As we age, oral health problems like plaque buildup, dry mouth, cavities, tooth decay, gum disease, and oral cancers can trigger pain, swelling, sensitivity to hot and cold foods and drinks. Neglected teeth also detract from an older adult’s personal appearance. The good news is with a bit of brushing, flossing and regular dental checkups, teeth and gums can often remain healthy for a lifetime. Sound teeth and healthy gums make it possible for an older adult to eat, speak, smile, and laugh without pain or embarrassment and also enhance their personal appearance.
The American Dental Association recommends everyone floss their teeth and brush at least twice a day with fluoride toothpaste to reduce tartar buildup, prevent cavities, and maintain healthy gums.
Tips for choosing toothbrushes and dental floss:
- Soft toothbrushes do not damage tooth enamel and are easier on the gums than firm bristled brushes. They also fit in the mouth comfortably.
- Brushes with larger handles are easier to manipulate for people with arthritis in their hands.
- Older adults who find it difficult to use a manual toothbrush may get better results with an electric powered brush.
- Toothbrushes should be replaced every three or four months or sooner if your loved one has had a cold, flu, or other illness.
- Dental floss should be strong enough to resist breakage.
- Waxed floss doesn’t get stuck or break between teeth as easily as plain floss.
- Dental picks may be easier to use than string floss.
Dental Appointments
When a dental appointment is coming up, sit down with your care recipient and ask if they have any current tooth, mouth or gum problems they would like to discuss with the dentist – make a list to take with you. Let them know new patients may be asked to complete a form listing chronic illnesses, painful mouth, sores, tenderness, or injuries in the mouth.
Many dentists are now using digital images to examine teeth, gums and other areas of the mouth. (Instead of the “bite-wing” x-rays your care recipient may be used to.) These images are created with an electronic sensor placed in the patient’s mouth. They are displayed almost immediately on a screen where the patient and the dentist can identify cavities, mouth and gum sores and other oral abnormalities and make it possible for treatments to begin immediately. The digital process is painless and takes only a few minutes to complete.
Remember to let the dentist know in advance if the person you are caring for has been diagnosed with memory loss and make sure they are comfortable treating them.
Schedule dental visits during the time of day when the person you care for is most alert, responsive, and at their best. Before you leave the house ask if they need to use the bathroom. If they seems nervous about the appointment ask the dentist if you can sit with him during the exam, cleaning and other procedures.
Bring a note pad along so you can write down any instructions the dentist gives you for any special care your parent will need at home. When the appointment is over write down the dentist’s instructions for home dental care, any medications they may prescribe, and dates for future appointments.
Dental Problems in People with Memory Loss
Older adults with memory disorders can’t always tell their caregivers about their oral discomfort. For busy caregivers, it’s often easy to overlook a care recipient’s daily oral health needs until he or she develops a painful problem. Be on the lookout for the following signs:
- Rubbing a cheek or jaw
- Moaning or whimpering
- Rolling or nodding the head
- Refusing hot or cold beverages and foods
- Refusing to wear dentures
- Sleep difficulties and restlessness
Dental Routine for People with Memory Loss
As memory loss progresses people may forget how to take care of their teeth. It’s up to caregivers to help them manage daily oral hygiene and maintain healthy teeth and gums.
- Make tooth care part of their daily routine.
- Brush teeth at the same times every day.
- Clean dentures every night.
- Use step-by-step instructions: “Hold your toothbrush.” “Put toothpaste on the brush.” “Brush your teeth.”
- Take your time. Wait until they completes each step before moving on to the next one.
- Don’t give them mouthwash if he or she might swallow it.
- Check their mouth regularly for any changes in teeth, tongue or gums.
- Continue regular dental check-ups as long as they are able to visit the dentist’s office.
- Ask the dentist for suggestions for making tooth and mouth care easier for both of you.
Dealing with Dentures
Poorly fitting dentures can cause sore gums and make chewing painful. Dentures must be cleaned everyday – just like natural teeth. If the person you care for complains about their dentures or has trouble chewing, check their mouth for sores, inflamed or red gums. Because the structure of the mouth changes over time dentures won’t fit properly and they may need adjustment or replacement. People with dentures also need regular dental visits for denture cleaning and a gum and tongue exam for oral cancer at least once a year.
The following video was presented to CNA’s in a health care facility – this information is relevant to anyone responsible for the oral care of another. This video covers:
- Importance of Oral Health
- Denture Care Protocol
- Infection Control
- Identifying Visible Mouth or Denture Problems
- Supplies and Steps to Denture Care and Cleaning
Sources: Thank you to the WellMed Charitable Foundation and mmLearn.org
We hope this information is helpful to you in the important work you do as a family caregiver.
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