The best advice I can give you about dealing with oral hygiene for someone who is living with a dementia-related disease is to thoroughly address all dental needs as early as possible after one’s diagnosis. Toothaches or other types of oral pain will only contribute to their confusion.
Caring for my dad with Alzheimer’s, we reached a point where I realized he completely forgot how to secure his dentures. Then there would be times when I tried to brush his teeth, he would clamp his jaw down so tight, you would think I was trying to break into Fort Knox. He acted as if was trying to extract all his teeth. Whenever this occurred, I simply cleaned the outside the best I could, coming back to finish the job at a more tranquil time. There was no reason to do battle over this, only making the plight worse.
I have constantly preached the importance of routine when caring for someone living with dementia. Their daily oral care should be no different. There’s no golden rule that teeth should be brushed first thing in the morning. I suggest picking a time of day when you believe they’re most cooperative and sticking to it.
Remember, people dealing with dementia quickly forget about objects they can’t see. Out of sight, out of mind, this includes their teeth. Brushing their teeth and cleaning their dentures will eventually become part of a caregiver’s duties.
Oral hygiene is extremely important for one’s health. When their teeth hurt, your loved one may stop chewing, or only chew on one side of their mouth. Please pay attention to this. Since malnutrition is going to be a concern during the late stage of dementia-related diseases, vigilance must be taken. A caregiver must constantly struggle to make sure he or she is eating and drinking enough. Poor oral hygiene will only add to this problem.
Taking proper care of their teeth and gums becomes a task that will become too complicated for them. Periodically check their gums for redness before brushing.
Speak with their dentist. Explain their cognitive condition, and that they may not be able to rely on their response to any discomfort.
As I stated earlier, get them in that dentist’s chair early. The further they advance, the more difficult this task will become.
Gary Joseph LeBlanc, CDCS
Dementia Spotlight Foundation