Dental Care for Alzheimer's Patients

Learn more about dental care for those with dementia and Alzheimer's.

Dementia, Alzheimer's Oral Health

Dementia is the general term used to describe a decline in mental ability that interferes with daily life. It is caused by damage to brain cells and there are many conditions that may cause it. Alzheimer's disease is the most common cause of dementia. It is a progressive and eventually devastating brain disorder caused by complex brain changes and cell damage that worsens over time. It causes problems with memory, thinking and behavior.

As Alzheimer's progresses, symptoms become more severe often leading to memory changes, confusion and behavioral changes. Loved ones might notice that the person with the disease may not remember to brush their teeth, remember why dental care is important, or may become confused or uncooperative when undergoing dental treatment. As oral health can greatly affect one's overall health, preventive dental care is extremely important during the early stages of Alzheimer's.

Daily Oral Care for a Person with Alzheimer's

Daily preventive care is of great importance in the early stages of Alzheimer's. This care should include regular professional exams and cleanings, any necessary follow-up care and brushing and flossing daily. These activities can help prevent dental pain, eating issues, digestive problems, infection, and the need for dental treatment in the future when the person may be unable to tolerate extensive procedures.

If you are caring for a loved one with Alzheimer's or dementia who is having difficulty with oral care at home, try following these oral healthcare tips provided by the Alzheimer's Association:

• Give simple, short instructions, breaking down the process when needed: "Pick up your toothbrush", "Put some toothpaste on the toothbrush", "Brush your teeth"
• Demonstrate brushing by holding the toothbrush and brushing for them, or by gently guiding their hand while they brush
• If you must do the brushing for them, brush in a gentle circular motion, at a 45-degree angle, using a soft bristled tooth brush, for at least two minutes, twice a day
• Floss daily, if possible; try using an interdental brush (Proxabrush^®) which is a tiny, tube-shaped brush to clean between teeth, or use a floss holder if regular floss is too distressing.
• Rinse dentures and partials after each meal, brush them once a day, and soak them in a denture cleanser each night. While they are out of the mouth, clean the gums, tongue, and roof of mouth with a soft toothbrush or wet gauze.
• If brushing is challenging, try using a different type of toothbrush; whether it is a child's toothbrush, a long handled toothbrush, or angled toothbrush. Be aware that using electronic toothbrushes may be confusing.
• If, despite your best efforts, you are unable to brush their teeth, do not try to force it - try again later.

Not all caregivers are able to provide dental care at home because it can sometimes be too difficult or an unpleasant task. If you are unable to provide care or assistance, address the issue with their dentist who may have additional advice or recommendations.

Professional Care

Every effort should be made to continue routine dental exams, cleanings and treatment while in the early stages of Alzheimer's or dementia. A dentist who has experience working with dementia, Alzheimer's and elderly patients may also be helpful.

Make sure to provide the dentist with a list of the person's health care providers and a detailed medication list to screen for any medications that may cause oral side effects. This will allow the dentist to coordinate care with their physician(s) and other caregivers when necessary.

Suggestions for a successful dental visit:

• If you find the person tends to be more alert at a certain time of day, try scheduling their appointment at that time
• Remind them of the appointment at least one day in advance
• Make sure they visit the restroom before the appointment
• Ask for clear follow-up instructions and date of future appointments in writing

Dental Pain

Individuals diagnosed with Alzheimer's often have trouble communicating when they are in pain:

• Look for any signs of sores or pain points when brushing and flossing.
• Watch for rubbing/touching of the cheek/jaw, moaning, and flinching when touching the face, and refusal to wear dentures/partials
• Look for signs of discomfort during mealtime. Strained facial expressions or refusal to eat could indicate mouth pain or poorly-fitting dentures/partials

Note: The information in this document is not meant to replace the advice of your dentist or another licensed healthcare professional. Talk to your dentist for any specific dental advice.