Alzheimer’s and Dementia
The following resources are intended to help caregivers and the dental team adapt their daily skills when providing routine oral health care for persons with Alzheimer’s or dementia is not always possible.
These sources of information have been produced by third parties and are intended to serve as general information only. It should not be used to replace the advice of a qualified health professional. CDA is not responsible for complete accuracy, maintaining editorial control or continued availability of information provided by third party websites.
Oral Health Care Resources for Caregivers
Organization: Canadian Dental Association
Product type/format:CDA Dental Patient with Special Health Care Needs Transition Process
Information about: This tool helps to guide patients, families, caregivers and oral health care providers seamlessly through the process of transition when an adolescent with special health care needs (SHCN) moves from pediatric to adult oral health care, or when an adult with special health care needs moves from one dental practice to another. The tool consists of 3 steps and can be used for and adapted to any SHCN patient group for assisting in transitioning individuals from one oral health care environment to another.
Organization: Canadian Dental Association
Product type/format: Brochure and Pre-visit questionnaire
Information about: Tips for parents and caregivers to make oral health care at home as easy as possible for persons with special health care needs.
Product type/format: Webpage, Section 7
Information about: Finding a dentist
Product type/format: YouTube video, starts at 6:30s
Information about: Oral Care Best Practices for Residents with Responsive Behaviour: Approaches and strategies
Product type/format: Webpage, Section 2
Information about: Learn how medications can affect the oral health of people with dementia.
Product type/format: Webpage, Section 3
Information about: Dentures; When are dentures required; Wearing dentures; Losing dentures; Dentures marking
Product type/format: Webpage
Information about: Daily oral health care tips and working with the dentist.
Product type/format: Facilitator Guide, Downloadable PDF (pg. 18)
Information about: Daily oral health care tips. The Facilitator Guide provides information, resources, and detailed steps for introducing the ‘Brushing Up on Mouth Care’ program into your continuing care workplace.
Organization:Healthy Populations Institute, Dalhousie University
Product type/format:YouTube video
Information about: Five-part video education series on personal daily mouth care for older adults: Many older adults experience a decline in physical and mental health as they age. This often leaves them dependent on others to assist them with their personal care needs.
- Part 1: This Oral Health Basics video focuses on importance of oral health, dental disease, prevention and assessment, personal oral care cards, tool kit, and your role.
- Part 2: This Brushing Techniques & Oral Health Products video focuses on toothbrushes, toothpaste, brushing technique, floss/floss alternatives and floss technique, mouth rinses, denture care products and cleaning technique, other oral health conditions and products.
- Part 3: The Considerations for Dementia video focuses on what dementia is (prevalence, type and symptoms), most common losses of dementia (7 A’s), responsive behaviours, and tips and techniques for providing oral care.
- Part 4: The Considerations for Palliative Care video focuses on the importance of palliative care, oral care for the palliative patient (general goal, symptoms and treatment for common oral conditions, tips and products for delivering daily oral care)
- Part 5: The Oral Health Assessment video provides an oral health assessment tool (o.h.a.t) and information on oral hygiene care planning.
Product type/format: Webpage
Information about: Tips for daily oral health care, including denture care, mouth checks, seeing the dentist, medications and oral disease, and signs of oral care problems.
Product type/format: Downloadable PDF
Information about: Approaches for Oral Care. Interventions for Residents in Long-Term Care with Responsive Behaviours, Communication or Functional Impairments.
Product type/format: An online marketplace of UK-based products and services for dementia and memory loss. Charity partners include Dementia UK, Young Dementia UK, Alzheimer’s Disease International, Alzheimer’s Society, to name a few.
Information about: A step-by-step guide to dental care and dementia, including why it’s important, what might help, a step-by-step guide if things aren’t working, and visiting the dentist.
Product type/format: Brochure, Downloadable PDF
Information about: Daily oral health care tips in French
Product type/format: Brochure, Downloadable PDF
Information about: Daily oral health care tips. Brushing teeth for seniors with a loss of autonomy.
Product type/format: Fact Sheet, Downloadable PDF
Information about: A guide to provide oral care for caregivers. Includes information on oral health and overall health, the role of the dental hygienist, maintaining good oral health, signs of inadequate oral care, routine care and treatment.
