DENTAL PROBLEMS WITH DEMENTIA CARE 

Many times, a person with dementia may be unable to communicate pain or discomfort in their mouth. 

SIGNS THERE MAY BE A DENTAL CARE PROBLEM: 

• Refusing food, especially hot, cold or hard foods. 
• Rubbing or touching their cheek or jaw. 
• Moaning or shouting out. 
• Pulling at the face or mouth. 
• Head rolling, nodding & flinching, especially when washing their face or shaving. 

• Refusing to wear dentures that were previously tolerated. 
• Restlessness, disturbed sleep, increased irritation or aggression. 
• Loss of appetite. 

If you notice these symptoms, consult with your doctor to help identify the cause, or seek professional dental care with a provider familiar with dementia patients. 

TIPS ON ORAL CARE 

As dementia progresses, the steps for dental care are easily forgotten. Brushing your teeth is a daily occurrence, it’s critical to make brushing your teeth a positive experience. 

• Provide short, simple instructions. Explain dental care by giving instruction one step at a time.  

• Always us “WE” instead of “YOU”. “Why don’t we go into the bathroom and brush our teeth”. No one wants to be told what to do. 
• Hold a toothbrush and show the person how to brush their teeth.  
• Use a “watch me” technique. Walk in the bathroom with them, put toothpaste on your toothbrush. Then, put toothpaste on their toothbrush. Next, start brushing your teeth. Allow your loved one to mimic your actions.  
•  Be flexible about location—sometimes a basin at the kitchen table is the most practical place.  
• Make it easy for your loved one to use a toothbrush. Try a large-handled one, or even stick the handle through a hole in a tennis ball to give them something easier to grasp. 

• Allow plenty of time and find a comfortable position if you must do the brushing yourself. Gently place the toothbrush in the person’s mouth at a 45-degree angle so you massage gum tissue as you clean the teeth. 
• If you are having trouble brushing and/or flossing your loved one’s teeth, try standing behind them. This is a more natural position for you and may help you do a more thorough job.  
• Don’t be rigid about timing. Even though first thing in the morning and last thing at night is optimal, it’s OK to practice dental care whenever your loved one is calm and cooperative during the day.  
• Anti-plaque mouthwashes can be an occasional alternative to tooth-brushing in difficult situations. 

• If the toothbrush irritates the mouth and gums, use cotton swabs or a finger wrapped in gauze to clean the teeth. If home dental hygiene is especially challenging, schedule more frequent visits for professional dental care. 
• Use flossing tools such as a floss holder or a tiny brush to clean between the teeth as part of your dental care. 
• If your loved one tends to swallow toothpaste or mouthwash, look for types that are safe to swallow, or switch to a homemade paste of baking soda and water.  
• Never pry your loved one’s mouth open or force an implement into his/her mouth. 

• Be aware of potential mouth pain. Investigate any signs of mouth discomfort. Refusing to eat or strained facial expressions while eating may indicate mouth pain or dentures not fitting properly. 
• Brag on what a good job they did and how much you appreciate their help. Always be patient with your loved one. Make it a positive experience! 

DENTAL CARE FOR DENTURES

• Try to rinse dentures after every meal and scrub them with a denture brush. 
• Dentures should be removed at bedtime and soaked overnight. A denture cleaning tablet or strong physical cleaning is needed at least once a day. 

• It’s always a good idea to have the dentures of a dementia patient marked for identification, especially if you use respite care. 
• According to the American Dental Association, your dentures might not fit correctly over time, so you may want to have a dentist check your loved one periodically to make sure the dentures fit well. 
•  Poorly fitting dentures are not only uncomfortable, but can interfere with eating – which, in turn, can affect nutrition. 
• You can have dentures cleaned professionally to remove any stains and bacteria. 

       OTHER WAYS TO HELP WITH DENTAL CARE 

• Encourage your loved one to drink plenty of water. 
• Monitor the person’s sugar intake. 
• Eating cheese may provide natural protection against the acids causing tooth decay and help rebuild tooth enamel. 
• Anti-plaque mouthwash can be helpful in preventing gum disease—but ONLY if it won’t be swallowed.                     

• Apples can help clean teeth while being chewed. Avoid hard candies. 
• Flossing may be more important than brushing. Use a floss holder, Flexi-Picks, or Stim-u-dent, or use a tiny brush that can fit between teeth to clean the gums as well as the teeth.