Caregiver Brushing

• When administering oral care to an elderly individual, move slowly and explain what you are doing. You must first set him up a suitable position such as sitting, lying with his head in your lap, or lying on his side. Then, use a dental stick with foam on the end in conjunction with a spray bottle of mouthwash to dislodge pieces of food from the mouth. Employ a plastic medical tray for catching the mouthwash. Then, brush the teeth with a soft bristle brush (with or without paste) making gentle, massaging strokes for five minutes. Brush in a set order and make sure to brush all sides and eating surfaces of the teeth. In addition, use a tongue scraper on the back of the tongue for 30 seconds. Finally, have the patient rinse with mouthwash for one minute.
  
  

Flossing

• If possible, introduce the elderly person to an automatic flosser, otherwise floss her teeth by hand. Whether you do the flossing or she does it independently, it is important to work the floss between the teeth with a zig zag motion and not snap it onto the gums. Once you work the floss in, rub in against the sides of the teeth and under the gum line.
  
  

Denture Care

• Brush the gums and the roof of the mouth before setting the dentures into place. Clean the dentures once a day and, if they break, send them to a dentist for repair. Monitor the elderly person for signs of gum bleeding, severe weight loss, loose or chipped teeth, red/swollen gums, change in tooth fit, very bad breath or loss of taste. If any of these symptoms appear, have the person see his dentist or doctor immediately.
  
  

Encouraging Independence

• If you want to maintain independence in the oral care regimen, adapting the toothbrush might be the solution. For instance, you can use a wide elastic band to gently strap the toothbrush to the elderly person's hand. Or, if she has trouble gripping, attach a sponge, bike handle grip, or rubber ball to the end of the toothbrush. If length poses a problem, use a ruler or tongue depressor to make the toothbrush longer. In all cases, do not let elderly patients share toothbrushes and make sure to replace a brush after three months.
  
  

Tips for Communicating While Providing Care

• If you experience difficulty providing oral care due a person's dementia or emotional reaction, try one of these tactics for making the process go more smoothly. Have another caregiver "rescue" the elderly person by shooing you out of the room and "helping" him finish the brushing etc. Or, use "chaining" where you start the process and he finishes it. Distraction and using your hand over his also work well in this situation.