Mouth, sight and hearing care: everyday health checks that are easy to miss

Health & daily life · 4 min read · Last updated 2 November 2026

Sore teeth, ill-fitting dentures, outdated glasses and untreated hearing loss are easy to miss, and they can affect eating, mood, safety and communication. In a person with dementia they are even easier to mistake for something else. This guide uses guidance from NICE and the Alzheimer's Society to explain what good care looks like. It is general information, not medical advice.

Mouth care in a care home

NICE guideline NG48 sets out what care homes in England should do for residents' oral health. Its main points include:

Assess every resident's mouth care needs on arrival, whatever the length or purpose of their stay, including respite and recovery stays. Ask how they usually care for their mouth, whether dentures are marked and when they last saw a dentist.
Record the results and any dental appointment in the personal care plan, start mouth care straight away for residents who need support, and update the plan when needs change.
Brush natural teeth at least twice a day with fluoride toothpaste.
Clean full or partial dentures daily, remove food debris and take them out overnight.
Let residents choose their toothbrush (manual or electric) and cleaning products where possible.
Ask whether unmarked dentures should be marked, and arrange it with the resident's permission.
Care staff should understand that untreated pain or infection may show up as changes in behaviour, particularly in residents with dementia or communication difficulties.

NICE also says care home policies should cover access to local dental services, including emergency and out-of-hours care and community dental services for people with complex needs.

Signs of mouth problems in a person with dementia

According to the Alzheimer's Society, a person with dementia may not be able to explain pain, so these signs should not be dismissed as just part of dementia:

Eating less or refusing food, especially hard, very hot or very cold foods.
Frequently touching the face or mouth, or a swollen face.
Leaving dentures out.
Restlessness, moaning, shouting, disturbed sleep or aggression, particularly when someone tries to help with mouth care.
Wincing during brushing.

It advises seeking help from a dentist or health professional if you see red, swollen or bleeding gums lasting more than a few days, cracked or sore mouth corners, swelling around the mouth, or red or white patches, especially on the tongue. Keep a note of when symptoms started and whether painkillers helped. For dry mouth, the Alzheimer's Society says to check hydration first and to ask a doctor or pharmacist about medicines that may cause it. See eating and drinking well in later life.

Sight and hearing

The Alzheimer's Society says sight and hearing problems can look like early signs of dementia, so the two are often hard to tell apart and one may mask the other. For someone who already has dementia, sight loss can bring more disorientation, mobility problems, falls risk, communication difficulties and isolation. Hearing loss can make it hard to follow conversations and may lead to isolation and a sense that dementia is getting worse.

Arrange regular sight tests, which can be adapted for people with dementia, and make sure glasses are current, clean and correct.
Arrange regular hearing tests. In the UK, a GP is the starting point and can refer to an audiology team.
Hearing aids can take time to get used to, and longer for someone with dementia. An audiologist can advise whether a hearing aid is the best option.
Improve lighting, use contrasting colours and keep spaces familiar and clutter-free.
Do not assume every change is due to dementia. Arrange sight and hearing checks first.

For communication tips, see communicating with a person with dementia. Good sight also helps prevent falls: see preventing falls in older age.

Questions to ask a care home

These are our suggested questions, based on the guidance above:

How do you assess mouth care needs when a resident arrives, and who helps with brushing and dentures?
Are dentures marked, and how are they kept clean and not lost?
Which dentist do residents see, and what happens in an emergency or out of hours?
How often are residents' eyes and hearing checked, and who makes sure glasses and hearing aids are worn and in working order?
How do staff recognise pain in residents who cannot explain it?
Can the home arrange visiting dentists, opticians or audiologists?

Dental, eye and hearing services differ by country, and in many places residents or families pay for them. Ask what is included in the fee. See understanding care costs.

Frequently asked questions

How often should teeth be brushed in a care home?

NICE says natural teeth should be brushed at least twice a day with fluoride toothpaste, and dentures cleaned daily and taken out overnight.

Can hearing or sight problems be mistaken for dementia?

Yes. The Alzheimer's Society says sight and hearing problems can look like early signs of dementia, and one can mask the other. It advises not assuming every change is due to dementia.

What if my relative will not let anyone help with their teeth?

The Alzheimer's Society notes that restlessness or aggression when help is offered can be a sign of pain. Ask the home and a dentist about a gentler approach. NICE says staff should know how to respond when a resident refuses care, in line with the law and local policy.

Sources and further reading

This guide is general information only, compiled from the public sources listed above as of the date shown. It is not legal, medical, tax, financial or care advice, and we cannot guarantee that it is complete, accurate or up to date. Rules, thresholds and prices change and differ by country and region, and some sources describe other countries' rules as examples. Check details with the authorities and care homes named, and take professional advice for your own situation before you act. If you spot an error, please email [email protected] and we will correct it.