How can we convince someone with dementia to brush their teeth?

11 answers | Last updated: Jun 05, 2017
A fellow caregiver asked...

My 88-year-old father has dementia and refuses to brush his teeth. How can we convince him to care for his teeth before they all fall out?

Expert Answers

Dr. David Blende, DDS, has more than 20 years' experience providing comprehensive dental care. His practice, the Blende Dental Group, serves the phobic, disabled, geriatric, and medically compromised communities through sleep dentistry. A division of his practice, Bay Area House Call Dentists, delivers dental services to senior communities and private homes in the San Francisco Bay Area.

This is an important question, because the process of disease and infection that takes place before teeth "fall out" can be a serious health issue. The mouth is very often a hidden nest of infection that seeds bacteria to the heart, lungs, and kidneys of the older adult population. Aspiration pneumonia, kidney infection, heart attack and stroke can all be linked to gum disease and dental abscesses. So it's important to keep the mouth clean.

The good news is that there are many techniques that a dentist or a hygienist can teach a patient with dementia that account for their individual limitations. It is also helpful if the dentist/hygienist can meet with family and caregivers and show them some tips, techniques and products that are tailored to your father's specific needs, especially if he is no longer able to take care of his own teeth.

Some of these techniques (which are written for dentists but are good tips for everyone) can be found in "Dental Care Every Day: A Caregiver's Guide" provided by the National Institutes of Health.

Community Answers

Mili answered...

Well about this problem on the dental care, maybe if you try doing it yourself in front of him, your father will do it by imitation; try it could be a way to help him out it could motivate the person to see you doing it. Remember these adults act like kids sometimes or most of the time, so it could be like a game. M

Lindasd answered...

I think the article misses the point. Someone with dementia (like Alzheimer's) doesn't have the ability to "learn".

Depending on the severity of the dementia getting a person in this state to do anything left on their own doesn't work.

Trying to get my mom to do it while you stand there and help is extremely challenging. My mother doesn't understand the whole concept any more. She can't move her brush in her mouth. She cannot "swish" in her mouth and she actually swollows toothpaste and special anti cavity rinses. I tried a simple electric brush while I stood there and it scared her and she got really upset. She absolutely refuses to let me help her brush since she's convinced she always brushes her teeth. If I "gently" remind her as we get ready for bed she gets very agitated and absolutely is sure she just brushed.

Someone should invent some special ice cream that also cleans teeth when eaten and my mom would have perfect teeth!

I have had nothing work. The dentist even tells me they see this all the time and there is little to be done other than more dentist cleanings. Good Luck on this one.

Nannysangel answered...

I, too, think the expert missed the mark on this one. Perhaps offering pieces of an apple, carrot or celery at the end of each meal will help cleanse the teeth naturally will help when all else fails.

After each meal, have the person follow you to the bathroom to wash your hands and brush your teeth together. Mili has a good idea - demonstrating the teeth-brushing ritual after each meal, something the care-giver does anyway, could instill in the care-receiver a sense of belonging to the activity and could even become something "fun" (who can make the most bubbles) for both participants instead of just one more thing you "have" to do.

I totally agree with LindaSD in that reminding someone with dementia that they need to do something just reinforces the feeling that they are forgetting just one more thing. Try getting up after a meal and saying, "Let's go brush our teeth" instead of "Do you want to brush your teeth" or "You need to brush your teeth" might meet with more agreeable responses. Choices and admonishments just don't work with dementia sufferers.

Lavonda answered...

My father has alzheimer's. I use a product called "Toothettes" with a solution called Perox-A-Mint. The "toothetes are a grooved sponge in a popsicle stick. It simply to use just dip the "toothette" in the solution and slide it around the teeth. There is no rinsing and the solution may be swallowed.

May God Bless all the caregivers and their loved ones today.

Mom's daughter answered...

My mother wears partials but will not take them out to be cleaned. I promise her that we will put them back in in the morning, but that does not good. Does anyone have any suggestions?

Kmcd4tom answered...

I now use gum,like trident,an a childrens mouthwash in case she swallows it,on rare accations she'll let me brush them,p.s. I was told tea is also good as it helps keep the mouth healthy.

Annieb5767 answered...

It is a caregiver's responsibility to seek information so that they can give the best care possible. The person with dementia should not be held responsible. Don't do anything to make them feel bad about not allowing you to brush their teeth.They depend on you to do what they can't. My loved one brushed his teeth four times a day when he was well. Now, he is afraid of the electric toothbrush and he doesn't remember what to do with a regular one.He often resists when I try to get him to brush.I researched the problem of giving good dental care to a person with advanced dementia. I found a wonderful educational u-tube demonstration presented by Teepa Snow.She suggested putting your hand on the person's shoulder to get their brain to focus on that rather than the toothbrushing (less resistance).It was amazing to see the difference in resistance.She also showed the proper way to hold the brush. You are to be on the patient's dominate side. Hold the brush in your hand not in the patients hand. Put their hand on top of yours. As you do the brushing movements,their brain thinks they are doing the brushing. Last but not least-pick your battles. If the person doesn't want to do it allow them to have that choice. They have lost so many choices. Move on to something pleasant and come back in a few minutes and try again.

Norcalgal answered...

I am also in the same vote with LindaSD. Mom will absolutely not let us brush her teeth, we also try with the Toothettes with a peroxide solution used to kill germs. It is very difficult as I believe she is in pain with her tooth. All that a dentist can do is pull teeth.

Lou12 answered...

thats maybe why your mum doesnt want to take her teeth out because shes resonating it with this pain get her pain under control then try the teeth one thing at a time maybe use picture cards to show them what your going to do they may not understand what your asking simple short instructions dont give them alot to deal with because it confuses them and then they can become frustrated and aggressive x

V e davis answered...

My heart goes out to you all. I concur that someone with Alzheimer's or other dementia cannot be instructed to do anything much at all. Mom is 85 and in Stage 6 of 7 stages of Alzheimer's. We've had 2 episodes of infection since January due to her partial not being removed at the AL. Short story, numerous trips to dentist and oral surgeon, causing Mom great anxiety and some pain when partial removed by force. I've given doctor's orders to AL wellness director stating the partial must be removed nightly. I visit Mom every week and have begun asking her to remove her partial while I am there so I can observe if she can. Last week she could not remove it. I strongly encouraged her to push through the pain and she removed it. Lots of blood and food particles came with it. I worked with her on cleaning her mouth and left the partial in a cup on Wellness Director's desk with instructions to keep it until I decide how to handle this. Wellness Director is well aware of the danger of partial not being removed nightly. I didn't even bring it up again. Mom's mind has declined dramatically since January dental problem when she consistently begged me, her sister and AL staff for her partial. Thankfully she has not mentioned it this time to me until yesterday. I took her out for lunch specifically to observe how she managed eating without her partial. The fish was a little too crunchy and she complained and fussed at me for taking her partial. I am her target. I'm calling dentist Monday but I do not expect the AL to manage the nightly removal of the partial, even if we up the level of care by $450.00 more a month. I've assured them we have the funds to up care level but they say it is not necessary at this time. Other than this matter, we are very pleased with the AL where Mom has lived for 3 1/2 years. Thank you for listening. I welcome your input. God bless you all who are care givers. Moving Mom to AL against her will was harder for me than burying my daddy!