Section 4: Oral Hygiene Techniques for People with Dementia
As older people become more frail and cognitively impaired, they become more dependent upon others to assist them with oral care. Caregivers can face complex challenges when providing oral care for others. People with dementia may refuse oral care, may not understand caregivers' instructions, may not open their mouths, may hit out at caregivers, may refuse to eat, may not be able to rinse and spit very well, or may have other problem behaviors related to dental pain.
However, there are a number of simple techniques that can be used to foster cooperation when undertaking oral care with individuals with dementia (Kovach, 1997; Chalmers, 2000). These include:
- Bridging
- Task breakdown
- Chaining
- Distraction
Modified dental equipment, such as the interventions discussed in Section 3 ("The Oral Health Care Plan"), can also help.
Above is a multimedia presentation that discusses each of the above communication techniques. This presentation runs about 4 minutes.
Course Citations
Blanco VB, Chalmers JM. Oral Hygiene Care for Functionally Dependent and Cognitively Impaired Older Adults. University of Iowa Gerontological Nursing Interventions Research Dissemination Core, 2002.
Chalmers J, Pearson A. Oral hygiene care for residents with dementia: a literature review. J Adv Nurs. 2005;52(4):410-419.
Chalmers JM. Geriatric oral health issues in Australia. Int Dent J. 2001;51(3 Suppl):188-199.
Chalmers JM, King PL, Spencer AJ, Wright FAC, Carter KD. The Oral Health Assessment Tool - validity and reliability. Aust Dent J. 2005;50(3):191-199.
Kayser-Jones J, Bird WF, Paul SM, Long L, Schell ES. An instrument to assess the oral health status of nursing home residents. Gerontologist. 1995;35:814-824.
Loesche WJ, Lopatin DE. Interactions between periodontal disease, medical diseases and immunity in the older individual. Periodontol 2000. 1998;16:80-105.
MacEntee MI, Thorne S, Kazanjian A. Conflicting priorities: oral health in long-term care. Spec Care Dentist. 1999;19:164-172.
Thomson WM. Dental caries experience in older people over time: what can the large cohort studies tell us? Br Dent J. 2004;196(2):89-92.
Thorne SE, Kazanjian A, MacEntee MI. Oral health in long-term care: the implications of organisational culture. J Aging Stud. 2001;15:271-283.