Mouth care and oral health for people with dementia

Use a pea-sized amount of toothpaste containing no less than 1450ppm fluoride – this will be marked on the tube.

Make sure you give them clear, short instructions, demonstrating what to do and gently guiding them to clean their mouth and teeth in stages.

Encourage them to spit out the toothpaste rather than rinsing, as the fluoride in the toothpaste will continue to protect their teeth.

It’s important to replace their toothbrush every three months, or sooner if it shows wear.

These tips may help:

• Use a toothbrush with a small head and medium bristles – a child’s toothbrush may be easier to use
• Clearly and simply explain what you are about to do, showing them the toothbrush and toothpaste
• Support their jaw to keep their teeth together while you clean the front of the teeth
• Encourage them to open wide while you clean the inside and chewing surfaces of the teeth
• Use gentle, circular movements, paying extra attention to the area where the tooth meets the gum

If they have only recently started wearing dentures, they may need support in getting used to a new oral hygiene routine. They may also need more help as their dementia advances. Try these tips:

• Encourage them to clean their dentures twice daily, or do it for them if they can’t
• Encourage them to clean any remaining teeth and their gums before bed, using a soft-bristled brush
• Make sure their dentures are cleaned over a bowl or sink of water so they won’t break if they’re dropped
• Use a special denture brush and denture paste or unperfumed liquid soap and water. Overnight tablet cleaners are less effective
• Ensure they take their dentures out at bedtime
• If the person is in a care setting, let the staff know that they wear dentures, and ask where they can store them safely
• It’s also a good idea to speak to a dentist about getting a spare set of dentures, or having the person’s name printed on them

If their gums bleed when cleaning their teeth, this means they have some plaque in their mouth, which is irritating their gums. Continue to brush their teeth, but if the bleeding doesn’t stop after two weeks, make an appointment with a dentist.

You should also ensure they see a dentist if they have loose teeth or ill-fitting dentures, and for routine check-ups – they may need help arranging and keeping these appointments.

• fresh fruit and vegetables
• bread with sugar-free spreads
• savoury crackers and cheese
• pitta bread with houmous or guacamole
• rice cakes or oatcakes
• plain yoghurt

Encourage them to drink water rather than fruit juice or squash that contains sugar. Milk and unsweetened tea and coffee are fine in moderation.

• have difficulty communicating that they are in pain
• cannot consent to treatment
• become resistant or distressed when treatment is attempted
• need extra advice or assistance with maintaining oral hygiene

If this is the case, their dentist or another healthcare professional may refer them to a local specialist dental service for people with additional needs. These services have staff who are trained to put people at ease and access to different treatment options to make dental care easier.

Treatment and appointments cost the same as standard dental care.

Dementia UK resources

• Getting the best out of GP and other health appointments
• Tips for better communication
• Pain and dementia
• Coping with distress

Other resources

• Oral Health Foundation