Oral health and the dementia patient

Oral care for loved ones with dementia can be difficult and even frustrating. This subject is near and dear to me as my mom just recently passed away from lewy body dementia. All aspects of her care become more challenging. With my mom, despite my best efforts and intentions often things would just not go as planned.

Keeping up with oral health for your loved one suffering from dementia is important, as poor oral health can lead to such things as gingivitis, gum disease and heart disease. It can cause bad breath and may begin to affect their ability to eat and chew. Dementia patients are often required to take multiple medications which can lead to dry mouth. The lack of saliva can make eating more difficult and may even cause irritation to the tongue.

Brushing our teeth is automatic for most of us but with dementia your loved one may have trouble remembering the steps. Modeling it for them or doing it together may make it easier for them and allow you to evaluate how well they are brushing. Brushing before bed is ideal and that should be kept going as long as possible. However it may ultimately, be necessary to pick times during the day that are less combative and calmer. An electric toothbrush, if tolerated, or a thick handled tooth brush can be of help if dexterity issues are present. Using fluoridated toothpaste is best, make sure to only a pea size amount as swallowing may occur. A mild mouth rinse, such as closys, can benefit, as long as they are capable of swishing without swallowing. It will help with inflammation, bleeding and plaque control. Be as consistent as possible with flossing by utilizing floss picks, inter proximal brushes or picks.

Consider having their teeth cleaned more frequently. Every three months can significantly reduce plaque and tarter allowing for more frequent evaluation for decay which is more prevalent with dry mouth.

If your loved one wears dentures it is important to take them out daily and clean them. While removed, inspect and clean gums and roof of their mouths with a soft bristle brush.

If there is refusal to cooperate, take a break, never force or pry their mouth open.

Although, the aforementioned oral care is easier said then done, the loving care you are providing will have a positive impact towards their comfort and overall health.

These, of course, are the ideals and on any given day, only some or maybe none will be possible. Be loving, consistent, and don’t sweat the bad days.