Dementia module introduction

During this module, we will be looking at how to assist a person with Dementia, to help maintain or promote their oral health. We will look at brushing, dentures, diet, dental visits and conditions of the oral cavity. It's important to maintain an individual's independence for as long as possible. This can be done by reminding that person to brush their teeth twice a day or creating brushing charts and reminder cues to help them. Ensure the person has all the equipment they need, such a suitable brush and paste.

A toothbrush should have a small head with soft to medium bristles. This does not need to be an expensive brush, and many suitable options are available. If a person lives in a care facility, it is a good idea that they have their name on the handle of the toothbrush to avoid them getting mixed up. It will also be useful in case the person goes to a hospital or a day centre. Toothbrushes are a breeding ground for bacteria. Try to avoid this by using toothbrush heads fitted over the top of the toothbrush and keep them clean by rinsing them after use and shaking off excess water. 

Replace all toothbrushes every three months. If you are brushing someone else's teeth, support them by brushing and encouraging them to look in a mirror and assisting where necessary. There may come a time when you need to take over brushing for that person. When this is the case, sit the person in a chair, kneel in front of them and encourage them to help you. Keep prompting them to help you, and talking to them throughout. Start at the front and work your way back as confidence and participation allows.

There are products that can help with this. Anti-foaming toothpaste can help maintain a person's dignity. And aprons and bibs can be used for both carer and cared for. Long-handle soft bristles toothbrushes may make it easier and less dangerous for the carer. Try to keep fingers out the way of the biting surface. Do not ask the person to open too wide, especially when brushing the back teeth. Small circular sweeping motions away from the gum are the best technique to use but patience and perseverance are the two most important elements.

Electric toothbrushes can make this easier for the carer but can be a strange sensation. Try to get them used to this sensation by getting them to turn the brush on and off before they try to brush with it. The thicker heavier handle can make the brush easier for someone to hold, and the fact that the toothbrush head osculates and pulsates means that you can just hold the bristles on the tooth rather than moving in a smooth circular motion.

Some people will never like or be suitable for an electric toothbrush. The head of an electric toothbrush should also be kept covered and should be replaced every three months.