What happens to a dementia patient who refuses to brush their teeth?

Sadly there are some battles not worth fighting.

Dad does not have dementia, yet his teeth are rotting out of his head. He brushes his teeth to some degree. He refuses to go to the dentist, last time was about 5 years ago, he had multiple minor abscesses and had the remains of several teeth removed. The procedure was painful, of course, so now he just lets them rot.

He was warned by his dentist that bacteria is getting into his system due to the poor condition of his gums and teeth. It may have contributed to an infection after the removal of a skin cancer.

But at 93 there is no point in arguing with him.

Your mom has periodontal disease, it sounds like, from the gum bleeding she's experiencing. When periodontal disease goes untreated, there is bone loss in the mouth which leads to tooth loss. When your mom starts expressing great pain in her mouth, you will need to take her to a dentist that offers sedation; she can be sedated (knocked out) while her mouth is examined, and then treated for whatever is going on at the time. If a tooth or teeth need to be extracted, they will be. That's about all that can be done for a dementia patient, really.

My mother had a few teeth that needed to be extracted while she lived in Memory Care AL. I had the visiting/traveling dentists come in to treat her in her recliner in her room. Surgery had to be performed to remove 2 molars, which was done under Novocaine, and she was stitched up right there. Her PCP ordered a Xanax to be given to her beforehand to keep her calm throughout the ordeal. If I could have had her sedated, I would have, but that wasn't an option. I also chose not to take her out of the MC to the dentist's office b/c she was wheelchair bound and 190 lbs, so I felt it was easier to deal with the matter in her room at the MC.

There's no easy way to handle dental issues when dementia is present. And I wouldn't fight your mother about brushing her teeth; it's too late anyway; the majority of the damage has already been done. Just treat her pain as it crops up, that's my suggestion.

Best of luck with a difficult situation.

my loved one has alzheimers dementia. i try my best to clean his teeth every day when i visit - the carers also brush his teeth. some days he will comply other days not. i use a children's toothbrush and also children's toothpaste as he doesn't understand now about rinsing and so if he does swallow the toothpaste it's not so bad. i keep a wet paper towel on hand also to wipe his mouth out as best i can. he used to say it 'burnt' when i cleaned his teeth before - i think this is because of the fluoride in regular toothpaste - since i've used the children's one he doesn't complain. they come in nice flavors such as strawberry. he also seems to like the toothbrushes which are brightly colored. at this stage i will do anything i can to help maintain his dental hygiene. there are also toothpaste 'bits' which are readily available online. they are small, tablet sized - once popped in the mouth they dissolve and if you can get a toothbrush in there to clean, may also help. we have a mobile dentist who comes out to clean his teeth also. i hope this is helpful.

Had the same problem with my husband. He was in memory care and now in skilled nursing. I got these and the attendants love them. No water or spitting out. They are regular sized and you can’t even tell there is toothpaste on them until you start using them. These are on Amazon.

36 Prepasted Disposable Toothbrushes | Pre-Pasted Soft Bristle Tooth Brush Set for Dental Care & Oral Hygiene | Individually Wrapped Toothbrush Pack Airbnb Gifts | No Water Needed (36 Pack) https://a.co/d/7UvkdZT

My father is 92 with frontal lobe dementia and can no longer brush his teeth. I hired a mobile dentist to come clean his teeth every 90 days. Dad is able to sit in the chair and let them clean his teeth for about 30 min. Sometimes we have to do 2 sessions to get both sides cleaned, which is 2 appointments. A lot of memory care and assisted living facilities have access to mobile dentist, who come in a handicapped RV that is fully equipped to perform dental work, including cleanings, fillings, root canals and crowns. You might want to see if a mobile dentist is available to come to the facility where you mom resides. My father is in the Houston, TX area.

These are sponge toothbrushes. I think they have toothpaste in them. May be gentler than a toothbrush.

