Caregiver Corner
By Jennifer Beach
Mary is exhausted. She has been stopping by her mother’s home almost daily for the past two months. Last week, her mom had a UTI (urinary tract infection) and ended up spending two nights in the hospital. She was very confused, dehydrated and had a fever from the infection. She was treated with antibiotics, stabilized and sent home. Since her return home, Mary’s mom has not been back to her old self and cannot be alone for extended periods of time. Mary has noticed her mom has bad breath; it is clear she has not brushed her teeth in some time. With all the challenges going on with her mom, the last thing Mary has thought about is her teeth.
Brushing teeth and oral hygiene can easily fall to the wayside for many individuals with dementia. And for many caregivers, it takes everything they have just to get through the day. Often, the one task many individuals with dementia do not like to do is brush their teeth, therefore this task is often forgotten.
Dental hygiene is important for overall health. Poor dental hygiene may lead to heart disease, gingivitis, stroke, osteoporosis and respiratory disease. In addition, the lack of dental hygiene can also affect one’s ability to eat, chew and talk. Certain medications can cause “dry mouth,” which makes it more difficult to eat and swallow, produce saliva, and causes tongue irritation.
Brushing teeth is a complicated process with many steps. For someone with changes in their cognition and memory, this task can become overwhelming and often forgotten.
Depending on each individual’s current situation and abilities, there are many ways we can potentially assist and support our loved ones with this important daily hygiene task:
- Supervision or assistance is often necessary. We can model the steps or talk our loved ones through the steps; either of these options might help the individual be more successful.
- Give the person the toothbrush with toothpaste already on it and put your hand over theirs to start the up-and-down brushing movement to help get started. It may be easier to stand behind the person while doing this.
- A toothbrush with a large handle can be easier to hold onto and maneuver. One idea to consider is using a tennis ball. Put the handle through a tennis ball to give the person something larger to grasp. There are also many large handle toothbrushs available online or you may want to try an electric toothbrush if your loved one can tolerate the vibrations.
- It might be easier if the caregiver is doing the brushing. Have the person sit on a chair and try brushing their teeth from behind; it may be easier from this position.
- The bathroom is not the only place for brushing teeth. A basin on a table or the kitchen sink might work better. It also doesn’t have to be the last thing at night before bed or the first thing in the morning. Find a time when that may work best for loved one.
- Never force someone to open their mouth, or attempt to pry their lips apart. If your loved one does not want to do the task, take a break and try later. If the toothbrush is too invasive or if the bristles are too rough on an individual’s delicate or sensitive gums, try using a Q-tip or gauze wrapped around your finger. If dental care at home is proving to be very difficult or extremely unpleasant for you both, make an appointment to see a dentist every two months for regular dental care.
- If your loved one is likely to just swallow or spit out the fluoride toothpaste, try brushing just with water or baking soda toothpaste.
- Possible signs of dental problems include someone rubbing or touching their cheek or jaw, moaning or shouting out, head rolling or nodding, and flinching, especially when washing their face or being shaved. Restlessness, poor sleep, increased irritation or aggression, and refusal or reluctance to put in dentures when previously there was not a problem are other signs of dental issues.
There is not one right way to help your loved one. You may have to try a variety of things and try at different times of the day. Remember what worked today may not work tomorrow, but two days from now it may work again. Regular dental checks are also beneficial. Talk to your dentist about what is working and where the challenges are. Keep trying to help your loved one with their oral hygiene the best you can. Having a clean mouth feels good and can make our foods taste better.
