Oral Care for Advanced Dementia: Tips for Total Assistance

As your partner's dementia progresses, you may find that your partner requires total assist with brushing their teeth. Even more, you may find providing this total assist increasingly difficult. This is because oftentimes your partner may not want to open their mouth or they can no longer spit well, if at all.

So, at this stage we are assuming that your partner is unable to assist with the task at all.

Tools you may find helpful:

• Mouth moisturizer: helps with dry mouth and lips
• Untreated Oral swabs: to moisten mouth or clean teeth; you always want to opt for untreated oral swabs as treated oral swabs can be abrasive and cause mouth sores
• Baby or Child's Toothbrush or a Silicone Toothbrush: when your partner has difficulty opening their mouth you may find using a smaller toothbrush more helpful; if your partner has a reflexive bite, meaning the clench down with their teeth with oral stimulation you may find using a silicone safer as to not harm your partner
• Towel and Small Kidney Shaped Basin: helps collect saliva and fluids that may come out of their mouth

You always want to brush your partner's teeth with them sitting as upright as possible similar to when they are eating or in an elevated side lying position. And then for toothpaste, you can just use water, a baking soda mouthwash, you can add a non-abrasive, alcohol-free mouthwash to some water, or use a child's tooth paste that is labeled safe for swallowing. With toothpaste, less is more at this stage and you may want to mix it into some water to help improve the consistency and lessen the residue that's leftover in the mouth.

Now, as you go through this process, you may find yourself needing to use several oral swabs or rinsing the brushes frequently if your partner has a lot of gunk in their mouth.

Also, don't forget to talk through the task and explain what you are doing. Your partner is much more likely to be relaxed and "compliant".

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