Oral Health for Dementia - Beyond Brushing

The Importance of Oral Health

The bacteria associated with periodontitis (gum disease) generate toxic enzymes (gingipains). A 2019 study in Science Advances¹ found gingipains in over 90% of all Alzheimer's brain samples tested, showing a consistent association between oral health and dementia².

Maintaining an oral hygiene routine focused on raising the pH of the mouth (more alkaline) and breaking up plaque (biofilm) can help free up resources the body needs for rest, repair, and daily activity.

Mouth bacteria thrive in acidic environments (low pH) but die in alkaline environments (high pH). As bacteria grow, they create biofilm (plaque). An effective oral hygiene routine breaks up bacterial biofilms (plaque) and raises the pH of the mouth to reduce further bacterial growth. This stops bad bacteria in their tracks, including the bacteria that cause cavities and gum disease.

Strategies for a more comfortable oral hygiene routine

Individuals living with dementia can become especially sensitive in their mouths, leading to avoidance or refusal of their previous oral hygiene routine.

Use a soft bristle brush

Stiff bristles can be painful to sensitive gums. Brushing is best done twice a day, upon waking and before bed, at least 30 minutes after eating or drinking anything other than water.

Switch to a baking soda based toothpaste

Baking soda raises the pH of the mouth, which inhibits bacterial growth.

• Wellnesse

What To Do If They Refuse Toothbrushing?

Baking soda in water is an effective and gentle oral rinse that raises the pH of the mouth after acid exposure³, inhibiting bacterial growth after meals. Make it yourself by mixing ½ teaspoon of baking soda in 4 ounces of warm water, or try an alkanizing (pH raising) mouthwash:

• Uncle Harry's Miracle Mouthwash

Xylitol-based chewing gum or mints can inhibit harmful bacteria. They can be used after meals or beverages if choking is not a concern.

• PUR Gum
• Zellies Mints

Eating cheese after other foods can help protect teeth. Having a piece of cheese at the very end of meals stimulates saliva to clean the mouth, increases calcium in the mouth, and may reduce the risk of cavities⁴.