Dental care

Our teeth, gums and oral hygiene are important to our health and wellbeing. Dementia can affect a person’s oral health and their ability to care for their teeth.

If someone you care for lives with dementia, you might find:

• they need your help to look after their teeth and gums
• they can’t remember when and how to take care of their teeth
• they lose interest in dental care, or find it tiring
• they’re no longer able to wear dentures as their dementia progresses.

Dementia can also cause changes that lead to other dental problems, including:

• reduced saliva production caused by medications or changes in brain function. Saliva keeps your mouth healthy and prevents tooth decay, ulcers and sores
• tooth decay, dry mouth and difficulties using dentures from taking sugar-based medications
• changed eating habits, including replacing main meals with snacks and sucking on lollies.

Here are some things you can do to help keep your loved one’s teeth and gums healthy.

Caring for natural teeth

You can keep your friend or family member’s teeth and gums healthy with regular brushing, flossing and rinsing.

Teeth brushing

You may need to support your loved one to brush their teeth, or you may need to brush them for them.

If they need your support with brushing:

• break down the task into smaller steps and take one step at a time
• use simple words and phrases to guide them through the process
• brush your teeth with them so they can copy what you do.

If you need to brush their teeth:

• explain what you’re going to do and ask their permission, if they’re still able to consent
• find a position that suits you and them — in front of them, to the side or behind
• use a soft-bristled toothbrush and fluoride toothpaste
• if they clench or spasm their lips or cheeks during brushing, try using a toothbrush that’s been bent backwards at 45 degrees. Slide the bent brush into the corner of their mouth to break the muscle spasm and lift their cheek out of the way.

Flossing and mouth rinses

• Try to floss daily to reduce plaque. If flossing upsets your friend or family member, try small interdental brushes instead.
• Mouth rinses and gels containing fluorides and antimicrobials can help to reduce dental decay and gum disease. Try using these weekly, but avoid taking fluorides and antimicrobials within two hours of each other.
• If you’re using a mouth rinse, pour it into a cup for the person to rinse. You could also put it into a small spray bottle to spray onto their teeth.

Other dental care

• Try to reduce the person’s sugar intake by offering sugar-free snacks. You could also consider using artificial sweeteners, but check this with a doctor if the person has diabetes.
• Offer water to drink, or reduced sugar or sugar-free soft drinks.

Caring for dentures

Dentures should be cleaned and brushed each day. If your loved one needs you to clean their dentures:

• rinse the dentures after every meal and thoroughly brush them with a hard toothbrush, nail brush or denture brush
• clean the dentures regularly with denture toothpaste or denture cleanser
• book a regular denture clean with the dentist.

If the person lives in residential care, make sure their dentures are marked with their name so they can be easily identified.

Visiting the dentist

Six-monthly visits to the dentist help keep your loved one’s teeth and gums healthy. If they’re eligible for public dental care, consider booking them into a dental hospital, as the hospital may have staff that specialise in treating people with dementia.

Dental problems

It can be difficult for people living with dementia to explain, describe or understand their pain. This means that pain can be missed or misdiagnosed.

These are some signs that your loved one might be in pain resulting from a dental problem:

• loss of appetite
• constantly pulling at their face
• refusing to brush their teeth
• restlessness
• disturbed sleep
• increased agitation or aggression.

Some common dental problems among people with dementia include:

• tooth decay: cavities and other tooth decay can be caused by reduced saliva production, sugar-based medications, and eating more sugar.
• dry mouth: this can also be caused by reduced saliva production and sugar-based medications. Medications or other products may help with this. You can also help the person to drink plenty of water, or spray water into their mouth using a spray bottle.
• mouth pain: poorly fitting dentures can cause mouth pain, while clasps on partial dentures can damage the mouth and tongue if they get caught on them. Reduced saliva can also cause mouth ulcers and sores.

If you think your friend or family member is in pain or has an issue with their teeth or mouth, make an appointment with their dentist.

Based on information provided by Associate Professor Jane Chalmers, a specialist in dementia dental health.

It’s okay to take care of your own health and happiness. If you're struggling as someone who cares for a person with dementia, contact the free, confidential National Dementia Helpline on 1800 100 500, any time of the day or night, for information, advice and support.