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Mouth care with a Collis Curve toothbrush

Key points

  • The Collis Curve toothbrush cleans three tooth surfaces at once, reducing the need for the person to follow complex instructions.
  • Approach from the dominant side, use a calm voice, and stop when the person shows signs of being done — even if the job is not perfect.
  • If swallowing is a concern, use baking soda toothpaste or just water instead of fluoride toothpaste.
  • Use a soft cloth or gauze to wipe the mouth if brushing is not tolerated.
  • Personalize the approach based on the type of dementia, stage, and relationship — what works one day may not work the next.
  • Always consult the dentist or doctor before introducing new oral care products or if there are medical concerns.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. Prepare the environment: Choose a calm time of day, ideally after a meal or before a preferred activity. Dim harsh lights, turn off the TV, and speak in a slow, warm voice. Gather everything you need: the Collis Curve toothbrush, a small cup of water, a towel, and a bowl for spit (if needed). If the person is in a wheelchair, lock the brakes and approach from the front so they can see you.

  2. Introduce the brush gently: Hold the Collis Curve where the person can see it. Say something like, 'Here is a special brush that will help clean your teeth quickly. Let me show you how it feels.' Let them touch the handle or bristles if they want. Do not rush. If they are suspicious, set the brush down and try again in a few minutes.

  3. Position yourself correctly: Stand or sit on the person’s dominant side. If they are right-handed, stand on their right; if left-handed, stand on their left. This reduces the feeling of being trapped and allows you to use your dominant hand to guide the brush. If the person is in bed, sit beside them and tilt their head slightly toward you.

  4. Use the Collis Curve motion: Gently insert the brush into the mouth, angling the curved bristles so they wrap around the teeth. Use a gentle back-and-forth or small circular motion. The curve will clean the outer, inner, and chewing surfaces simultaneously. Do not scrub hard — let the bristles do the work. Focus on one section at a time (e.g., upper right, then upper left).

  5. Offer a sip of water or a break: After 30–45 seconds, pause and offer a sip of water from a cup or a straw. Say, 'Good job. Let’s take a sip.' If the person is unable to spit, use a small bowl or a towel to catch excess water. If they resist spitting, simply wipe their mouth with a soft cloth and move on.

  6. Finish with a gentle wipe: When the person shows signs of being done (turning away, closing mouth, tensing), stop brushing. Use a damp, soft cloth or gauze to gently wipe the gums, tongue, and inside of the cheeks. This removes any remaining debris and provides a soothing finish. Say, 'All done. You did great.'

  7. Clean the brush and store it: Rinse the Collis Curve under warm water and let it air dry. Replace the brush every three months or sooner if the bristles become frayed. If the person uses dentures, clean them separately with a soft brush and soak them overnight.

What not to do

  • Do not force the mouth open: If the person clamps their mouth shut, prying it open can cause pain, fear, or a bite reflex. Instead, try a different approach: gently press on the cheek near the back teeth to encourage a slight opening, or use a mouth prop (available from a dentist or online) designed for dementia care. Alternatively, brush the outside surfaces only and use a damp cloth for the inside.

  • Do not use a regular toothbrush with hard bristles: A standard flat brush requires the person to open wide and follow complex instructions. Hard bristles can also irritate sensitive gums. The Collis Curve’s soft, curved bristles are designed to be gentler and more effective for assisted care. If you do not have a Collis Curve, use a soft-bristled child’s toothbrush as a temporary substitute.

  • Do not rush or show frustration: If the person senses your stress, they may become more agitated. Take deep breaths, slow down, and use a calm tone. If they resist, stop and try again later. Teepa Snow reminds us that 'Eddie was done' — meaning it is okay to stop even if the job is not perfect. Consistency matters more than perfection.

  • Do not use fluoride toothpaste if swallowing is a concern: Many people with dementia have difficulty spitting and may swallow toothpaste, which can cause stomach upset or more serious issues. The Alzheimer’s Association advises using baking soda toothpaste or just water if swallowing is a risk. Always consult the person’s dentist or doctor before using any new oral care product.

  • Do not forget to clean between the teeth: The Collis Curve cleans the surfaces but does not replace flossing. If the person tolerates it, use an interdental brush or a water flosser on a low setting. If they resist, skip flossing and focus on brushing. The Alzheimer’s Association notes that flossing helps prevent cavities and infections, but it is not worth causing distress.

Practical tools

  • Collis Curve toothbrush

    A toothbrush with curved bristles that clean three tooth surfaces at once. Available online or at some medical supply stores. Choose the soft-bristle version for sensitive gums. It is not electric, so it is quiet and less startling. Cost is around $10–15.

  • Baking soda toothpaste or water

    If the person swallows toothpaste, use a small amount of baking soda mixed with water, or just water on the brush. Baking soda is safe if swallowed and helps neutralize odors. Avoid mint-flavored toothpaste if the person finds it too strong; try unflavored or mild fruit flavors.

  • Soft cloth or gauze for wiping

    Keep a damp, soft washcloth or a roll of gauze nearby to wipe the person’s mouth after brushing. This can be soothing and removes any leftover paste or debris. Use it to gently clean the tongue and gums if brushing is not tolerated.

  • Mouth prop (bite block)

    A small, soft plastic or foam device that keeps the mouth slightly open during brushing. Available from a dentist or online. Use only if the person is calm and you have been shown how to place it safely. Never force it. Discuss with a dentist first.

  • Calm, simple phrases to say

    Use short, positive statements: 'Time to clean your teeth.' 'Open a little.' 'Good, almost done.' 'You are helping me so much.' Avoid questions like 'Can you open your mouth?' because the person may say no. Instead, use gentle directives: 'Let’s brush the bottom teeth now.'

  • Routine checklist

    Post a simple visual checklist in the bathroom: 1) Get brush, 2) Wet brush, 3) Brush top teeth, 4) Brush bottom teeth, 5) Rinse, 6) Wipe mouth. Use pictures if helpful. This can help the person feel more in control and reduce anxiety.

Discuss with your clinician

Ask the dentist if a Collis Curve toothbrush is appropriate for your loved one’s specific oral health needs (e.g., gum disease, loose teeth, or dentures).

If the person has difficulty swallowing, ask the doctor or speech therapist about safe swallowing techniques during mouth care and whether a fluoride toothpaste is safe to use.

If the person has bleeding gums or mouth sores, ask the dentist if a medicated mouth rinse or gel is needed, and whether the Collis Curve might aggravate the condition.

If the person is on blood thinners, ask the doctor if gentle brushing is safe, especially if gums bleed easily.

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