You are NOT alone, if as a caregiver, you struggle with your spouse or parent to maintain good oral health habits—in other words they don’t care about brushing their teeth and don’t want you to do it for them.
Dental care is important, particularly during the middle and later stages of dementia, but due to cognitive loss, routines such as brushing teeth, showering, dressing, and eating to name a few and the reasons for maintaining them may no longer be important for your loved one. The side effects of antidepressants, antipsychotics, and sedatives include dry mouth which can cause discomfort, build-up of bacteria and food debris, gum disease, and tooth decay because saliva is a natural cleanser. People with dementia need to have regular dental checkups to guard against pain and/or ill-fitting dentures or partials, which they may not notice and/or effectively be able to tell you about. Signs of dental problems may include refusal to eat (hard or cold foods particularly), increased restlessness (moaning or shouting), disturbed sleep, frequent pulling at face or mouth, and/or aggressive behavior.
Some tips we’ve found (as formal caregivers) may help with the brushing process:
• It may be easier to persuade someone to brush if they are not alone—people with dementia often will cooperate if they can copy someone else’s actions.
• Break down the process into smaller steps for better understanding.
• For clenches or spasms bend the toothbrush backwards at a 45 degree angle by running the handle under warm water to bend then slide it into the corner of the mouth to break muscle spasms and help lift the cheek out of the way.
• Dental products often used for small children may be appropriate for those with dementia: Tooth tissues remove bacteria quickly without brushing or flavored toothpaste is safe to swallow.
• You may want to sing or hum or tell a story while brushing, as it often encourages a smile or laugh and relaxes jaws (and emotions).
• If you’ve tried everything and still cannot get the job done, forget it for now—it’s not worth arguing or fighting over—try again later.
~Tamara Nixon, BS, CHES
