The best advice I can give on the subject of oral hygiene is to have all dental needs attended to during the earliest onset of dementia. Toothaches or any other type of pain can greatly contribute to the confusion.
While dealing with my father’s Alzheimer’s, I realized he had completely forgotten how to secure his dentures. As I would attempt to brush his teeth he would clamp his jaw down so tight you would think I was trying to break into Fort Knox! He was behaving as though I was about to extract all of his teeth. Whenever this occurred, I would simply brush the outside the best I could, coming back later for a more thorough cleaning at a more tranquil time. There’s no reason to do battle about the matter. It will only make the situation worse.
I’ve constantly preached how important “Routine” is throughout my writings and seminars on caregiving for those living with dementia. The subject of daily oral hygiene should be no different. There is no golden rule stating that their teeth have to be brushed first thing in the morning. Pick a time of day when they’re most cooperative and stick to it.
Oral hygiene is extremely important for everyone’s health and comfort. When patients’ teeth hurt, they will probably just stop chewing. Since malnutrition is of special concern those with dementia-related diseases, the caregiver must be vigilant in order to avoid such a problem. It is a constant struggle to insure they are eating a sufficient diet in the latter part of the disease.
Speak to the dentist to make sure he or she understands the patient’s cognitive condition, and make sure he or she checks the patient thoroughly. One simply cannot rely on memory-impaired patients’ responses when regarding discomfort and going through bouts of anxiety just from putting them in a dentist chair.
Periodically check his or her gums for redness or sores.
Remember, Alzheimer’s patients quickly forget about objects they can’t see. Out of sight, out of mind.
Gary Joseph LeBlanc, CDCS
Director of Dementia Education
Dementia Spotlight Foundation