Product type/format: Information Sheet, Downloadable PDF (pg. 7)
Information about: Brushing up on Mouth Care: An oral health resource for those who provide care to older adults. Includes information on common oral conditions, hydration, dementia and oral care, cavities and diet, denture care, dry mouth, gingivitis, labeling dentures, oral cancer, oral care during cancer treatment, oral swabs, palliative oral care, gum disease, taste and swallowing disorders, and dysphagia and oral care.
Product type/format: Telephone service
Information about: Free specialized dementia advice and education. 1-866-408-5465 (Canada-wide toll free)
Product type/format: Downloadable PDFs and Videos
Information about: A range of mouth care factsheets and video clips for caregivers of dependent individuals, including long-term care residents. Topics include but are not limited to gloving; basic mouth care for denture wearers and those with natural teeth; special considerations for mouthcare based on an individual’s personal situations and abilities; essential mouthcare products and supplies; how-to instructions for brushing someone else’s teeth; optimal positioning for improved mouthcare; how to optimize time during mouthcare; and toothbrushing techniques at the bedside.
Oral Health Care Resources for Dentists and the Dental Team
Product type/format: My Trip to the Dentist YouTube Video
Information about: Check out this video promoting inclusive oral health care, designed to prepare children for their visit to the dentist.
Product type/format: CDA Dental Patient with Special Health Care Needs Transition Process
Information about: This tool helps to guide patients, families, caregivers and oral health care providers seamlessly through the process of transition when an adolescent with special health care needs (SHCN) moves from pediatric to adult oral health care, or when an adult with special health care needs moves from one dental practice to another. The tool consists of 3 steps and can be used for and adapted to any SHCN patient group for assisting in transitioning individuals from one oral health care environment to another.
Product type/format: Complete Tool and Stand-alone form (downloadable PDFs)
Information about: The tool, Dental Treatment Case Complexity Assessment Form and Recommendations for Persons with Special Health Care Needs, aims to encourage private and public dental clinics to make dental services more accessible for persons with special health care needs. It may also help dentists assess the complexity of individual cases and determine whether to treat or refer these patients to clinics where specialized care can be provided. This assessment tool is not intended to evaluate specific oral health conditions or emergency oral health treatment options.
Product type/format: Brochure and Pre-visit questionnaire
Information about: General guidance and pre-visit questionnaire to assist dentists and the dental team in providing oral health care for patients with special health care needs.
Product type/format: Online course
Information about: The Lifelong Smiles for Individuals with Intellectual Disabilities (ID) online course is designed to help you, through 4 modules, more effectively connect with and support clients with ID in maintaining good oral health over their lifetime.
Product type/format: Webpage
Information about: Dental problems that people with dementia face and methods for treatment and prevention.
Product type/format: Brochure, Downloadable PDF
Information about: Guidelines on Oral Hygiene: Steps for Oral Hygiene and Reminders for Dentists and Support Workers/Families
Product type/format: Brochure, Downloadable PDF (Fr)
Information about: Mouth care for persons with loss of autonomy
Product type/format: Checklist, Downloadable PDF
Information about: Ten observations which may indicate that an individual is in pain, and that the cause may be orally related.
Product type/format: YouTube video (dementia content starts at 6:30s)
Information about: Oral Care Best Practices for Residents with Responsive Behaviour: Approaches and strategies
Know the warning signs
Learn more about other oral health conditions
Explore more essential topics to deepen your understanding of oral health and take proactive steps toward maintaining a healthy smile.
Frequently asked questions
Find answers to some of the most common questions about oral health, dental treatments, and more.
Do I really have to go to the dentist every six months?
How often you go for dental exams depends on your oral health needs. The goal is to catch small problems early. For many people, this means a dental exam every six months. Your dentist may suggest that you visit more or less often depending on how well you care for your teeth and gums, problems you have that need to be checked or treated, how fast tartar builds up on your teeth, and so on.
Ask yourself the following questions:
- Do I floss every day?
- Do I brush twice a day with a fluoride toothpaste and follow my dentist's instructions on how to brush properly?
- Do I eat a well-balanced diet, including food from all food groups, and limit sweets and sticky foods?
- Do I smoke?
- Do I have a history of cavities or gum disease?
- Is my overall health good?
The answers to these questions are all factors that affect your oral health. They will help you and your dentist decide how often you need to visit for dental exams. It's worth noting that you should not determine your need for dental care on what your dental plan covers.
Do I need x-rays at each visit?
