It Takes A Village – Mouth Care Without a Battle For Those Living With Dementia

September 9, 2025

Submitted by Dr. Joy Poskozim DDS, FSCD, CDP

Founder of Joyful Dental Care – House Calls, Advocate, & Presenter

Geriatric House Call Dentist for over 15 years, Dr. Joy Poskozim speaks to Long-term Care Facility Administrators, Nursing Staff, Caregivers, and loved ones on the importance of oral health care as we age. Her goal is to share as much dental information as possible, thereby making it easier to communicate to traveling dentists on what oral health problems residents may have.

Having provided oral care for the geriatric community for over fifteen years, Joy understands medical conditions – and the subsequent issues revolving around them – supersede oral care.

Mouth Care Without a Battle.

What A Great Pic!

The caregiver is making contact and holding the resident’s hand. The power of touch is truly amazing. And, having a family member there to rely on in case of confusion, but having her step back to allow her loved one to communicate with her caregiver speaks volumes on the trust and support of where her loved one lives.

Coming together For One Sole Purpose

All of us health care professionals coming together for the one sole purpose of providing the best care we can for our memory care residents is not easy. Here are two slides I use for my lectures for my dental professionals:

I love those slides so much. Making sure the families know what their loved ones want in the future is so important in order to be able to follow through when decisions have to be made for them.

I also think we all can relate to these points, no matter what type of health care professional we are. Ageism is a thing, but I truly have never seen it in my line of work in any of the places I go to, let alone my dental office. No one can teach love, respect, and value of another’s life. It comes from within. And when I see this in action, I feel such a sense of gratitude and compassion for both parties.

Collaboration between caregivers and their residents is crucial in order to maintain healthy relationships as well as overall health, which includes oral health. The University of North Carolina came up with a great plan: Mouth Care Without a Battle. This approach has shown how to prevent bacterial pneumonia in most of the memory care residents studied. Why is this important? Because over 85% of bacteria in bacterial pneumonia is ORAL bacteria. No one in this day in age in a first or even second world country should have people expiring due to bacterial pneumonia. Bacterial pneumonia can best be prevented by including brushing teeth twice daily after meals as part of Activities of Daily Living.

“Poor mouth care causes as many as half the cases of pneumonia in nursing home residents and other people with physical and cognitive impairment. Bacteria that cause pneumonia live in dental plaque, from which they’re released into the saliva and then aspirated into the lungs. This is no small problem, as over two million episodes of nursing-home acquired pneumonia occur every year, many of which require hospitalization and result in death. Recent research indicates that as many as half of these infections — and deaths — could be avoided with good mouth care.

That’s not all. Poor mouth care also leads to poor nutrition, both by promoting tooth loss and by causing gingivitis (gum inflammation due to chronic infection). Gingivitis is uncomfortable, and chronic pain from gingivitis can lead to agitation. In addition, inflammation in the mouth makes diabetes harder to control and may even be linked to heart attacks.
Bottom line: good mouth care benefits both older adults and the people who provide their care.

Studies have shown that mouth care in persons with cognitive and physical impairment is often done inconsistently or not at all. And the older persons most likely to not receive mouth care — persons with severe disabilities or advanced dementia — are also the most susceptible to pneumonia, poor oral intake, and other problems related to poor oral hygiene. So the question is not “should” mouth care be improved, but “how.” “

This is what the Alzheimer’s Association has to say about brushing techniques:

Be Flexible, Patient, And Understanding

Help the person living with dementia to be independent for as long as possible.
Brush the way the person likes. Do they like to wet the toothbrush before they put on toothpaste? Do they like to spit as they go?
Take your time. Don’t rush the person through a task.
Put yourself in their shoes. The person might struggle or seem unsure. Let them know that they are safe, they are doing a good job, and you are there to help them.
Give praise when they do something well.”

These are all excellent points and I am grateful that the general public have really good suggestions in order to help those living at home with their daily oral hygiene.

Getting a loved one to any doctor’s appointment can be truly difficult, let alone expensive if using a MedTaxi or some other form of transportation. Think about the nursing homes you work for or know about. Do they have dental professionals (dentists and/or dental hygienists) who come to this community regularly, or do they only have a name to be considered a resource in case of an emergency?

The Special Care Dentistry Association has a list of travelling oral health professionals that can be found based by state:

Need a Dentist?

Senior Care Denistry Association

https://www.thescda.org/

Geriatric House Call Dentistry – Mobbile Denistry For Ederly Seniors

https://www.geriatrichousecalldentistry.com/

For Virtual Or In-Person Training

And, if in need of having virtual or in-person training with your caregivers, nurses, etc., look no further than yours truly! I provide programs ranging from one hour to all day with demonstrations, seminars, and continuing education for the licensed health care professionals:

https://joyposkozimdds.com/work-with-joy-medical/

Long term Care and Continuing Care communities do not need to have a dental operatory, or dental room, to be able to provide good dental care. I go to one that has a dental room, but sometimes it is simply easier to perform most care in the comfort of their own rooms, especially for my patients living with one of the dementias.