Facilitating Independent Tooth Brushing in Persons with Dementia

‍One of the biggest keys to facilitating independent tooth brushing is setting up the environment for success. This often means removing the clutter and labeling things when necessary. If possible, you only want to have out what they will need for the task: a toothbrush, toothpaste, and a rinse cup (if used).

Now, the next biggest key is instructions. These directions can be provided verbally or through signage.

Any instructions should be short and straightforward, and provide step-by-step instructions. It is also helpful to use demonstration and gestures when necessary.

Now, step-by-step instructions will vary for everyone; some may not need cues for every step. Some steps may come automatically. The order of steps may also differ for different people.

Give them a chance to problem solve and see what they do and adjust accordingly. The goal is for them to do as much of the task by themselves as possible without becoming frustrated.

But, here is an example of verbal instructions:

• It's time to brush your teeth dad.
• Here's your toothbrush. (hand it to them or point to where it is)
• Let's wet it first. (point to the water handle or turn it on)
• Your toothpaste is right here (point or hand it to them)
• Let me know if you need help opening it.
• Squeeze a little toothpaste on your toothbrush
• Go ahead and start brushing your teeth (demonstrate the motion)
• Don't forget to get the other side. (demonstrate changing side)
• Great! Now, spit! (demonstrate the act)
• etc., etc.
  

If your partner can read and follow signage a toothbrushing sign may say something like this (with corresponding pictures). Again all steps may not be necessary and the language may differ:

*place the toothbrush and toothpaste in an easily visible place right next to the sink.*

*it may also be helpful to label where they should return the toothbrush and toothpaste*

1. Wet toothbrush with water
2. Take cap off toothpaste
3. Put toothpaste on toothbrush
4. Put cap on toothpaste
5. Brush teeth with toothbrush
6. Spit into sink
7. Rinse toothbrush with water
8. Rinse mouth with water
9. Wipe mouth with towel
10. Turn off water

You can even simplify it even more:

1. Wet toothbrush
2. Put toothpaste on toothbrush
3. Brush teeth
4. Spit
5. Rinse toothbrush
6. Rinse mouth
7. Wipe mouth
8. Turn off water

or even more:

1. Put toothpaste on toothbrush
2. Brush your teeth
3. Spit and rinse your mouth

Typically when you simplify the directions (provide fewer cues or skip steps), it means that they need less guidance and can fill in the gaps for the other steps.

Again, everyone's needs will differ and therefore, the instructions you provide or the words you use on signage will differ. This can take a little trial-and-error to see what works best for your partner.

Trial-and-error is a very normal part of tuning into the needs of your partner. There is no need to shy away from it — instead, embrace it!

‍

*Inside the Paw Pass membership of the Treehouse a "How I Brush My Teeth Sign."

‍

‍

‍