Looking after oral health in aged care

Key points:

• Bad dental hygiene can have a big impact on the health and wellbeing of older people in aged care

• Make it clear to your aged care provider than oral health is a really important part of your everyday life

• Sometimes difficult behaviours in people with dementia are actually linked to underlying pain due to dental issues

Developing oral diseases can drastically impact your quality of life and even result in severe pain if teeth are not taken care of properly.

It can result in bacteria from dental plaque entering the body through airways and bloodstreams, which can result in aspiration pneumonia, heart attacks, stroke, a lowered immune system and poor diabetic control.

Bad dental hygiene can also affect continence management; cause delirium, depression, and dementia; and impact skin integrity, mobility and nutrition intake.

Having good, maintained oral health is incredibly important and helps protect the body against certain infections -which is incredibly important for an older resident’s overall health.

How to check your oral health

There are recurring noticeable feelings or factors that can alert you to poor dental hygiene. Common problems residents experience in residential aged care facilities include:

• Sore corners at the side of your mouth or a sore tongue

• Thrush on the tongue

• Gum disease or severe gum disease

• Oral cancers

• Ulcers and sore spots

• Sore mouth

• Dry mouth

• Tooth or root decay

• Poorly fitted dentures which require attention

• Poor oral hygiene, ie, bad breath or noticeable food stuck in teeth

It’s important that residents have their oral hygiene checked by nurses and care workers daily for any of the above signs and should be documented and reported to the Registered Nurse.

Dementia and poor dental hygiene

People with dementia can struggle with someone helping to brush their teeth or administering oral care. They sometimes lose the ability to communicate what issues they are having, so it can be difficult to identify what might be causing them pain.

If a person with dementia is having dental issues and they are unable to explain that they are having these issues, it can result in bad reactions of challenging behaviours.

Some behaviours that could indicate pain from bad oral health management include fear of being touched, not opening their mouth, not understanding or responding to directions, biting down on toothbrushes, or hitting out.

It’s important that the person with dementia is communicated with effectively, both verbally or non-verbally, and the person providing the oral care develops ways to get access to the resident’s mouth without causing distress.

Best ways to keep your mouth healthy

Having a consistent routine for oral health care is important to make sure your teeth are being constantly attended to.

The first step is to brush morning and night with a high fluoride toothpaste.

For an older person, a soft toothbrush on gums, tongue and teeth, might be less painful than a stiffer bristle toothbrush.

People with dentures are also more likely to develop a fungal infection. It’s important to clean your dentures often to remove plaque and other bacterias, as well as remove your dentures before bed. Cleaned dentures should also be left overnight in cold water.

Receiving dental care in a nursing home

While every aged care provider should be providing oral hygiene services to residents, it is a good idea to make sure you outline your dental care needs in your care plan with the residential aged care facility.

Make it clear to your aged care provider that oral hygiene is really important to you and that it needs to be a regular part of your routine.

You can choose to visit a private dentist, however, if your mobility or any other issues get in the way, mobile dentists are a good alternative to receive good oral health checkups and oral care.

A mobile dentist is able to provide all of the services you would be provided at a normal dentist office and also takes the pressure off aged care staff and their workload.

What is your dental hygiene routine to keep your teeth healthy? Tell us in the comments below.

Related content:

The importance of elderly nutrition
Hydration for elderly people and the dangers of dehydration
Dementia behaviour changes and challenges
Mental health services for older people in aged care