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Dementia and Oral Health

Dementia makes mouth care harder over time, and someone who cannot explain their pain may show it in other ways. Here is why dental care matters, how to plan it early, and where families and carers can get help.

Updated September 2026·By the OHA editorial team·8 min read·How we write
Key takeaways
  • As dementia progresses, people need more help with mouth care. Let them do as much as they can for as long as they can.
  • See a dentist soon after a diagnosis, while treatment is easier to cope with, and agree a plan for the future.
  • Pain may show as eating less, touching the face, refusing mouth care, restlessness, poor sleep or aggression. Do not put these down to dementia without checking the mouth.
  • Keep dentures in use for as long as possible, mark them with the person's name, and take them out at night.
  • In England, NICE says care homes should assess each resident's mouth care needs when they move in and support daily brushing.

The Alzheimer's Society says that for someone with dementia, looking after their teeth and gums can become increasingly difficult. The Australian Dental Association says people with dementia can be at greater risk of poor oral health, including people with Alzheimer's disease, vascular dementia, Parkinson's disease and Huntington's disease.

For step-by-step brushing and denture cleaning, see caring for someone else's teeth.

Why does mouth care get harder?

The Alzheimer's Society says a person with dementia may:

  • forget their mouth care routine or dental appointments
  • struggle to do tasks in the right order, hold a toothbrush or judge distances, such as putting toothpaste on a brush
  • lose interest because of low mood, tiredness or apathy
  • find dental treatment hard to accept, or be unable to say they are in pain.

Dementia can also change the mouth itself:

  • Dry mouth. The Australian Dental Association says medicines used to treat dementia can reduce saliva, which raises the risk of tooth decay and can make dentures uncomfortable. Dementia Australia adds that changes in brain function can reduce saliva too. The Alzheimer's Society says it is common for people with dementia not to drink as much as they need. See dry mouth.
  • Diet. Dementia Australia says eating habits can change, with snacks replacing meals and sucking on sweets, and that sugary medicines can cause decay. The Australian Dental Association says soft or modified diets in aged care can be high in sugars and refined carbohydrates.

See a dentist soon after diagnosis

The Alzheimer's Society says it is a good idea to see the dentist soon after a diagnosis. The dentist can find and treat problems before treatment becomes too difficult to tolerate, and may agree a plan for the future, such as removing teeth likely to cause trouble later. The American Dental Association (ADA) also suggests dealing with dental needs early, while the person can cooperate.

When booking, the Australian Dental Association suggests:

  • telling the practice about the dementia diagnosis
  • taking a full medical history and list of medicines
  • choosing a time that suits the person's routine; a morning may be best if they experience sundowning, which the Alzheimer's Society describes as changes in behaviour, such as distress or agitation, in the late afternoon or early evening.

Both it and the Alzheimer's Society say to keep seeing the same dentist for as long as possible.

Signs of mouth pain in someone who cannot tell you

In the later stage of dementia, a person may not understand their pain or be able to ask for help (Alzheimer's Society). Signs listed by the Alzheimer's Society and Dementia Australia include:

  • struggling to eat or refusing food, especially hard, very hot or very cold food, or loss of appetite
  • frequently touching or pulling at their face or mouth, or a swollen face
  • leaving their dentures out
  • restlessness, moaning or shouting, or disturbed sleep
  • refusing mouth care, or increased agitation or aggression.

The Alzheimer's Society says not to dismiss these as part of dementia. It suggests pointing to your own teeth, watching for wincing during brushing and looking in the mouth for swelling or bleeding, and noting when the signs started and whether painkillers helped. The ADA says someone who keeps resisting brushing may be in pain.

Making mouth care easier

Helping them understand. Oxford Health NHS Foundation Trust suggests making sure the person has their glasses and hearing aids, approaching from the front, introducing yourself each time, and giving one short instruction at a time. The US National Institute on Aging (NIA) suggests talking them through each step, such as "take the cap off" and "put the toothpaste on the toothbrush".

The setting. Oxford Health says the bathroom is familiar and can help, but in the later stages a person may not recognise themselves, so a mirror can confuse them and another room may be better. Music they enjoy may help them relax.

If they refuse. Oxford Health describes "rescuing": another carer takes over, and the person may accept them. If you are alone, step out, wait a minute and try again. The ADA suggests a different time of day, a different toothpaste flavour or warm water. The Australian Dental Association describes yawning in front of the person, which may prompt them to open their mouth.

If they bite the brush. The NIA says a child's size toothbrush can help.

Make a plan. The Australian Dental Association says people with dementia should have a mouth care plan specific to their needs. Oxford Health suggests recording how the person likes their mouth cared for.

Consent

The Alzheimer's Society explains that under the Mental Capacity Act 2005 a person with dementia is assumed able to make their own decisions, including refusing treatment, unless the dentist assesses otherwise. If they cannot decide, someone legally authorised, such as a health and welfare Lasting Power of Attorney, may decide in their best interests.

Dentures and dementia

  • Keep them in use. The Alzheimer's Society says the person should ideally keep wearing dentures as long as possible, or they may struggle to eat foods they enjoy. A denture fixative can help some people, though it has to be replaced daily and can taste unpleasant.
  • Lost and broken dentures are common. The Alzheimer's Society says new ones can take many weeks and several appointments, and some people never get used to them. Dementia Australia suggests asking your dentist how long they keep the moulds from which dentures are made.
  • Mark them with the person's name, especially in residential care or hospital (Alzheimer's Society, Australian Dental Association).
  • Take them out at night and clean them (Alzheimer's Society). In the advanced stages, the ADA says gums under dentures can be sore and fragile, so wipe the mouth with a soft cloth dipped in water.

See dentures for everyday care.

Care homes

In England, NICE guideline NG48 says care homes should:

  • assess each resident's mouth care needs as soon as they move in, and record them in their care plan
  • support residents to brush natural teeth at least twice a day with fluoride toothpaste, and to clean dentures and remove them overnight
  • make sure staff understand how untreated dental pain can affect the behaviour of people, including those with dementia, who cannot explain it.

The Alzheimer's Society suggests sharing any mouth care plan with staff and asking the manager how dental care is arranged. In the US, the ADA says long-term care facilities must by law provide routine and emergency dental care.

When a regular dentist can no longer help

  • UK: the Alzheimer's Society says the person may be referred to a community dental service or special care dentistry, and a dentist may be able to visit at home. Treatment under sedation or general anaesthetic carries risks, so should be discussed with the person and their family. See dental sedation.
  • Australia: the Australian Dental Association says specialists in special needs dentistry work in some states and territories. Dementia Australia suggests a dental hospital for people eligible for public dental care.
  • US: the NIA suggests looking for a dentist experienced in treating people with Alzheimer's, and mentions mobile dentistry.

Where to get help

  • UK: Alzheimer's Society Dementia Support Line, 0333 150 3456.
  • Australia: Dementia Australia's National Dementia Helpline, 1800 100 500, 24 hours a day.
  • US: the NIA lists the Alzheimer's Association helpline, 800-272-3900, and its own Alzheimer's and related Dementias Education and Referral (ADEAR) Center, 800-438-4380.

For help with costs, see dental costs and help and finding a dentist.

When to see a dentist
  • The person shows signs of mouth pain, is eating less, or keeps refusing mouth care.
  • Their gums are red, swollen or bleeding for more than a few days, the corners of the mouth are cracked or sore, or you see red or creamy white patches (Alzheimer's Society).
  • Their dentures are loose, broken or lost, or their gums are sore.
  • They have just been diagnosed and have not seen a dentist recently.
Get help urgently
  • A possible dental abscess, which the Alzheimer's Society says can be very painful and distressing: in the UK, the NHS says ask for an urgent dentist appointment or contact NHS 111.
  • Call 999 or go to A&E (or your local emergency number) if they are finding it hard to breathe, speak, swallow or open their mouth, or have a lot of swelling in the mouth (NHS).

Frequently asked questions

Does gum disease cause dementia?

This has not been shown. A 2020 NIA research summary describes a large US study that linked gum disease and mouth bacteria with later Alzheimer's disease, but notes that this kind of research can find a link without proving cause, and that dementia itself makes brushing harder. It says clinical trials are needed.

Should someone with advanced dementia still wear dentures?

Ideally yes, for as long as they can, because without them eating is harder (Alzheimer's Society). If they can no longer keep them in, ask their dentist.

What if they will not let me brush their teeth?

Try another time or another carer, and consider pain as a reason (Oxford Health, ADA). If it continues, contact their dentist.

Sources

  1. Dental and mouth care, Alzheimer's Society, accessed September 2026
  2. Dentures and dementia, Alzheimer's Society, accessed September 2026
  3. Dental treatment and dementia, Alzheimer's Society, accessed September 2026
  4. Sundowning and dementia, Alzheimer's Society, accessed September 2026
  5. Dental care, Dementia Australia, accessed September 2026
  6. Dementia and its effect on oral health, Australian Dental Association, accessed September 2026
  7. Oral health for adults in care homes (NG48): recommendations, NICE, accessed September 2026
  8. Oxfordshire Community Dental Service: memory loss and mouth care, Oxford Health NHS Foundation Trust, accessed September 2026
  9. Dental abscess, NHS, accessed September 2026
  10. The caregiver's guide to dental health, American Dental Association (MouthHealthy), accessed September 2026
  11. Alzheimer's caregiving: bathing, dressing, and grooming, NIH National Institute on Aging, accessed September 2026
  12. Large study links gum disease with dementia, NIH National Institute on Aging, July 2020, accessed September 2026

This article is general information about oral health. It is not a diagnosis or a substitute for advice from a dentist or doctor who knows your situation. If you have pain, swelling, bleeding that does not settle, or a problem that is getting worse, see a dental professional. In an emergency, contact your local emergency service.

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