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Oral Care

As dementia progresses, people with cognitive decline may slowly neglect oral and dental care and even forget how to brush their teeth. However, good dental health will help maintain regular eating, reduce digestive problems, tooth decay and gum diseases, and prevent behavioural problems linked to dental issues.

Causes of Oral Problems

Insufficient saliva

Saliva helps maintain oral health, prevent tooth decay and other oral problems. Certain medications and physical conditions may cause less saliva secretion

Use of drugs

Some drugs contain sugar which may lead to tooth decay, dry mouth or cause oral and dental discomfort

Changes in eating habits

When eating more frequently, saliva has less time to work to neutralise excess acid in the mouth, leading to higher risk of tooth decay

Lack of care

People with dementia may ignore oral hygiene and dental care, leading to tooth decay and oral discomfort

Symptoms of Oral and Dental Problems

01
Unable to fall asleep soundly

02

Loss of appetite

03

Refusal to participate in daily activities

04

Frequently pulling own face or mouth

05

Remove the dentures from the mouth

06

More frequent emotional changes, moaning or screaming, and even becoming aggressive in some cases

Daily Oral Care Routine:CHECK

People in the early stage of dementia should be mindful of dental care and the prevention of oral problems. In the middle and late stages of dementia, caregivers need to provide more assistance. However, caregivers should encourage people with dementia to care for themselves as long as they can. 

CLEAR

Clear explanation

Just saying “brush your teeth” may seem too broad, or too complicated, for people with dementia, so try to give step-by-step verbal guidance, for example:

  1. Squeeze the toothpaste onto the toothbrush
  2. Pick up the toothbrush
  3. Put the toothbrush into the mouth
  4. Brush the upper teeth
  5. Brush the lower teeth

Caregivers can demonstrate and then ask him/her to follow suit, or gently take his/her hand to brush teeth together.

HABIT

Maintain good habits

Know his/her habits and preferences and brush teeth at a fixed time and place as a habit. Move to a dining table if he/she does not want to brush teeth in the bathroom.

EXECUTION

Get on with cleaning

  • Clean teeth or dentures at least twice a day
  • Use dental floss or interdental brush 
  • Brush teeth with moderate strength
  • Gently brush the gums especially the edges
  • Play soft music to help him/her to relax
For oral hygiene procedures, check the “Dental Club” website of the Department of Health:  http://www.toothclub.gov.hk/chi/adu_01_02_01_07.html#start

CALM

Keep emotions in check

  • Don’t force him/her in the routine, and if they refuse or look irritated, rest and try again later
  • If he/she can no longer take care of himself/herself, stay patient and prepare to help with verbal guidance

KEEP CHECKING

Dental check

  • Arrange regular dental check-ups
  • Identify a dentist with experience in serving people with dementia
  • Keep a detailed record of dental consultations. Inform the dentist and nurse in advance about his/her situation and special needs, such as using music to relax or keeping the caregivers around for company
  • Tell the dentist about medications being taken, if any, or any drug allergy