Alzheimer’s Disease, Dementia, & Oral Health: What You Need To Know

Alzheimer’s disease and dementia can significantly impact a person’s oral health. In this article, MDA dentists explore this link and discuss the oral hygiene challenges those with Alzheimer’s disease and dementia face. We’ll also cover common dental problems associated with these illnesses and offer tips for caregivers to help their loved ones maintain good oral health.

Understanding Alzheimer’s Disease & Dementia

Alzheimer’s disease and dementia are progressive brain disorders that lead to problems with memory, thinking, and behavior1,2. As these diseases worsen, everyday tasks like brushing and flossing can become difficult. All too often, this leads to poor oral health. Poor oral hygiene habits may also make Alzheimer’s disease and dementia symptoms worse and cause discomfort, pain, and even serious infection2.

The Connection Between Cognitive Decline & Oral Health

People with Alzheimer’s disease and dementia have more difficulty keeping their mouths healthy as a result of physical and mental limitations. Poor oral health can lead to difficulty chewing and swallowing. Making it hard for people with Alzheimer’s and dementia to eat and get proper nutrition. Changes in pain perception and cognitive decline may make it difficult for someone to know when they are experiencing a dental issue and to tell someone about it3.

Common Dental Complications Associated with Alzheimer’s & Dementia

People living with Alzheimer’s and dementia often face a variety of dental complications due to poor oral hygiene, changes in saliva production, and other lifestyle factors. Common dental issues and denture-related problems may include:

  • Increased risk of tooth decay, gum disease, and tooth loss due to poor oral hygiene practices4.
  • Higher likelihood of developing multiple or severe dental cavities5.
  • Dry mouth as a result of aging and certain medications, leading to difficulties in swallowing and speaking.
  • Untreated dental issues can cause serious infections that have the potential to spread throughout the body and impact overall health6.
  • Challenges in maintaining denture and gum hygiene due to cognitive impairment and physical limitations, leading to mouth lesions, ulcers, and infections7.

Maintaining good oral health, including proper denture care, helps individuals with Alzheimer’s and dementia prevent further complications and safeguard their overall well-being.


It’s common for those with Alzheimer’s disease and dementia to forget to remove their dentures before going to sleep at night. Frequently sleeping with dentures can lead to a painful gum infection called denture stomatitis7.

Connecting Dental Plaque & Gum Disease to Alzheimer’s & Dementia

While we do not yet know the exact mechanisms behind the connection, researchers have found a strong link between dental plaque buildup and gum disease (gingivitis) and Alzheimer’s disease and dementia. In fact, having one of these conditions increases the risk of developing the other4.

Alzheimer’s & P. Gingivalis: The Gum Disease Bacteria

Researchers are investigating the link between dental plaque, a sticky bacteria buildup in our mouths, and Alzheimer’s disease. Some studies have discovered the presence of a specific oral bacteria called P. gingivalis (commonly known as the gum disease bacteria) inside the brains of people with Alzheimer’s disease. It has been suggested that this bacteria could cause swelling and damage to brain cells, leading to memory problems and other symptoms of Alzheimer’s disease8.

Recently, researchers have been looking into the possible connection between P. gingivalis in dental plaque and the onset of Alzheimer’s disease8. However, more studies are needed to figure out the exact nature of this relationship.

Poor Oral Hygiene & Dental Plaque

When people do not or cannot brush their teeth regularly and pay close attention to their oral health, this can lead to a buildup of dental plaque. Too much plaque can cause gum disease, a chronic infection in the gums. In severe cases, excessive dental plaque buildup can lead to aspirational pneumonia, a dangerous lung infection. This can be life-threatening for frail and medically compromised individuals with Alzheimer’s disease or dementia6.

Gum Disease & Cognitive Decline

Cognitive and physical decline can make people more likely to develop gum disease (gingivitis) due to poor oral hygiene habits and increased levels of oral bacteria. Gum disease is an active infection that harms the gums and mouth’s soft tissues, causing swelling, redness, and gum bleeding. If not treated, it can worsen from gingivitis into a more severe form of infection called periodontitis.

As gingivitis progresses into periodontitis, plaque builds up beneath the gum line. Causing deep pockets of infection to form between the teeth and gums. As the infection spreads, the body starts to attack itself, damaging the soft tissues and bones that support the teeth. In the end, periodontitis destroys the jawbone, causing painful tooth loss and bone loss9.

This active infection can spread to other areas of the body, like the heart or lungs, where it can become life-threatening, especially for people with other health problems10. For people with Alzheimer’s disease and dementia, it’s important to treat gum disease and other issues early to protect their overall health. Keeping up with good oral hygiene habits and getting regular dental care can help lower the risk of infection from gum disease spreading.


All of these conditions may run in families. If one or more is prevalent in your family, MDA dentists and healthcare professionals recommend adopting a proactive approach to both oral and overall health. This includes routine dental care, where you are closely monitored for signs of gum disease, and regular dental cleanings that focus on plaque removal, performed by an MDA dentist or dental hygienist.

Routine Dental Care for People Living with Alzheimer’s & Dementia

Regular dental checkups and prompt treatment of dental issues are important for maintaining good oral health, especially for people with Alzheimer’s disease and dementia. MDA dentists recommend that patients visit at least every six months for a dental checkup and come in immediately if they experience a dental issue. Routine care can help identify and address dental problems, such as early signs of tooth decay or gum disease before they get worse2.

Challenges & What to Expect at the Dentist

For people with Alzheimer’s disease and dementia, going to the dentist can be very stressful and confusing. The key to providing good care for people living with these conditions is keeping them calm and comfortable at their dental appointments.

