Do you have a parent or loved one who lives in a care facility or utilizes assisted living? Whether it’s your in-laws, parents or an aging family friend, you want to be there to support their overall health and well-being. Sometimes distance or hectic schedules can make it difficult to have a watchful eye on your loved one’s wellness.

Oral health can be easily overlooked until dental issues become painful and severe—especially in long-term care facilities. Here are five key questions you can ask the team at your loved one’s nursing home or assisted living facility to ensure their oral health is a priority:

What policies are in place to ensure residents are following their daily oral health care routine?

• This will vary by facility. Assisted living facilities providing limited care and a focus on independent living, for example, may not provide daily reminders to residents about brushing and flossing. Skilled-nursing facilities may include brushing and flossing as part of residents’ morning and bedtime routines.
• The guidelines for brushing and flossing for older adults is the same: Brush for 2 minutes twice a day with a fluoride toothpaste and floss daily.

What assistance is provided to residents who are unable or unwilling to properly brush and floss?

• For older adults with poor hand coordination or a condition like arthritis that affects manual dexterity, brushing and flossing may be uncomfortable or difficult. Electronic toothbrushes are often easier to grip and can make brushing easier.
• Older adults with dementia often neglect their oral health care and can be resistant to help. Find out what solutions are in place to ensure good dental health in these situations.
• Specialized oral hygiene products may be available to make it easier to brush and floss effectively.

Are dental devices, such as dentures, cleaned and maintained?

• Failure to properly care for dentures could result in discomfort or infection. Make sure the care team knows how to care for dentures and that dental checkups are provided periodically to ensure a proper fit.

Do residents have access to regular oral health care from trained dental professionals?

• Federal law requires long-term care facilities to provide residents with preventive and emergency dental care. Each facility should have an agreement with a dental professional to deliver oral health care services and make referrals.
• Some care facilities will have a dental provider visit twice a year to perform examinations on older adults who have limited mobility. Others take patients to the dentist. See what the set-up is for your loved one.

How often do residents receive a dental exam and/or cleaning?

• Most people should visit the dentist for an exam and cleaning 1-2 times a year. People with poor oral health or specific health conditions may require more frequent dental visits.
• Dry mouth, tooth decay, tooth loss, and tooth sensitivity are common problems older adults experience that may require extra attention from a dental professional.

It’s also a good idea to check in with your loved one’s care team periodically for updates on their oral health. Ideally, you’ll be able to do this in person and work with the staff to set up or continue a dental care routine that your loved one can easily participate in. This may include scheduling dentist visits for the year and determining how they will get to those visits. If transportation is not available, consider alternative resources. Eldercare Locator is a public service supported by the U.S. Administration on Aging. It can connect you and your loved one with transportation services to get them to their dentist and doctor appointments.

Maintaining oral health at any age is an ongoing practice. Make sure your loved one’s smile is being cared for on a daily basis.

Chemotherapy and radiation are often used to treat cancer. Cancer treatments can cause oral side effects with your mouth, altering your ability to eat, talk, and swallow. You’ll want to promptly address these problems, so they don’t cause a delay in treatment. That’s why it’s vital to understand the most common side effects of cancer treatments.

Dry mouth

Radiation, especially in the head and neck area, can damage salivary glands and cause extreme dry mouth. To help prevent tooth decay and mouth infections, you will need to actively manage dry mouth by:

• Drinking lots of water to keep your mouth moist.
• Avoiding spicy and salty foods.
• Chewing sugar-free gum.
• Sucking on ice chips or sugar-free hard candy (just don’t bite down!).
• Asking your dentist about a saliva substitute or other remedies.

Mucositis

Oral mucositis, a potentially painful side effect of chemotherapy, occurs when cells that line the mouth become swollen, irritated, and inflamed. This can happen because chemotherapy breaks down both cancer cells and healthy cells.

The most common symptoms include redness and swelling in the gums, sores in the mouth and throat, burning and aching in the mouth, and abdominal cramps and tenderness.

As with dry mouth, you can manage the pain by drinking plenty of fluids, using lip balms or creams, brushing and flossing regularly, and sucking on ice chips. Avoid smoking, alcohol, and eating spicy, acidic and rough or hard foods. Look for non-alcoholic mouthwashes and steer clear of toothpastes that contain sodium lauryl sulfate (SLS), which can irritate the tissues that line the mouth and worsen mucositis.

Change in ability to taste

When undergoing cancer treatments, foods can taste different than they previously did or may seem to have no flavor at all. Radiation therapy may cause a change in sweet, sour, bitter, and salty flavors. Chemotherapy drugs may cause an unpleasant chemical or metallic taste in your mouth.

If this happens to you:

• Try marinating or adding herbal spices to a bland dish.
• Switch to other high-protein foods such as chicken, eggs, fish, turkey, beans, or dairy products when red meat tastes off.
• Use plastic utensils and non-metal cooking dishes if food tastes metallic.
• Try sugar-free hard candies, gum, or mints to get a bad taste out of your mouth.

Sometimes patients receiving head and neck cancer treatments cannot tolerate the flavor of their regular toothpaste. Don’t let this interfere with your oral hygiene. Try other flavors to find one that won’t irritate your mouth.

Schedule an appointment with your dentist before you begin chemotherapy or radiation treatments. Your dentist can treat any current issues and show you how to take care of your mouth to help prevent or alleviate side effects. It’s likely your dentist will also prescribe a higher strength fluoride toothpaste. Continue to take good care of your mouth during treatment and visit your dentist regularly.