As
Alzheimer's progresses, the person with dementia may forget how to brush his or
her teeth or forget why it's important. As a caregiver, you may have to
assist or take a more hands-on approach. Proper oral care is necessary to
prevent eating difficulties, digestive problems and infections.
In the early stages of Alzheimer's, dental care focuses on
prevention. Getting check-ups and cleaning and flossing teeth regularly can
prevent the need for extensive procedures later on, when the person with
dementia may be less able to tolerate them.
During the middle and late stages of Alzheimer's, oral
health may become more challenging. The person may forget what to do with
toothpaste or how to rinse, or may be resistant to assistance from
others.
Loss of
appetite may be a sign of mouth pain or ill fitting-dentures.
Try these tips:
·
Provide
short, simple instructions. Explain
dental care by breaking directions into steps. "Brush your teeth" by
itself may be too vague. Instead, walk the person through the process. Say:
"Hold your toothbrush." "Put paste on the brush." Then,
"Brush your teeth."
·
Use a
"watch me" technique. Hold
a toothbrush and show the person how to brush his or her teeth. Or, put your
hand over the person's hand, gently guiding the brush. If the person seems
agitated or uncooperative, postpone brushing until later in the day.
·
Keep the
teeth and mouth clean. Very
gently brush the person’s teeth, gums, tongue and roof of the mouth at least
twice a day, with the last brushing after the evening meal and any nighttime
liquid medication. 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 the person wears dentures, rinse them with plain water
after meals and brush them daily to remove food particles. Each night, remove
them and soak in a cleanser or mouthwash. Then, use a soft toothbrush or
moistened gauze pad to clean the gums, tongue and other soft mouth tissues.
·
Try
different types of toothbrushes. You
may find that a soft bristled children's toothbrush works better than a hard
bristled adult's brush. Or that a long handled or angled brush is easier to use
than a standard toothbrush. Experiment until you find the best choice. Be aware
that electric dental appliances may confuse a person with Alzheimer's.
·
Floss
regularly. Most dentists recommend flossing
daily. If using floss is distressing to the person with Alzheimer's, try using
a "proxabrush" to clean between teeth instead.
·
Be aware of
potential mouth pain. Investigate
any signs of mouth discomfort during mealtime. Refusing to eat or strained
facial expressions while eating may indicate mouth pain or dentures that don't
fit properly.
For more tips, join ALZConnected, our online support community where caregivers
like you share their ideas.
·
Find the
right dentist. Contact your local dental society to
find the names of professionals who have experience working with people with dementia
or with elderly patients.
·
Coordinate
care. Provide the dentist with a list of
all health care providers who are caring for the person with dementia, as well
as a list of all medications. Certain medications can contribute to dry mouth
and other oral health issues.
·
Keep up with
regular dental visits for as long as possible. This will help prevent tooth decay, gum problems, pain and
infection.
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