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Oral care for dementia - 10 top tips

Gary Mitchell 25 Aug 2023 Area of Practice Long Term Conditions Area of Practice Older People

To mark World Alzheimer’s Month throughout September 2023, the RCN Older People’s Forum will be sharing blogs about dementia. This blog by Dr Gary Mitchell MBE and Professor Gerry McKenna talks about oral care for dementia: 10 top tips.

Oral health is a crucial aspect of overall well-being, especially for individuals with dementia. As healthcare professionals, you play a pivotal role in maintaining the oral hygiene and comfort of individuals with dementia. Here are 10 essential tips to help you provide effective oral care and support.

1. Early action matters: timely intervention is key. Encourage regular dental check-ups, especially after a dementia diagnosis. Early visits to the dentist can identify potential issues, address oral health needs, and provide tailored advice to prevent complications.

2. Maintain a consistent routine: establish a daily oral care routine and stick to it. Consistency is essential for people with dementia. Encourage independence in oral self-care whenever possible and offer gentle prompts as the condition progresses.

3. Choose the right products: select toothbrushes with small heads and soft bristles for a gentle touch. Use fluoride toothpaste and consider non-foaming options for those who struggle with spitting. Denture care is equally important – ideally these would be removed at night, cleaned daily and soaked in a cleansing solution as recommended by a dental professional.

4. Address dry mouth: many medications used in dementia care can cause dry mouth, increasing the risk of dental issues. Offer frequent sips of water and consult a healthcare provider for possible saliva substitutes if necessary. Avoid using sugary drinks to address dry mouth.

5. Watch for signs of discomfort: individuals with dementia may struggle to communicate discomfort. Observe changes in eating habits, increased drooling, or signs of oral pain. If you notice any issues, consult a dentist promptly.

6. Adjust care with disease progression: as dementia advances, adapt your approach. Be patient, use distraction techniques, and involve family or caregivers when consent for treatment becomes challenging. It may become necessary to assist with oral care, including toothbrushing.

7. Seek specialist services: for individuals with advanced dementia, consider specialised dental services in your area. This may require a referral from a dentist or GP. These professionals have experience in providing care for those with additional needs.

8. Respect informed consent: while involving the person with dementia in decisions is essential, there may come a point where they lack capacity. Engage family, professionals, or legal representatives to ensure decisions are in the individual's best interests.

9. Maintain regular mouth checks: even if the person has no natural teeth or dentures, regular mouth checks are crucial to screen for issues like mouth cancer. Early detection can significantly impact treatment success.

10. Be kind and patient: lastly, the compassionate care you provide makes a significant difference. Approach oral care with empathy, understanding, and respect for the individual's dignity.

By following these essential tips, you're playing a vital role in ensuring the oral health and overall comfort of individuals with dementia. You may also find the following resources useful for your practice, see: TOPIC intervention materials and training video.

Thank you for reading.
Dr Gary Mitchell MBE (Chair of the Older People’s Forum, RCN) @GaryMitchellRN and Professor Gerry McKenna, Clinical Professor, School of Medicine, Dentistry and Biomedical Sciences @GerryMcKenna_

Gary Mitchell

Gary Mitchell

RCN Older People’s Forum Chair

Reader (Education) at Queen’s University Belfast

Page last updated - 03/02/2024