You may have a parent, spouse or friend who has difficulty maintaining a healthy mouth on their own. Oral hygiene may be overlooked by older adults with dementia-related conditions or their caregivers, making these adults at an increased risk for tooth decay and gum disease and may lose their ability to brush their teeth effectively. They may pay less attention to personal grooming. Medications may complicate their oral health.
Proper care of the mouth and teeth can help prevent eating difficulties, digestive problems and extensive dental procedures down the road, however brushing is sometimes difficult because a person with dementia may forget how or why its is important to take care of his or her mouth. Often times there is limited dexterity which causes the inability for the patient to brush and floss the entire mouth properly.
Tips to assist with oral care include:
- Provide short, simple instructions. “Brush your teeth” by itself may be too non-specific. Break down each step by saying, “Hold your toothbrush.” “Put paste on the brush.” Then, “Brush your teeth with the toothbrush.”
- Use a “watch me” or “hand-over-hand” technique. Hold a brush and show the person how to brush his or her teeth. Or put your hand over the person’s hand, gently guiding the brush.
- Monitor daily oral care. Brush teeth or dentures after each meal and floss daily. Remove and clean dentures every night. Very gently brush the person’s gums, tongue and roof of the mouth. Investigate any signs of mouth discomfort during mealtime. The person may refuse to eat or make strained facial expressions while eating. These signs may point to mouth pain or dentures that don’t fit properly.
- Keep up with regular dental visits for as long as possible. A dental care routine is essential for healthy teeth. Ask Dr. Johns for suggestions or items that may help make dental care easier.
Dr. Johns is aware that patient’s with advanced dementia have both good and bad days. Often times, if a caretaker gives our practice a heads up, that you would like to bring in your loved one on a “good day,” even last minute, we will often accommodate the request.
When caring for someone who is confined to bed, they may have so many health problems that it is easy to forget about oral health. However, it is still very important because bacteria from the mouth can be inhaled into the lungs and cause pneumonia.
If you are a representative for a nursing home resident who requires dental care and is enrolled in Medicaid, there is a regulation, called an Incurred Medical Expense, that may help pay for medically necessary care as determined by a dentist or physician. The Medicaid caseworker at the nursing facility and the physician providing care can work together to apply the Incurred Medical Expense to pay for needed dental care.