Instructions for Encouraging a Dementia Sufferer to Clean Their Teeth

Maintaining Dental Hygiene for Dementia Patients: A Comprehensive Guide

Effectively maintaining dental hygiene for individuals with dementia requires a combination of tailored strategies, caregiver involvement, and professional collaboration.

Caregiver Assistance and Training

Dementia patients often struggle to maintain oral hygiene independently due to cognitive decline and physical limitations. Caregivers must provide hands-on help with toothbrushing and flossing, using gentle, patient techniques and possibly adaptive tools. Training caregivers on effective oral care routines and the importance of meticulous biofilm (plaque) removal is crucial to prevent caries and periodontal disease.

Routine Oral Health Screening and Maintenance

Regular oral assessments by dental professionals experienced in geriatric and dementia care are vital. On-site or domiciliary dental visits can reduce stress and logistical challenges for patients, improving access to preventive and routine care. Enhanced periodontal screening to detect early inflammation should be performed regularly for patients over 50 or those with periodontal history.

Use of Appropriate Dental Products

Employing anti-inflammatory mouthwashes and toothpastes containing essential oils or antimicrobial agents can help manage oral inflammation and maintain a healthier oral microbiome. Such products should be recommended considering patient tolerance and ability to comply.

Multidisciplinary Collaboration

Establishing networks between dentists, dental hygienists, geriatricians, neurologists, general practitioners, and caregivers facilitates comprehensive care addressing both oral health and systemic conditions related to dementia. This approach can optimize prevention and treatment planning.

Preventive Focus and Minimal Intervention

Maintaining comfort, dignity, and quality of life through preventive care and minimal intervention techniques is essential when managing dental health in vulnerable dementia patients. Dental therapists trained in special care dentistry can play a valuable role in domiciliary settings.

Addressing Dental Appliances

Attention to denture fit and hygiene is important, as ill-fitting dentures or sore gums can contribute to discomfort and poor nutrition, which further complicates dementia care.

Education and Awareness

Both patients (if possible) and caregivers should be educated about the oral-systemic connection, risks of poor oral health in dementia, and techniques to minimize disease progression.

Brushing a Dementia Patient's Teeth with an Electric Toothbrush

Apply a pea-sized amount of toothpaste to the electric toothbrush before brushing.
Gently guide the electric toothbrush to the dementia patient's mouth, starting with the upper teeth.
Brush each tooth surface, the gumline, and the tongue side of the upper teeth.
Move on to the lower teeth, following the same procedure.
Rinse after brushing the lower teeth.
Finish the process by praising the dementia patient for their cooperation and effort.

Neglecting dental hygiene can lead to oral health issues, and it's not advisable to go without brushing for an extended period. Brushing together with a dementia patient can make the process more appealing. If the patient doesn't cooperate, try different times of day, soothing music, or seek professional advice. Installing a bidet in the bathroom can simplify the process of cleaning for the elderly with dementia. Flossing and tongue scraping after every meal can help combat bad breath and cavities. Use a small towel to wipe the patient's face dry after brushing.

In summary, maintaining dental hygiene in dementia patients requires regular, assisted oral care tailored to their cognitive and physical abilities, supported by professional dental involvement and coordinated multidisciplinary efforts to enhance care access and effectiveness.

References: [1] - Docseducation.com, 2025 [2] - National oral health survey NZ, PMC 2025 [3] - GDC UK blog, 2025 [4] - Alzheimer's Society UK, 2025 [5] - PMC article on OHS-interRAI, 2025