Tips for Carers of People Who Are Resistant To Oral Care Provision
- Do everything you can to make mouth care a pleasant experience e.g. use a softer toothbrush and pleasant tasting toothpaste/gel Some people may exhibit less resistance when carers encourage them to carry out their own mouth care.
- Develop an oral care routine. People with dementia may have patterns so ask family members or previous carers for advice or assistance.
- Carry out the task where the person is most comfortable.
- Don’t approach them from behind. Always come down to their eye level.
- It is important to label all oral care products, including dentures, brushes and toothpaste in case they go missing or end up in another room.
- Encourage spitting out toothpaste rather than rinsing as this allows the fluoride to provide maximum protection.
- Some people, especially those with dementia, may be unable to spit and should use a non-foaming toothpaste without sodium lauryl sulphate.
- Distract the care recipient by giving them something to hold like another toothbrush.
Communication Tips for Carers
- Talk clearly at the care recipient’s pace.
- Explain in short sentences and in simple terms what you’re doing.
- Try only to ask questions needing a yes or no answer.
- Use reassuring and appropriate body contact and gentle touch.
- Be willing to slow down or try again later.
- Offer praise for completion of each step if necessary.
Myth Buster for Carers
Oral healthcare is so important for the following reasons:
Our mouths contribute to the quality of our lives by affecting how we look, speak and enjoy food.
- To prevent infection and pain
- To ensure comfort
It is essential that oral care is documented. Care staff should protect themselves by providing evidence that resident’s needs have been met. Oral health risk assessments, care plans and documentation of daily care should be carried out for every resident.
It is very important not to rinse with water after brushing as toothpaste contains fluoride and it can also contain antibacterial ingredients. The surface of the enamel is made up of minute crystals and when we eat sugar we lose some of these crystals from the surface of our teeth. Given the chance these crystals will go back in to our teeth and if they have come in contact with fluoride they are better quality/stronger than before. It is much better to use mouthwash at a different time of day from when we brush our teeth as toothpaste always contains a much higher concentration of fluoride than mouthwash.
Note: If a care recipient becomes upset if you discourage them from rinsing after brushing, it is not appropriate to pressurise them. It is probably different advice from what they’ve been doing their whole lives. But if you ever get the chance to leave toothpaste on the teeth, it is much better to do so.
When providing oral care for someone else you often have no idea what is going on in their mouth. It could be painful/sore due to tooth decay, gum disease or infections linked to a dry mouth e.g. thrush (which can be extremely painful).
Therefore it is better to err on the side of caution and use a soft/very soft toothbrush when we are providing oral healthcare.
Note: When feeling the difference between very soft toothbrushes and the more typical toothbrushes provided in a care home, the staff will often comment that the soft ones are too soft. However even these can cause pain for those with a sore mouth. The soft bristles are still effective at removing plaque and bacteria.
If despite our best efforts to be gentle a care recipient still finds brushing very painful, you may need to arrange for them to see a dentist.
Toothbrushing, diet and dental visits are the main steps towards good oral health, but may need some adaptations for older people.
For a FREE Oral Health Assessment form to download and duplicate click HERE
Since June 2017 it is mandatory for care homes to carry out an oral health assessment on all new residents regardless of how long their stay is. (QS151)
Keep up to date
From the makers of
Use on extra soft, small brush head for optimum results.
Contains 1450ppm fluoride for best protection.