Recommendations for Carers - Caring for the oral health of Alzheimer's patients

Routines may need to change as Alzheimer's disease symptoms become more severe.

The patient may become more forgetful, confused or anxious when it comes to brushing their teeth. At this stage, the Old Grammar School Dental Surgery's guidance is given below:

• Guide the patient to the bathroom – it’s common for people with more advanced Alzheimer's disease to lose their way or become confused about where they need to go.

• A carer should always assist the patient with brushing their teeth twice daily

• If possible, we recommend rinsing Corsodyl mouthwash for 60 seconds before brushing – rinsing with mouthwash can help clear food particles from their mouth. Mouthwash isn’t a replacement for brushing but can be helpful at difficult times.

Twice daily oral hygiene routine for the health carer assistance of patient.

• Make sure your hands are clean. Wash your hands thoroughly first and wear disposable gloves to avoid risk of infection.

• Apply a pea-sized amount of fluoride toothpaste to a toothbrush. Press it well into the bristles so it doesn’t fall off – particularly if using an electric toothbrush.

• Stand to the side of the patient and hold the toothbrush. Preferably use an electric toothbrush.

• Use your fingers on one hand, that is not holding the toothbrush, to gently lift the resident's cheek away from their teeth and gums. This should make it easier for you to see inside the whole of their mouth as you brush.

• When a patient's teeth are brushed, there may be a lot of blood in their saliva and bleeding. NB This is a normal consequence of severe gingivitis and this should not stop a carer from brushing the patient's teeth.

• Brush the teeth and gums in a circular, ‘round-and-round’ motion not backwards and forwards.

• Make sure you brush the teeth from these different angles:

  • behind the teeth (the ‘inside’), with the toothbrush facing diagonally towards the gum

  • on the top (biting surface) of the teeth, with the toothbrush facing horizontally up or down

  • in front of the teeth (the ‘outside’), with the toothbrush facing diagonally towards the gum.

• Brush the top set of teeth for one minute (spend 30 seconds on each side of the mouth). Repeat this on the bottom set of teeth.

• Use the recommended interdental brush to clean in between teeth, if you are able to do this.

• Encourage the patient to spit out the toothpaste after brushing. They should not rinse with water or use mouthwash straightaway. This helps to keep fluoride on the surface of the teeth to protect them from decay.