You Mom probably has gum desease if her gums are bleeding that much and they are hurting. I have been thru the process but it was 40 yrs ago. With regular cleanings I have kept it at bay. You can brush all you want but flossing and regular cleanings help to prevent gum desease. I know, not an easy task. I had to actually have my gums cut open to graphed the bone, scraping off the damage bacteria made. Your Mom will not be able to go thru this process but I would ask the dentist if putting her under would be OK. Just long enough to give her a good cleaning. As said, the poison given off by the bacteria causing the problem can make her sick. If her breath smells like rotten eggs/sulfur, she has gum desease.

https://www.walmart.com/ip/100-Pcs-Suction-Oral-Swabs-Disposable-Sponge-Swabs-Cavity-Cleaning-Tooth-Shape-Unflavoured-Swabs-Disposable-Care-Swab-Mouth-Pink/989663676?wmlspartner=wlpa&selectedSellerId=18988&&adid=22222222227989663676_18988_142769376613_18354731446&wl0=&wl1=g&wl2=t&wl3=631649406389&wl4=aud-1651068664746:pla-1877571100265&wl5=9003829&wl6=&wl7=&wl8=&wl9=pla&wl10=125210027&wl11=online&wl12=989663676_18988&veh=sem&gclid=Cj0KCQiA-JacBhC0ARIsAIxybyNlRnnBTLEOWzgwk5yyTdkeGW3UZ9BGCfez19nuDNQtMkwssC5jUjcaAt8wEALw_wcB&gclsrc=aw.ds

My mother had dementia and became afraid of her toothbrush. She no longer knew what it was, and when her caregiver brought it close, she'd become very frightened. Caregiver did the best she could in cleaning her teeth. No dentist appointments were possible because she was bed-bound for years and we kept expecting her to die. But she didn't until after 5 years from the time we were sure she had dementia. She was 95 at death. She'd taken good care of her teeth all her life and hadn't lost any, but by the time she died, her teeth had turned brown. I never knew the cause for this, but it didn't matter. They seemed intact and neither teeth nor gums appeared to cause pain. She could no longer communicate in any meaningful way and it was impossible to know.

Try giving her a toothbrush all set up to brush for herself, and say nonchalantly, Here you go Mom, for a quick little brushing, like its routine. Positive, positive, positive. Always. They really would rather do things themselves, but it can be too much effort. Physically but also mentally, from us ordering them around like they are our kids.


The technical... Make sure it's a soft and small child's brush. Maybe in the comfort of her chair. Have on the ready a couple cups for rinsing and for the waste. Or even a little tub for waste. And something to dry her mouth or catch stuff as she goes (make that 2 dry cloths). That is much easier. Even just a large yogurt container. If that is just not doable, some child's mouthwash to swish around in lieu of brushing. Don't in any way criticize the brushing. Just be glad it is taking place. Try once a week, then work up 2x, etc. You can add in assists later, such as "Oh did you get the back?" Have a great tasting kids SWEET mouthwash for after. Say something like here's the good part! You will probably have to tell her not to drink it but swish and spit. If its a kids, it will be ok if she does accidently drink it. Reinforce with Don't you love that fresh clean feeling?? Or "I always love that fresh clean feeling". Be genuine with that. Dementia is all about sensing. If she refuses all, try again the next day. Sometime she may. Or you might even say want me to do it for you? :) Just a quick brushing, so you don't get infection. If she agrees, then truly make it a quick brushing! Don't try to get it all. You can get some one dsumy, some another. The key is to make it a positive moment and build routine.

Another idea to start is (in her chair). "Let me see that smile again". When she smiles, say domething like " Yup yup looks like you got something in your teeth there. Let me grab you a tooth brush. And then go through the above.

And then after, Ok let me so pearly whites!! Beautiful. I love that smile of yours. Hollywood smile, Hollywood smile. Whatever makes sense to you. Humor, loving, all that good stuff. Best of luck and God bless!!

I agree with the person that said pick the right time. You know your mother best and when she is more calm. My father, who had Alz, would respond to "I love you" when he would get upset with something we were doing to help him. I would just repeat it over and over again and it calmed him. He was also more will to do things first thing in the morning right when he woke. So that was when we would bathe him so he would not get irritated. Maybe brushing your moms teeth does not need to be after meals like most people do. As long as you get her teeth brushed maybe twice a day...anytime of the day. Kind words and a soothing voice always calmed my father....maybe even a distraction story or music will help. It is all trial and error. My husband is bedridden so I choose the best times to get the job done. Try not to get frustrated and always try to put yourself in her shoes.

The teeth and gums will end up hurting even more and will rot my suggestion:

Finger toothbushes... from Walmart

20pcs Disposable Finger Stalls Toothbrush Gauze Dental Finger Brush Oral Hygiene Cleaning Wipes Teeth Cleaning Accessory for Outdoor (White)