We see many people living with dementia at Westleigh Dental Care and are experienced with dealing with all sorts of scenarios.

People living with dementia may be more prone to dental problems including tooth decay, gum disease and dry mouth leading to fungal infections.  Remembering to follow a good oral health routine or expressing they have problems may be difficult. People can forget how to hold a toothbrush, or struggle to remember what to do in the right order. They may also have low mood and apathy toward taking care of their oral health and themselves in general. Problems left untreated may get worse or lead to further complications.

What you can do to help

Brushing

  • Encourage the person to brush their teeth twice daily.  You may need to sit with them whilst they do this or show them what they need to do.  Use a pea size amount of toothpaste that has no less than 1450ppm of fluoride.  If you suspect they have sensitive teeth look for brands that specifically cater for this such as Sensodyne.
  • Make sure that brushes are in good shape and are replaced regularly.
  • If the dementia worsens you may need to take over the brushing of their teeth. Ensure you explain what you are doing and support the jaw as you go.  Encourage them to spit out, but not to rinse with water or mouthwash (unless recommended by your dentist). This will allow the fluoride to remain on the teeth and protect them for longer.

How to brush your teeth https://youtu.be/BapR9J86ZZw?si=Fnawc8sGKeN15Ys5

Dentures

  • Dentures should be washed twice daily using unscented soap and a specialist brush.  This is more effective than soaking them in solution. Gums and any remaining teeth should be brushed with a soft brush.
  • Dentures should be taken out overnight and stored safely.  If the person is in a care setting, having their name on them can be useful, as can a spare set.
  • If the denture breaks, then you can bring them into us at the surgery for an assessment. If there is a clean break then usually this can be sent overnight for a repair, or if its more complicated you may need to book in for a new set of dentures.

Diet

Limiting sugar intake will help to reduce damage to the teeth.  If the person is eating a sugary snack such as fruit, it is better to have that in one go than to have lots of sugary snacks throughout the day such as boiled sweets. Water is better to drink than sugary drinks.  Milk and unsweetened tea and coffee are fine in moderation.

Spotting the signs

Look out for signs of discomfort such as the person holding their face or grimacing when they have hot or cold drinks.  Gums that are bleeding should continue to be brushed to clear the plaque, but if the bleeding continues for more than two weeks then consult your dentist.  Poor fitting dentures may also lead to discomfort.

Maintaining dental check- ups and hygiene appointments.

We would encourage the person to continue to attend their routine dental check- ups and hygiene appointments.  They may need help making these appointments.  Depending on their understanding it may also be necessary for them to have a chaperone present to help them to understand what the dentist or hygienist is recommending.  There may also come a point where you are legally responsible for making health decisions for them. Treatment will always be discussed in detail with your dentist so you can ensure you are making an informed decision on their behalf.

Specialist care

We will continue to work with our dementia patients for as long as they are comfortable to see us, however, there may come a time when visiting us becomes too distressing for the person.  When this happens, we can recommend At Home https://www.athomedental.co.uk/, a dental service where a dentist will visit the person in their own home and extra time is taken to cater for the person’s needs.

The dentist may also refer the patient to specialist care within the NHS if this is considered the best option, although the waiting times may be lengthy.

For more information on oral health, you can visit the Oral Health Foundation https://www.dentalhealth.org/.

For help regarding dementia the following organisations are there to help.

Dementia UK https://www.dementiauk.org/

Alzheimers Society https://www.alzheimers.org.uk/