Encourage daily mouth care

Be alert to signs of dental problems

Keep mouth moist

See the dentist at least once a year

Large amounts of bleeding from the mouth or gums.

Everyone's gums bleed a little. Sometimes blood gets mixed with saliva and looks like a lot, but it really isn't. Severe bleeding, should be checked by a doctor or dentist since it can be an early sign of oral cancer.

Severe swelling.

A swelling the size of a golf ball near the eye, on the upper or lower jaw, or on the neck, may be a sign of a serious infection especially if accompanied by a fever. Serious infections can spread to other areas of the body and can become life threatening.

Severe pain in the mouth.

Severe pain may be caused by a decayed tooth or gum ulcer. If the older person is unable to tell you about pain, there are several ways that a person can non-verbally show they are in pain: noticeable changes in behavior (such as slapping of the face) and/or changes in eating habits (going off food).

Trauma to the mouth from a bad fall leaving cuts, abrasions, bleeding, and/or fractured bones.

The older person should be seen by a doctor or oral surgeon immediately.

A broken denture, tooth, or filling.

Dentures can be repaired within a day or two. Broken teeth usually can be repaired, though, in some cases, they may need to be pulled.

Trouble chewing.

This may happen if the older person has lost some teeth. A denture or partial denture may be the answer.

Loose teeth.

Loose teeth are a sign of advanced gum disease. Loose teeth can usually be saved with treatment, even if there is a lot of bone loss around the teeth.

Sore mouth.

This can be caused by certain medicines, lack of saliva, or a cut from a sharp tooth or denture.

Bad breath.

Gum disease or plaque and tartar on the teeth can cause bad breath. Bad breath should go away if the older person: brushes daily, flosses, and makes regular checkups with the dentist. If the problem does not go away, contact your dentist or doctor.

Bleeding gums.

Plaque can cause bleeding gums. By performing daily mouth care, plaque disappears and gums stay healthy.

Redness or white film or "curd" in the mouth.

People with dry mouth and who have certain diseases are more likely to get yeast infections in the mouth. If there is redness or a white curd that can be wiped away, these are signs of a yeast infection. A doctor or dentist can treat the infection with an anti-fungal medicine.

If dentures are loose, or if the older person is using denture adhesives.

If someone has to use an adhesive, it is a sign that the dentures do not fit well. Make an appointment with the dentist. A new set of dentures or relining of the dentures will make dentures more comfortable and may make adhesives unnecessary.

Where is the problem? Is it a particular tooth or area of the mouth?

How long has the problem lasted?

Is there pain?

Is there bleeding?

Is there swelling?

If the problem was caused by trauma, like a fall, describe what happened.

Be sure proper brushing techniques are used.

Plaque should be removed from the front, back, and chewing surfaces of the teeth by brushing in small back and forth (side to side) or circular motions. Be sure to pay close attention to the area where the teeth meet the gum line. The goal is to remove all the plaque that accumulates there on a daily basis. Ask your dental hygienist or dentist to show the older person the proper way to brush teeth.

If the older person is having problems using a regular toothbrush, an electric toothbrush may be easier to use. Ask the dentist to show you or the older person how to use it. Other ways to make brushing easier include the following: make a larger grip for the brush handle by wrapping it with aluminum foil or masking tape, buy a toothbrush with a larger handle, or make the handle longer by attaching a piece of wood or another toothbrush handle. Use a floss holder to make flossing easier.

If you are going to brush the older person's teeth, stand behind and to the right of the person (if you are right-handed). Always start with the same tooth. Clean the surface of every tooth, moving from one tooth to the next. Move the brush in a soft circular motion. Brush the tongue, roof, and inside of cheeks (if the older person is bedridden, use cloth or a piece of cotton gauze to do this). Ask the dentist or dental hygienist to show you how to brush someone else's teeth.

Use a toothbrush with soft, rounded bristles.

Hard bristles can damage teeth and gums.

Remove dentures at least 6 hours every day.

Dentures should be taken out before bedtime. This relieves the gums from the pressure of the dentures. Dentures should be stored in water when not in use so they do not warp. Use fresh water each time you store the dentures.

Scrub dentures daily.

Fizzy tablets will not do the job. Dentures should be scrubbed with a denture brush every night or after every meal. Denture creams (available at drug stores) and liquid detergents are good.

Learn how to handle dentures.

If you feel uncomfortable about removing dentures, talk to your dentist or dental hygienist. They can teach you how to handle and remove dentures.

Replace toothbrushes.

Get a new toothbrush every three months or after a major illness.

Encourage stopping smoking.

Smoking causes gum disease, dry mouth, and has been linked to oral cancer.

Take an active role with dental appointments.

Encourage the older person to make dental appointments or, if necessary, make appointments for him or her. At the dentist's office, be available to explain problems and write down the answers. Have the dental hygienist explain things to both you and the older person. If the dentist suggests a special kind of toothbrush or cleaning aid, offer to help the older person choose the one that is best suited to his or her needs.

Examine the mouth once a month.

Check for early signs of disease. Inspection can reduce the risk of serious problems developing.

Ask about artificial saliva.

Artificial saliva makes the mouth more comfortable. You can buy artificial saliva such as Optimoist, Oralbalance gel, Mouthkote, and Salivart at the pharmacy. Also, water soluble gels like K-Y Jelly can be used. It lasts for a longer time in the mouth than artificial salivas.

Rinse the mouth before meals and throughout the day.

Rinse with water or a salt solution, using one teaspoon of salt in one quart of water. Do not use mouthwashes with alcohol because they dry out the mouth.

Use a lip moisturizer before eating.

Use petroleum jelly, lip salve, or cocoa butter on the lips. If lips are moist, food is easier to chew.

Encourage sipping 1 to 2 quarts of liquid a day.

Eating ice chips, sugar-free popsicles, frozen juices, or frozen drinks are good ways to take in liquid.

Encourage dunking bread, crackers, and baked foods in coffee, tea, milk or soup to make them moist.

Moistening food is another way to fight dry mouth. Dip bread in soup, shredded meat in marinade, or toast in coffee. Use sauces and gravies to moisten food, making it easier to chew and swallow.

Be on the lookout for dental problems and make appointments with the dentist as soon as they are noticed. Make sure the older person brushes and flosses on a daily basis. Make an appointment with the dentist at least once a year, even if the person has few or none of his or her own teeth and wears dentures.

Remember to examine the mouth regularly and ask the older person if there are teeth or mouth problems. Examine dentures. Check that they fit comfortably. They should not drop from the gum line when speaking or eating.

Some problems will improve quickly while others will take more time. For example, gingivitis should clear up after two weeks of good daily mouth care. Treatment for more serious gum disease can last up to six months or longer. Yeast infections will disappear in just a few days with anti-fungal treatment.