Poor dental health can affect a person’s comfort, appearance, eating, nutrition, behaviour and general health. Every person with dementia needs an individualised preventive approach to dental care that should ideally begin as soon as dementia is diagnosed.
Dementia can cause dental problems for several reasons:
- Dementia can cause changes to memory and thinking, which can impact the person’s dental care routines.
- Taking medications and changes in brain function caused by dementia can reduce saliva production. Saliva is essential to maintain a healthy mouth and prevent tooth decay, mouth ulcers and sores.
- Sugar-based medications taken long-term can lead to tooth decay, the condition ‘dry mouth’, and difficulties using dentures.
- Changes to eating habits, such as replacing main meals with snacks, sucking lollies or drinking sweetened tea, can cause dental problems.
Why someone may need support
Someone living with dementia may need your help with dental care because they:
- can remember to look after their dental care, but may need your support to do it
- may not remember how and when to take care of their teeth
- may not be aware they need your support to maintain dental health
- may lose interest in brushing and using dental floss; or dental care may become daunting or tiring.
Care of natural teeth
Daily dental care
If the person with dementia requires your support with brushing:
- Break the task down into smaller steps.
- Try brushing your teeth alongside the person and slow down your routine, so they can copy what you do.
If you need to brush the person’s teeth:
- Before brushing, seek their permission and explain what you are about to do.
- Position yourself to the front, side or behind the person to find what suits you both.
- If the person clenches or spasms their lips and cheeks together during brushing, try using a toothbrush bent backwards at 45 degrees. Slide the bent brush into the corner of the mouth to break their muscle spasms and help lift the cheek out of the way.
- Use a soft-bristled toothbrush for all tooth surfaces and the insides of the cheeks.
- Use fluoride toothpaste.
- Regular use of floss can reduce plaque. If flossing is distressing for the person, try using small interdental brushes instead.
Weekly dental care
- Mouth rinses and gels containing fluoride and antimicrobial agents can help reduce dental decay and gum disease. These are available from the chemist.
- If using a mouth rinse, pour into a cup for the person to rinse, or pour into a small spray bottle to spray onto the person’s teeth.
- Fluorides and antimicrobials should not be used within two hours of each other; consider using one in the morning and the other at night.
Monitoring sugar intake
- Consider the use of artificial sweeteners in drinks and snacks. If the person has diabetes, check this with their doctor.
- Try offering sugar-free snacks.
- Offer water, reduced sugar or sugar-free soft drinks.
If you notice tooth decay such as a cavity, discuss and monitor this with a dentist.
Dentures should be cleaned and brushed daily.
If the person with dementia requires your support, break down the task into smaller steps.
If the person is unable to look after their dentures independently:
- Rinse dentures after every meal and thoroughly brush them with a hard toothbrush, nail brush or denture brush, and plain soap and water.
- Clean dentures regularly with specially formulated denture toothpaste or denture cleanser.
- Book a regular, professional denture clean with the dentist.
- Be mindful of partial denture clasps. They can be very damaging to oral tissues and the tongue if caught and can be more difficult to remove than full dentures.
- If the person is living in residential care, dentures should be marked for identification.
In the later stages of dementia, it may not be possible for the person to wear dentures.
People with dementia frequently suffer from dry mouth. Some medications and products are available that may help. Talk to the doctor and dentist about these. You can also help the person to drink plenty of water, or spray water into their mouth using a spray bottle.
Recognising possible dental problems
Many people living with dementia in moderate and advanced stages are unable to verbally express discomfort or pain.
Some changes in behaviour may indicate dental problems, such as:
- loss of appetite
- constantly pulling at their face
- refusing oral hygiene care, like brushing their teeth
- mouth pain caused by dentures that don’t fit properly
- increased restlessness
- disturbed sleep
- increased aggression or agitation.
Visits to the dentist
- Six-monthly dental check-ups are important to look after the person’s dental health.
- If the person is eligible for public-funded dental care, book an appointment with a dental hospital; they may have staff who specialise in treating people with dementia.
- Request permission from the person with dementia to accompany them into the appointment.
Based on information provided by Associate Professor Jane Chalmers, a specialist in dementia dental health.
- Call the National Dementia Helpline on 1800 100 500.
- Carer Gateway provides free practical information, resources, education and counselling to support carers.
Call: 1800 422 737
- For information, advice, common sense approaches and practical strategies on the topics most commonly raised about dementia, read our Help Sheets
- Dementia Australia library service
- Dementia Australia support
- Dementia Australia education