing:
Dementia specialist Teepa Snow discusses Dementia Dental Care – The Importance of Environment.
Toronto Dentist, Dr. Natalie Archer, teaches us how to properly care for our loved ones dentures, assist them with teeth brushing, and generally discusses oral hygiene and the elderly.
Thank you for taking the time to read this. Enjoy your day.