How caregivers can brush their dependent patient's teeth


People with some level of immobility or dementia may not always be able to pay the necessary attention to oral hygiene, which is when their caregiver has to step in and help them brush their teeth. — dpa

Proper oral hygiene is important at any age, and perhaps especially so for the elderly.

If they’re home-care patients, they may need help from caregiving family members.

Here are some things that caregivers should know:

> Why is proper oral hygiene so important in old age?

There are several reasons.

As we get older, our gums naturally recede.

This exposes the relatively soft tissue of the tooth necks, making them much more susceptible to decay, according to a manual by the Berlin-based Centre for Quality in Care (ZQP).

This non-profit, non-governmental German foundation focuses on improving the long-term care of older care recipients.

Dry mouth can be a problem as well – often as a side effect of medications.

A dry mucous membrane lining the inside of the mouth is not only irritating, but also provides a poorer anchor for dentures.

What’s more, bacteria can multiply more easily and cause inflammation.

”Poor oral health can result in many problems, from infections and pain to malnutrition and pneumonia [e.g. via bacteria from a gum

infection],” says ZQP co-managing director Daniela Sulmann.

> What should caregivers know before brushing an elderly home-care patient’s teeth for the first time?

”The oral cavity is an intimate area,” so it’s important to be gentle and empathetic, points out the dental association in the German state of Baden-Württemberg.

It’s difficult for many older people to accept help in brushing their teeth – they feel embarrassed.

Caregiving family members should therefore coordinate the toothbrushing procedure with the patient, and announce every step


This creates trust.

To ensure that everything goes smoothly, caregivers should learn a few necessary hand motions so that they become routine.

And they should remove any wristwatch, bracelets or rings they’re wearing so as not to accidentally injure the patient.

Thorough handwashing – both before and after toothbrushing – is also a must.

And to prevent infections, the ZQP advises wearing disposable gloves.

> How best to get the patient to open their mouth?

Caregivers can induce the patient to open their mouth by stroking the area around it with their finger.

They can also place their index finger between the patient’s lower lip and chin, and carefully push the lower jaw downward, the ZQP says.

If the patient is unable to open their mouth, a mouth prop can help.

Caregivers can slip the wedge-shaped implement over a finger and then place it between the patient’s rows of teeth, allowing their mouth to be easily opened.

What caregivers should never do when holding the cheek, the experts say, is to cause the patient’s cheek to become caught between their rows of teeth, as this can lead to wounds to the cheek that heal poorly.

> How to remove dentures from a patient’s mouth?

Dentures must be properly cleaned as well, so that harmful bacteria can’t multiply on them.

To remove a patient’s dentures, the ZQP recommends proceeding as follows: Support the back of the patient’s head with one hand, then grasp the dentures with the thumb and index finger of the other hand.

Full dentures can be loosened by gently wiggling them.

To be on the safe side, caregivers can remove the dentures over a washbasin that’s lined with a towel.

If the dentures slip out of their hand, the dentures will have a soft landing spot and won’t be damaged.

> What if the patient is uncooperative?

Particularly patients suffering from dementia may refuse to have their teeth brushed.

In this case, the ZQP advises that caregivers find out why.

There may be a very specific reason for the patient’s unwillingness: Perhaps they find the taste of the toothpaste unpleasant, or the buzzing of the electric toothbrush disturbing.

It’s important that caregivers don’t press the patient.

Sometimes it helps to try later, or to have someone else take over. – By Ricarda Dieckmann/dpa

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Dental health , teeth , caregiving


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