As a caregiver, trying to help a senior to brush their teeth can be difficult and can feel somewhat demeaning for the senior. Acknowledging this potential challenge prior to jumping in to give advice can make the process go smoother and will result in less controversy. We all think of brushing our teeth as something that is a "personal" grooming task but helping a senior to brush their teeth, to floss, or to clean their dentures is an important part of the caregiving role.
Teeth Brushing Tips for Seniors
(1) Investigate first to see if you can determine if dental hygiene is being practiced regularly. Feel the toothbrush after they retire for the night to see if it is wet.
(2) Mention that you left the toothbrush out with the toothpaste applied which can be a visual clue.
(3) If dentures are involved, keep a cup prepared with the cleansing solution on the bathroom sink or vanity and mention that the doctor said it was important for daily cleansing. Hopefully, they will comply.
(4) Break down the tasks involved and consider going through the steps together.
According to the Centers for Disease Control and Prevention (CDC), more people than ever before are keeping their original teeth as they age. This is great news because good oral health contributes to good overall physical health and emotional well-being. The sooner elderly people begin to take better care of their teeth, the more likely they are to keep their teeth and have a higher quality of life.
That being said, it isn't always easy convincing someone to take the time to floss and brush. Elderly people may have cognitive impairments that make it necessary for caregivers to take on the role of the daily dental hygienist.
Caregivers often have to choose their battles. Since tooth care is not optional, here are some tips that may be beneficial to anyone who has a senior in his or her care who is unmotivated or unable to practice the important self-care task of tooth brushing independently or on a normal basis.
Experts with the American Dental Association have offered suggestions to make it easier for dementia caregivers to provide good oral health practices. Because dementia can cause people to misinterpret communication efforts, it is recommended to pay closer attention to non-verbal communication techniques over verbal ones.
Keep requests to one task at a time. If necessary, break down tasks into smaller, simpler ones.
For instance, when it's time to brush teeth, instead of saying, "Let's go brush your teeth," a caregiver might try breaking the task down into steps such as:
By breaking down the task into smaller, less cognitively challenging tasks, the chances of a person with dementia getting upset and flat out refusing become less likely. It may also be beneficial to use picture cue cards or have labels where things like the toothpaste and toothbrush are located, even if they are out on the counter. This also helps reduce dementia-related frustrations.
A regular routine is also important to keep whenever possible. Routine carries a momentum that can help an elderly person cooperate.
Elderly people are more prone to thin and bleeding gums, dry-mouth, bone loss, sensitivities, and oral cancers. Therefore, it is necessary to take certain precautions above and beyond the routines of healthy young adults. Teeth should be gently brushed at least twice a day; once in the morning and again before bed, but it may be necessary to brush after lunch.
A soft bristled brush should always be used and needs to be replaced at least every 3-4 months, according to the American Dental Association. A toothbrush or brush head of an electric brush should be replaced sooner if the bristles become frayed. A frayed brush can worsen gum erosion, cause bleeding, or be painful to use, causing an elderly person to fight against tooth brushing.
It is also important to replace the toothbrush often because microorganisms begin to grow and can cause harmful infections. For elderly people with weakened immune systems and open sores or bleeding surfaces, replacing the brushes often is of utmost importance. Bacterial infections in the mouth can cause periodontal disease that leads to bone loss, tooth loss, and painful gum recession. Periodontal disease has been linked to cardiovascular diseases and diabetes-the two most fatal health conditions associated with aging.
"Regular visits to the dentist are important to maintain"
Dry mouth is a common side effect of certain medications and is a major contributor to periodontal disease. It is a condition that can be treated by a dentist. It is important to guard against dry mouth because it could be a reason why those in care fight and refuse when it comes time to take care of their teeth. Saliva plays a crucial role in keeping the teeth clean and harmful bacterial growth down. Without enough of it, a person is more apt to have swollen and tender gums, offensive breath, and erosion of the tooth's enamel that leads to decay. Regular visits to the dentist are important to maintain. If possible, keep the same dentist. Having the same dentist every time can help a person with early-onset dementia feel more at ease. The dentist will also be able to better monitor any changes from the last visit. Regular cleanings will go a long way in preventing major problems from developing by keeping gums healthy and taking a proactive role in treating conditions, such as dry mouth, early on.
Truth be told, some days will just be easier than others. However, understanding how important dental care is and making a few minor adjustments may help caregivers to become more patient when it comes to the struggle of cleaning an elderly person's teeth.
American Dental Association. (April 25, 2014). Providing Dental Care for Patients with Dementia. Available at http://www.ada.org/en/public-programs/action-for-dental-health/action-for-dental-health-success-stories/providing-dental-care-for-patients-with-dementia. Last Visited March 28, 2016.
Vargas, C. M., Kramarow, E. A., Yellowitz, J.A. (March 2001). The Oral Health of Older Americans. Centers for Disease Control and Prevention. National Center for Health Statistics. Available at http://www.cdc.gov/nchs/data/ahcd/agingtrends/03oral.pdf. Last Visited March 28, 2016.