How do you help a parent with dementia who has a toothache?

When a parent has dementia, they may not be able to tell you their tooth hurts. Instead, pain may show up through changes in eating, sleep or behavior. Knowing what to look for, and what to do, can help you get them the care they need. 

What you will learn in this article: 

• People with dementia may show dental pain through behavior changes instead of words. 

• There are simple comfort steps you can take while you arrange professional care. 

• A calmer dental setting and simple communication can make the visit easier. 

• Daily mouth care may require more caregiver help as dementia progresses. 

If you are concerned about a parent’s dental health, schedule an appointment with an Aspen Dental provider who can work with you and your parent's care team. 

Why dental pain is easy to miss in someone with dementia 

People with dementia may not always be able to tell you when they're in pain. The National Institute on Aging notes that pain may show up through changes in behavior, facial expressions, sleep or eating instead.¹ 

That can make it easy to mistake for a change in dementia symptoms. Pay attention to behaviors that are new or suddenly worse. 

What are the behavioral signs that may point to dental pain? 

Watch for signs such as:¹ 

• Refusing to eat or having trouble during meals 

• Increased agitation or restlessness 

• Crying or moaning 

• Grimacing or looking uncomfortable 

• Trouble sleeping 

• A sudden change in behavior with no clear cause 

None of these signs confirms a toothache on its own. But a new behavior change, especially around eating or mouth care, is worth taking seriously. 

What can you do at home right now? 

If you suspect your parent has dental pain, there are a few safe steps you can take while you arrange a dental visit. These are comfort measures only. They do not replace professional care. 

Check your mouth carefully 

With clean hands and good lighting, gently look inside your parent's mouth. You are looking for anything obviously wrong: a broken tooth, swollen gum, redness or visible decay. Do not probe or press. If your parent resists, do not force it. Even a brief look can give you useful information to share with the dentist. 

Offer soft, cool foods 

Hard, crunchy or hot foods can make dental pain worse. Offer soft options like yogurt, mashed potatoes, scrambled eggs or cool (not cold) foods. If your parent is eating more comfortably on one side, note which side. This detail helps the dentist narrow down the problem. 

Use over-the-counter relief carefully 

Before giving your parent an over-the-counter pain medicine, check with their physician or pharmacist. The safest choice can depend on their health conditions and the other medicines they take. Do not give more than the product label or their healthcare professional recommends. 

How to prepare for the dental visit 

A dental visit may take more planning when your parent has dementia. The American Dental Association (ADA) recommends reducing noise and distractions, keeping instructions short and simple and allowing a trusted caregiver to provide reassurance when appropriate.² 

Call ahead and explain the situation 

Tell the office your parent has dementia when you make the appointment. Share anything that helps them stay calm, including how they respond to new people, touch or instructions. 

Bring the right information 

Bring a list of current medications, known allergies and important medical information. Let the dental provider know about behaviors that could affect the exam, such as trouble following instructions or resistance to opening their mouth. 

Time the visit strategically 

Choose a time of day when your parent is usually calm and alert. Avoid times when they are often tired, hungry or agitated. 

Stay in the room 

Your presence can reduce your parent's anxiety. Ask to stay with them during the exam. You can hold their hand, speak calmly and help the dental provider understand what your parent is trying to communicate. 

Why dental health becomes harder to manage as dementia progresses 

Dental problems can become easier to miss as dementia progresses. The ADA notes that people with dementia often have a harder time keeping up with brushing and flossing at home, which raises their risk for cavities, gum disease and other oral infections.² 

A parent who once brushed and cleaned their teeth independently may gradually need reminders or hands-on help. Regular home care and dental visits can help catch problems before they become more painful or harder to treat. 

Staying ahead of dental issues (rather than waiting for a crisis) is one of the most practical things a caregiver can do. 

Keeping up with daily mouth care at home 

Daily mouth care may become harder as dementia progresses, and your parent may increasingly need hands-on help with brushing and flossing. The ADA recommends brushing for two minutes twice a day with fluoride toothpaste and cleaning between the teeth once a day.³ 

If your parent needs help, try these approaches: 

• Use good lighting so you can see inside the mouth. 

• Keep your parent in a comfortable position. 

• Explain what you are going to do before you start. 

• Give one simple instruction at a time. 

• Consider a powered toothbrush if it is easier for your parent to use. 

• If your parent resists, try again at a different time of day. 

• If they wear dentures, clean them every day and remove them before bed. 

If daily mouth care is becoming harder or your parent seems uncomfortable, talk with your dental provider. They can check for problems that may be causing discomfort and help you find ways to support their oral health. 

How do you help a parent with dementia who has a toothache? FAQs 

Still have questions about dental care for a parent with dementia? These answers cover a few common concerns.  

What if my parent refuses to open their mouth at the dental office? 

This is common, and experienced dental providers know how to handle it. Let the office know in advance. A dental provider may use a shorter exam, a mouth prop or a different positioning approach. In some cases, sedation dentistry is an option for patients who cannot cooperate with standard care. Ask the dental provider what they recommend based on your parent's specific situation. 

Is sedation dentistry safe for someone with dementia?  

It can be, but it requires careful coordination. Sedation affects older adults differently than younger patients, and some dementia medications interact with sedatives. Your parent's dental provider and primary care physician should review the plan together before any sedation is used. When a patient cannot cooperate with standard care, sedation is sometimes considered the most appropriate option. That decision should always involve the full care team. 

How often should someone with dementia see a dental provider? 

At least twice a year, and more often if they have a history of gum disease, dry mouth or denture problems. Regular professional dental care is important for older adults with cognitive impairment. More frequent visits make it easier to catch problems early, before they become painful. 

Sources 

¹ National Institute on Aging: “Taking a Person With Alzheimer's Disease to the Hospital.” https://www.nia.nih.gov/health/alzheimers-caregiving/taking-person-alzheimers-disease-hospital 

² American Dental Association: “Aging and Dental Health.” 

 https://www.ada.org/resources/ada-library/oral-health-topics/aging-and-dental-health 

³ American Dental Association, MouthHealthy: “The Caregiver’s Guide to Dental Health.” https://www.mouthhealthy.org/life-stages/adults/caregivers-guide-adults-over-60