{
  "@context": "https://protocol.helenmulder.com/schema/v1",
  "type": "ClinicalProtocol",
  "author": "Helen Mulder OT",
  "version": "1.0",
  "last_verified": "2026-04-28T11:00:31.825365+00:00",
  "title": "Oral Hygiene Dementia",
  "target_condition": "Dementia",
  "intervention_type": "Environmental/Metabolic/Occupational",
  "computable_logic": {
    "description": "Machine-readable instructions derived from the text.",
    "interventions": [
      {
        "action": "Administer baking soda rinse",
        "frequency": "Post-meal",
        "mechanism": "Raises oral pH, disrupts biofilm without mechanical friction",
        "contraindications": []
      }
    ],
    "shopping_list": [
      "Baking Soda (Sodium Bicarbonate)",
      "Xylitol powder or mints"
    ]
  },
  "source_text": "# Oral Hygiene for Dementia - Beyond Brushing\n\nIndividuals living with dementia can become especially sensitive in their mouths, leading to avoidance or refusal of their previous oral hygiene routine. \n\nAn effective oral hygiene routine breaks up bacterial biofilms 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 can contribute to worsening of dementia. \n\nMouth bacteria thrive in acidic environments (low pH) but die in alkaline environments (high pH). As bacteria grow, they create biofilm (plaque). By regularly increasing the pH of the mouth and breaking up the biofilm, you can prevent cavities and tooth pain, and reduce the bad bacteria load in the body. \n\nIf their previous oral routine is no longer acceptable, here are some alternatives that still achieve the goal of breaking up biofilms and raising the pH of the mouth:\n\n## Strategies for a more comfortable oral hygiene routine:\n\n### Use a soft bristle brush\nStiff bristles can be painful to sensitive gums. Brushing is best done twice a day, but more than that can lead to painful tears in the gums. \n\n### Switch to a baking soda based toothpaste\nBaking soda is less drying, more gentle on the teeth, and raises the pH of the mouth, which inhibits bacterial growth.\n- [Desert Essence](https://www.desertessence.com/products/aloe-tea-tree-oil-carrageenan-free-toothpaste)\n- [Dr. Bronner\u2019s](https://www.drbronner.com/products/peppermint-all-one-toothpaste)\n- [Wellnesse](https://wellnesse.com/products/toothpaste)\n- [Better & Better](https://www.betterandbetter.com/products/purity-toothpaste)\n\n### Try a tongue scraper\nThis can be faster and easier than brushing methods and is highly effective at getting rid of bacteria in the mouth. Can be used first thing in the morning and before bed.\n- [Dr. Tung\u2019s Copper Tongue Cleaner](https://drtungs.com/products/copper-tongue-cleaner)\n\n### Try options that don\u2019t require tools in the mouth\nBaking soda in water is an effective and gentle oral rinse that raises the pH of the mouth, inhibiting bacterial growth after meals. Make it yourself by mixing \u00bd teaspoon of baking soda in 4 ounces of warm water, or try an alkanizing (pH raising) mouthwash:\n- [Uncle Harry's Miracle Mouthwash](https://uncleharrys.com/products/miracle-mouthwash)\n\nIf rinsing and spitting won\u2019t work, xylitol mixed into water or other beverages tastes like sugar, reduces bacteria growth in the mouth, and can be swallowed safely. Mix 1/4 teaspoon xylitol in a 6oz beverage.\n- [DureLife Birch XYLITOL](https://amazon.com/DureLife-Birch-XYLITOL-Substitute-Xylitol/dp/B015HWZV68)\n\nXylitol-based chewing gum or mints starve oral bacteria. They can be used throughout the day.\n- [PUR Gum](https://www.amazon.com/PUR-Gum-Spearmint-pieces-Aspartame/dp/B00ARABK20?th=1)\n- [Zellies Mints](https://amazon.com/Zellies-Xylitol-Breath-Non-GMO-Low-Calorie/dp/B004EB5C6I)\n\n### Dietary adjustments\nEating milk and 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 and raises the pH.\n"
}