Many people who work to take care of their bodies do a fairly good job. They make time to fit in exercise, eat healthy, and don’t engage in risky behaviors, such as smoking. But sometimes, we forget that one of the most important aspects of our well-being include the parts we can’t see, like our teeth. Poor dental hygiene has been linked to several conditions[1. “How Poor Dental Care Can Affect Your Overall Health,” https://www.colgate.com/en/us/oc/oral-health/conditions/gum-disease/article/sw-281474979066921], such as heart disease, diabetes, and respiratory infections.
Caring for the teeth is even more important for older adults than it is for the general population. Because dental problems can affect the ability to chew and eat, frail older adults are at risk for not getting all their necessary nutrients. They may also be on medications that make food taste bland or metallic, or simply cause dry mouth. All these conditions can also make chewing and eating problematic.
But what do you do if your loved one has cognitive impairments that don’t allow them to see the dangers in poor oral health? Or if they don’t understand what you’re trying to accomplish by doing the basics, such as brushing their teeth? There’s no doubt that providing dental care for aging individuals with dementia can be challenging. Here are some tips to make it easier.

A Gentler Way to Provide Dental Care

Tooth brushing is one of the foremost aspects of dental care — and one that caregivers for dementia patients often struggle with. Your loved one’s dementia may not allow them to recall the various steps to complete this task; therefore, you must do it for them (or at least supervise and assist).
If the person is in the beginning stages of dementia, and simply needs reminders, try verbal ones first. If your loved one still seems confused, you can model the steps involved with your own toothbrush, pretending to go through the motions of cleaning your teeth.
It’s also important to find the right time for dental care for your loved one. Most dental professionals recommend brushing twice a day, but this doesn’t have to be done in the morning and evening. Although it’s a good idea to brush right after your loved one gets up, if they tend to be groggy or irritable at this time, wait until they feel calmer. “Sundowning,” or the advent of aggressive behavior in dementia patients at nightfall, is a very real phenomenon. It is also one that can make bedtime brushing difficult. Again, although it’s ideal to brush after the last meal of the day, brushing beforehand is better than not doing so at all.
Don’t neglect dentures[2. “Caring for Dentures,” https://www.webmd.com/oral-health/guide/caring-dentures] when providing dental care either. They need daily brushing and rinsing just as your loved one’s natural teeth do. Also, watch for changes in the person’s mouth that may necessitate new or refitted dentures. It’s not uncommon for an older adult’s gums to shrink over time, rendering their current dentures useless.
Finally, find a dentist who is compassionate toward (and has experience with) dementia patients. Working with them is different than working with older adults in general, so the dentist in question needs a particular set of skills to provide proper care. Word-of-mouth is a good way to get referrals, but you can also ask a home health agency, long-term care facility, or geriatric physician for recommendations as well.

Take Your Time When Helping Aging Individuals with Dementia

Assisting aging individuals with dementia with their oral care takes time – both in the short and the long-term. Be patient with yourself and the person you’re caring for. Allow extra time to go through their routines, or hire a home health aide to make things easier for both of you. In the long-term, your loved one may become used to your attempts at caring for them, or they may regress and continue to struggle against you. But no matter what, know that the time you spend doing it is key to your loved one’s well-being, making it one of the greatest gifts you can offer them.
If you are unsure of how to best help an aging loved one, the trained and compassionate staff at the Institute on Aging is here to help you make that decision and gain the best in at-home care for older adults. Contact us to find out more.