16. Mouth Care

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Good mouth care is very important to prevent cavities, bleeding gums, gum infections and pain. A healthy mouth is important for general health. Healthy teeth and gums allow people to eat, speak and socialize without being embarrassed. Toothaches and gum infections can make it even harder to function for elderly people, people with dementia or cognitive impairment.  Mouth and gum infections can lead to other health problems like heart disease, stroke and pneumonia.

Brushing Teeth

  • Wash your hands and put on gloves.
  • Set up the supplies such as the toothbrush, mouth swabs, mouthwash, cup or bowl or basin.
  • Place supplies on the sink. If the person cannot brush at the sink, place a bowl or basin on a tray with paper towels under the bowl or basin. If there is no tray, use the kitchen table or other safe surface.
  • Wash the toothbrush in the sink. Put a small amount of toothpaste on the brush.
  • Brush the teeth softly. Brush the outside of the teeth, then the inside of the teeth.
  • Softly brush the upper teeth by brushing at the top of the gums and moving downward. The reason for this is because it moves the plaque away from the gums. For lower teeth, brush upward away from the gums.
  • Lightly brush the tongue.
  • After you are finished brushing, have the person rinse with water and spit into the sink or the bowl or basin.
  • After you are done, rinse out the toothbrush and put away the supplies.
  • Remove the gloves and wash your hands.

Dentures

  • Wash your hands and put on gloves.
  • Put dentures in a water-filled container.
  • Brush dentures thoroughly.
  • Ask the person to rinse mouth with an alcohol-free mouthwash if they want to.
  • Put the dentures in the person’s mouth.
  • Rinse out the denture container.
  • If the person does not want to wear the dentures, put the dentures in the denture container with water.
  • Remove gloves and wash your hands.

If you see any redness, bleeding or sores, report this to your supervisor.

Mouth Care for Persons with Dementia, Alzheimer’s Disease or Cognitive Impairment

  • Slowly walk toward the person, smile and look into the person’s eyes.
  • Tell the person what you are going to do and why you’re doing it.
  • Speak slowly and clearly. Be patient and repeat what you said if necessary.
  • Ask the person if it’s okay before starting.
  • Be positive and encouraging.
  • Only do as much as you can do if the person becomes upset.

Person Who Refuses Mouth Care

  • Try to find out why the person does not want mouth care like being afraid or mouth pain.
  • If the mouth is painful, look for broken teeth, redness or sores in the mouth. Tell your supervisor if you see this.
  • If the person is afraid, play music the person enjoys, say things that are calming.
  • Try talking about something the person enjoys, the weather or other positive topic.
  • Try to do mouth care around the same time every day.
  • Tell the person all of the good things about mouth care like getting the food out of the teeth, their mouth will feel better, their smile will be brighter.
  • If the person refuses, try again at another time.