How often you need to have x-rays also depends on your oral health. A healthy adult who has not had cavities or other problems for a couple of years probably won't need x-rays at every appointment. If your dental situation is less stable and your dentist is monitoring your progress, you may require more frequent x-rays.
If you are not sure why a particular x-ray is being taken, ask your dentist. Remember that dental x-rays deliver very little radiation; they are a vital tool for your dentist to ensure that small problems don't develop into bigger ones.
Related Resources
I want to find a new dentist. How can I find a Dentist, and how can I get my records transferred?
The first step in choosing a new dentist is to list your needs, which might include:
- Location
- Hours of practice
- Language(s) spoken
- Generalist or specialist practice
- Asking your family and friends if they can recommend a dentist. Other members of your community, such as your doctor, may be able to offer suggestions. Some provincial dental associations have Web sites that allow you to search for a dentist in your area (see "Other Resources" below).
Yellow Pages advertising may also prove helpful. It will list each dentist's location, and may include other details that will help you in your search.
Once you have narrowed your list to two or three names, call the dentists to see if they are accepting new patients. This initial call may also give you some sense of the office environment, but there's nothing like the first visit to help you decide if it's a good match for you.
How can I get my records transferred?
Original dental records belong to the dentist who provided the treatment, and not the patient, because dentists have to keep all of their records for a period of time, as set out by their provincial dental regulatory body. Once you have selected a new dentist, you can request that a copy of your records be transferred from your former dentist.
You may be required to sign a release form from your former dental office and you may also be charged an administrative fee for having your records copied and sent to another dental office. If you have questions about the records transfer process in your province, ask your dentist or contact the provincial dental regulatory body.
Other Resources
Provincial Regulatory Authorities and Provincial Associations
Does my dentist need to wear gloves and a mask, and how do I know he or she is using clean tools?
Your health is very important to your dentist. One of the ways that your dentist helps you stay healthy is by preventing the spread of germs. One of the best ways to do this is to use barrier protection such as gloves and masks.
Your dentist and other dental team members also wash their hands regularly. In addition, they sterilize equipment used in the dental office and clean the furniture and fixtures in the examining rooms. This system is referred to as "standard precautions." It means that every patient is treated in the same way because patients don't always know if they're sick. It's always better to be safe than sorry.
If you would like to know how this system is carried out in your dentist's office, ask to be shown how it's done. Dentists welcome the opportunity to ease their patients' concerns, rather than have them leave the office with unanswered questions. Once you see the work that goes into making the dental office a clean and safe environment, you will feel reassured.
It is worth noting that even though standard precautions are used, it is still important to tell your dentist of changes in your health. This will help your dentist suggest the right choices of treatment for you.
When should I take my child to the dentist for the first time?
It's important to get an early start on dental care, so that your child will learn that visiting the dentist is a regular part of health care. The first step is to choose a dentist for your child.
It may be your own dentist or one who specializes in treating children (called a pediatric dentist). Once you have selected a dentist, call the office to find out at what age he or she prefers to see child patients for the first time. CDA encourages the assessment of infants, by a dentist, within 6 months of the eruption of the first tooth or by one year of age.
It's important to make the first visit a positive experience for your child - one reason why it's best to visit before a problem develops. If you think there is a problem, however, take your child to the dentist right away, no matter what age.
If you are a nervous dental patient, ask your spouse or another family member to take the child for the appointment. If your child senses that you are nervous, he or she may feel nervous too. When you talk to your child about going to the dentist, explain what will happen without adding things like "it won't hurt" or "don't be scared."
Be sure to get an early start on regular dental care at home. Start cleaning your child's mouth with a soft damp cloth before teeth come in and continue with a soft toothbrush once he or she has a first tooth. Limit the number of sugary treats you give your child, and focus on healthy food choices from the very beginning.
Other Resources
Why doesn't my dentist just accept payment from my insurance company? I don't have dental insurance and can't afford to go to the dentist. What can I do and why does dentistry cost so much anyway?
Dental plans, offered by many employers, are a means to help you pay for your dental treatment. Most Canadians enjoy dental plans and the insurance companies that provide them are actually benefit carriers. Carriers reimburse patients based on the level of coverage decided by the patient's employer.
When you visit the dentist, it's the dentist's role to make a treatment plan based on your oral health needs. Your needs may be different from what is covered by your dental plan. It is your right to decide whether or not to go ahead with any treatment.
