Wellness + Nutrition

Help a loved one with Alzheimer’s disease have better oral health

More than 5 million Americans have Alzheimer’s disease — the most common type of dementia.1 The large majority are 65 years of age or older.2 With about 10,000 people in the U.S. turning 65 every day,3 the number is expected to continue to increase.4

If you have a loved one with Alzheimer’s disease, it’s important to keep up with their oral health. Here’s why, along with some ways to help.



The importance of oral health

If oral health is neglected, people with Alzheimer’s disease can suffer a rapid decline in dental health — creating issues with eating and causing infections. A plan for regular professional care should be developed soon after diagnosis. All existing dental problems should be treated in the early stages of Alzheimer’s disease because they are often more difficult to treat as the disease progresses.



The person with Alzheimer’s disease should also practice a good oral health routine, including brushing, flossing and visiting the dentist regularly. They may initially be able to handle their daily oral care themselves, but the duties will eventually shift to a caregiver. Giving short, simple instructions or demonstrating how to brush and floss may be helpful for someone with Alzheimer’s disease.

Good oral health is also important to overall health. For instance, poor oral hygiene contributes to the likelihood of contracting a form of bacterial pneumonia, a common concern for elderly people with weakened gagging or cough reflex, including those with Alzheimer’s disease. 



Common dental issues

Aging teeth and gums make it more challenging to keep a mouth healthy. Alzheimer’s disease can make it even more difficult. Older people with dementia often have multiple oral health problems, including tooth decay, bleeding, gum disease, dry mouth, oral sores and infection.

Be aware of these potential problems:

• Dry mouth is the result of reduced saliva flow that is often caused by medications. It can lead to ulcers, oral fungal infections (candidiasis), denture sores, gum disease and serious cavities. In addition to other at-home solutions, the patient’s dentist may recommend fluoride treatments and a saliva substitute.

• Cavities are frequently an issue because, in addition to dry mouth, people with Alzheimer’s disease often eat softer, stickier, higher carbohydrate and sugary foods. They also frequently have a significant amount of plaque — making daily oral health care even more vital.

• Dentures can become more difficult to wear due to lack of saliva, decreased muscle control and less supporting bone. Dentures are also often misplaced. If your loved one is living in a nursing home or other facility, have their dentist label the denture with an identifier. It’s  also important that dentures be removed and cleaned daily.

• Broken teeth occur more frequently in older people in general. A broken tooth is a dental emergency and should receive immediate treatment.  

• Abscesses in the teeth or gums can be very painful, so they also qualify as dental emergencies that require immediate care. 

It can be very painful and it is sometimes difficult for people with Alzheimer’s disease to communicate they’re experiencing any kind of mouth pain. Look for these possible signs:

    • Rubbing cheek or jaw

    • Moaning or shouting

    • Wincing while eating

    • Flinching, especially when washing their face or shaving 

    • Restlessness and increased irritation

    • Reluctance to eat or put dentures in





Questions to ask a dentist

In addition to daily oral health care, it’s important for people with Alzheimer’s disease to receive regular professional dental care as long as possible to help prevent cavities, gym issues, pain and infection.

If you are selecting a dentist for your loved one, ask these questions:

• Are you experienced in caring for people with Alzheimer’s disease? You may want to consider a specialist in geriatric dentistry or a dentist who will travel to a home or care facility if it becomes too difficult for the patient to go to the dentist.

• How do you work with the patient? The dentist should take care in explaining to the patient and caregiver what will take place during a procedure. In addition, the dentist should ask the patient to only do one thing at a time.

If you have loved one with Alzheimer’s disease, make sure dental care occurs during the time of day when the patient is the most cooperative and alert. Also be prepared to sit with your loved one throughout. Finally, provide the dentist with a list of medications your loved one is taking, a list of other health issues and the names of their other health care providers so they can coordinate care.