Alzheimer’s Disease & Oral Care Challenges

Someone who is living with Alzheimer’s Disease requires regular Dental Hygiene visits.

It is ideal to have a dental assessment early on,when someone is first diagnosed with this disease.

As Alzheimer’s progresses, the person may forgot to brush his or her teeth or forget why it is important. As a caregiver, you may have to assist them and this can be particularity challenging in the middle to late stages of this disease. Proper oral care is essential to prevent eating difficulties, digestive problems and infections. A dirty mouth will increase aggressive bacteria and led to increased risk of pneumonia, oral yeast infections and a quick dental decline.

A person living with Alzheimer’s in the middle to late stages can become resistant to oral care. There are several things you can do to help make this task easier:

  1. Provide short, simple instructions. Simply saying “brush your teeth” is too vague. Instead, walk the person through the process say: “hold your toothbrush”. Put paste on the bristles, then brush your teeth.  I love to use the “Hand-Over-Hand” technique. Have the person hold their toothbrush in their dominate hand. Then simply hold your OWN hand UNDER their hand. Guide them to brush their teeth, while they are holding their own brush. This is a great way to help the person feel they are still in control and will encourage them to maintain their own capabilities. When your loved one sees their own hand coming toward their face, this is less threatening. This technique can be combined with the shoulder pressure. In a gentle manner, use your hand to apply gentle pressure on their opposite shoulder. The mind is tricked into thinking about this pressure and often the person is less focused on what is happening in the mouth.
  2. When a biting reflex occurs in the middle to late stages it can be terrifying for caregivers when they brush teeth. The fear of being bitten and the obstacle of having the person chomp down on the toothbrush as soon as it’s placed in someone’s mouth. Open Wide foam sticks can be purchased and this helps to keep the opposite side of the mouth open, while providing oral care. This is also a handy tool to use for someone who is living with Parkinson’s Disease, M.S. or A.L.S.
  3. Gentle approach to care! Always approach the person at the front, never to the side or behind them. Kneel down if they are sitting or in a wheelchair. Standing over them can make them feel vulnerable. Introduce yourself and instead of saying we are going to “brush your teeth”.Instead try this: ” I am going to spend time with you today and make your mouth feel fresh and clean. ” Depending on the person, they maybe more responsive when you  show them the toothbrush, show them want you plan on doing my demonstrating brushing (pretend). You can gently stroke their cheek and put the brush up to their lips first.
  4. Distraction methods may work with some people. Let them hold a rolled up towel or ball if they have a grab reflex.                                              Sing or put on music. Provide lot of praise and encouragement in a gentle tone while providing mouth care.
  5. When someone is not able to spit the toothpaste, simply dip the brush in mouthwash or use a xylitol based or fluoride free paste that is safe to swallow.

June is Alzheimer’s Awareness Month. Stay tuned for more helpful hints and information about the link between this disease and oral health.