You should not decide based on what your plan covers. If you agree to have the treatment, it's your responsibility to pay for it. It is the responsibility of the benefits carrier's to reimburse you for the amount covered by your dental plan.
Many dentists are willing to contact a patient's benefits carrier, on a patient's behalf, to find out if a treatment is covered. The patient has to pay the portion that's not covered and the dentist may offer a payment plan to help.
I don't have dental insurance and can't afford to go to the dentist. What can I do and why does dentistry cost so much anyway?
If you do not have a dental plan and cannot afford to pay your entire bill at once, ask your dentist about a payment plan. If you cannot afford care, even with a payment plan, contact the nearest:
- Social services agency to see if you qualify for government-funded dental care
- Dental school where senior dental students provide treatment at a reduced cost
Dental services may seem expensive. In Canada, we don't have to pay directly when we visit a doctor or hospital, so we may not realize the high cost of providing health services. Overhead costs are high for dentists. They have staff, equipment and other operating costs.
The good news is that you can avoid costly dental treatment by brushing, flossing and visiting your dentist regularly for a dental exams. Regular dental exams cost money, but they are less expensive than fixing serious dental problems that stem from neglect.
Other Resources
What's the difference between the bleaching I can do at home with a kit from the store and the bleaching that my dentist does?
Dentists have been doing what's called "non-vital" bleaching for many years. Non-vital bleaching is done on a damaged, darkened tooth that has had root canal treatment. "Vital" bleaching is done on healthy teeth and has become more popular in recent years.
Vital bleaching, also called whitening, may be carried out in the dental office or the dentist may instruct the patient on how to do the bleaching at home. There is also a wide variety of products for sale in stores. Not all products are the same and not all give you the same results.
Different products, including those used by dentists, may also have different risks and side effects.
Here is an overview:
Whitening toothpastes with abrasive ingredients are really not bleaching products at all, but work on surface stain only. These products are sold in many stores.
Some whitening toothpastes do contain a chemical ingredient (or "bleach") that causes a chemical reaction to lighten teeth. Generally, they have the lowest amount of "bleach." They may not whiten as well as stronger products, but they have less chance of side effects. These pastes are brushed onto teeth and rinsed off, like regular toothpaste.
Bleaching kits sold in stores stay on your teeth longer than toothpaste and contain stronger "bleach". These store-bought products do not come with the added safety of having your dentist monitor any side effects. They also come with a one-size-fits-all tray that holds the "bleach" and is more likely to leak the chemical into your mouth.
Dentists may use products with stronger "bleach", but they give patients careful instructions to follow. They are also trained to spot and treat the side effects that patients sometimes report during bleaching. In addition, if a tray is needed to apply the "bleach", dentists supply custom-made trays. Because products used by dentists are strong, they tend to produce the best results.
Patients should be aware that the long-term use of whitening or bleaching products may cause tooth sensitivity or tooth abrasion. Please consult with your dentist before using a whitening or bleaching product.
My dentist is recommending treatment (I know nothing about). What should I do?
Ask questions. It sounds simple enough, but sometimes we feel embarrassed to ask simple questions. There is no need to feel that way.
You will feel much better, and be able to make a better decision, if you understand the dental procedure that is recommended to you. If you don't say anything, your dentist may think that you already understand.
Here are some tips when asking questions. Ask:
- If you can see any pictures of the procedure or what it looks like when it is done;
- How many times your dentist has done this procedure in the past;
- How much it will cost;
- How long it will take;
- If it will need to be redone in the future;
- If there are alternatives to the procedure and if so, what are the pros and cons of each option.
The final decision about how and when to proceed with any treatment is yours. To help you understand what is involved in the treatment, your dentist may give you some printed material to read.
If you have already left the dental office without asking questions, call back later. Be careful about getting information from unknown sources, including sources on the Internet. Some of this information may not be reliable.
After all your questions have been answered, if you are still uncertain, you may wish to get a second opinion from another dentist. Often, a second opinion will give you confidence that your dentist has planned the right treatment for you.
How do I make a formal complaint concerning the professional services received in a dental office in Canada?
CDA is not responsible for handling complaints since we have no mandate to regulate dentists. Formal complaints concerning the professional services received in a dental office are handled by your provincial regulatory body.
A directory of provincial dental regulatory authorities is available on CDA's website at: Regulatory Authorities & Provincial Associations.
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