Old age, illness, and dentures don't diminish the need for oral hygiene and regular dental checkups. The amount of saliva (which cleans teeth) decreases with age, leaving the mouth more vulnerable to tooth decay and infection. Pair that with the inability to brush and floss, and the risk soars.

Dentures should be checked regularly for proper fit. Long-living people are also at high risk for oral cancer -- another reason for regular dental visits.

When your elder's loss of dexterity or lack of a firm grip make holding a toothbrush akin to holding a greased pig, try to:

• Attach the brush to the elder's hand with a wide elastic band.
• Enlarge the brush handle with a sponge, rubber ball, or bicycle handle grip.
• Wind adhesive tape around the handle.
• Lengthen the handle with a piece of wood, such as a ruler or tongue depressor.
• Introduce an electric toothbrush.
• Brush his or her teeth with a wet toothbrush or an electric toothbrush.
• Clean her mouth with swabs designed for this purpose; oral swabs can be found in most medical supply stores.
• Clean his mouth with a damp cloth.

For confused elderly, you can stand by the person and give short several simple instructions: "Hold your brush," "Now put toothpaste on the brush," "Now raise the brush to your teeth," "Now brush your top teeth," or "Now brush your bottom teeth." You can even brush along with him, mirroring what to do.

Skip the toothpaste if the elder is at risk for aspiration pneumonia.