How can I help my wife with brushing her teeth?

A fellow caregiver asked...

Can you give any suggestions for a dementia-diagnosed wife whose motor and movement skills are seriously hampered? How can I help in brushing her teeth for her? She simply cannot handle a toothbrush.

Expert Answer

Helene Bergman, LMSW, is a certified geriatric care manager (C-ASWCM) and owner of Elder Care Alternatives, a professional geriatric care management business in New York City. She consults with nursing homes and daycare programs to develop specialized programs for Alzheimer's patients.

Maintaining good oral health for persons with dementia is important but also very challenging to caregivers. This is true whether ones motor skills are compromised or not. Research has shown that oral disease is prevalent in adults with dementia for many reasons. If the patient is still functioning independently but has a moderate memory impairment, he or she might go into the bathroom but forget for what or when there, how to perform the brushing teeth task. It is also common for a patient to say, "I brushed my teeth already" when in reality he/she hadn't and the caregiver might accept that; this is the same with other ADL's(activities of daily living) like bathing or even eating. Chronic diseases and medications can negatively affect dental health and bacteria easily breeds in the mouth. Thus, despite any resistance or opposition, this task should be accomplished.

If your spouse's motor skills impair her ability to complete the task, then you may need to perform it with her in a step by step process. If possible, have her see what is being done and perhaps distract her by putting something soft in her hands (stuffed animal if appropriate). Then tell her as you perform each step. Patients even with advanced dementia can follow simple directions (i.e. open your mouth, rinse). However, if she is at a more advanced stage, you can help swab her mouth with Foam Oral Mouth Swabs. These can be obtained either from adaptive equipment websites or in specialized drug stores. This process, in addition to periodic visits to the dentist for routine cleaning, will contribute to better oral hygiene.