MDA dentists are medically trained to work with people with Alzheimer’s disease and dementia. They understand the unique challenges and oral health risks they face. MDA dentists and their dental care team focus on patient comfort and clear communication during treatments to help patients feel at ease. They may use strategies like speaking slowly and clearly, using short sentences, and providing simple instructions. Visual aids, like pictures or diagrams, may also be used11.

Personalized Care: Paying Attention to Patient Comfort

Individualized strategies are essential for reducing patient stress and improving the dental care experience, especially for people with Alzheimer’s disease and dementia. MDA dentists and their care team know that providing the best care all comes down to what will make the patient the most comfortable. In advance of a visit, be sure to discuss any special considerations and needs with the dental care team.

At a dental visit, personalized strategies can make the patient feel more at ease. These may include:

  • The caregiver remains present during the appointment.
  • The patient brings a comforting object like a stuffed animal to hold during the visit.
  • Breaking complicated treatments into several shorter visits.
  • Scheduling visits during quiet times to avoid loud noises and busy environments.
  • Choosing early morning appointments, as many with cognitive decline feel their best earlier in the day12.

MDA Dentists: A Valuable Resource for Caregivers

MDA dentists and their dental care teams are dedicated to working closely with caregivers, offering guidance on oral hygiene techniques and specialist referrals when necessary. It’s always okay to ask them questions about your loved one’s oral health. MDA dental care teams are accustomed to talking with caregivers about complicated and difficult dental issues. They are a supportive resource, offering advice and tips for promoting consistent at-home daily care and providing compassionate care.


Use the MDA’s Find-A-Dentist tool to find an MDA dentist near you. Inform the dental care team about any Alzheimer’s or dementia diagnoses before the initial visit. Some practices may refer you to colleagues who specialize in geriatric dentistry or in treating medically vulnerable individuals.

Daily Strategies for Caregivers

Caregivers are vital in promoting oral health for those with Alzheimer’s and dementia13. MDA dentists understand how difficult it can be to ensure your loved one follows a daily oral care routine when they live with Alzheimer’s disease or dementia. Here are some strategies that you may use to help your loved one maintain good oral health:

  • Develop a consistent routine for brushing with fluoride toothpaste and flossing at the same time every day.
  • Encourage and assist with oral hygiene as needed.
  • Consider using electric toothbrushes or assistive devices designed for individuals with limited dexterity13.
  • Help make sure dentures are cleaned and maintained regularly.
  • If necessary, help remove dentures at night, so they are not worn while sleeping7.
  • Pay attention to soft-tissue health, checking for signs of inflammation or infection in the mouth.
  • Promote a balanced diet of fruits, vegetables, whole grains, and lean proteins to support good oral health.
  • Limit sugary snacks and sweet and acidic drinks that contribute to tooth decay, including pop, juice, sports drinks, and sweetened coffee beverages.

Drawing Connections

Understanding the connection between Alzheimer’s disease, dementia, and oral health helps caregivers and healthcare providers provide compassionate care for those living with these conditions. With support from an MDA dentist, caregivers can help their loved ones maintain good oral health despite the challenges posed by these devastating illnesses.


  1. USAgainstAlzheimer’s. Alzheimer’s Disease: Get the Facts. UsAgainstAlzheimer’s 2023.
  2. Alzheimer’s Association. Dental Care. Alzheimer’s Association 2023.
  3. Foltyn P. Aging, dementia, and oral health. Aust. Dent. J. 2015; 60(1 Suppl)86-94. Accessed online:
  4. Kaliamoorthy S, Nagarajan M, Sethuraman V, Jayavel K, Lakshmanan V, Palla S. Association of Alzheimer’s disease and periodontitis – a systematic review and meta-analysis of evidence from observational studies. Med Pharm Rep. 2022;95(2):144-151. Accessed online: doi:10.15386/mpr-2278
  5. Daly B, Thompsell A, Sharpling J, et al. Evidence summary: the relationship between oral health and dementia. Br Dent J. 2017;223(11):846-853. Accessed online:
  6. Marchini L, Ettinger R, Caprio T, Jucan A. Oral health care for patients with Alzheimer’s disease: An update. Spec Care Dentist. 2019;39(3):262-273. Accessed online: doi:10.1111/scd.12375
  7. Delwel S, Binnekade TT, Perez RSGM, Hertogh CMPM, Scherder EJA, Lobbezoo F. Oral hygiene and oral health in older people with dementia: a comprehensive review with a focus on oral soft tissues. Clin Oral Investig. 2018;22(1):93-108. Accessed online:
  8. Dominy S, Lynch G, Ermini F, et al. Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Sci Advances. 2019 Jan 5;(1). Accessed online: doi: 10.1126/sciadv.aau3333
  9. American Academy of Periodontology. Gum Disease Information. American Academy of Periodontology 2023.
  10. Dioguardi M, Di Gioia G, Caloro GA, et al. The association between tooth loss and Alzheimer’s disease: a systematic review with meta-analysis of case-control studies. Dent J. 2019; 7(2):49. Accessed online:
  11. Gao SS, Chu CH, Young FYF. Oral health and care for elderly people with Alzheimer’s. Int J Environ Res Public Health. 2020 Aug 7;17(16):5713. Accessed online: doi:10.3390/ijerph17165713
  12. Alzheimer’s Association. Sleep Issues and Sundowning. Alzheimer’s Association 2023.
  13. Rozas NS, Sadowsky JM, Jeter CB. Strategies to improve dental health in elderly patients with cognitive impairment: A systematic review. J Am Dent Assoc. 2017;148(4):236-245.e3. Accessed online: