How does caregiver accomplish oral hygiene when resident with dementia becomes combative?

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Daily oral and personal hygiene is becoming difficult due to agitation and combativeness of resident with dementia. Any suggestions or tips?

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I, too, would like to hear from the community about this issue. I'd think if there is no way that the caregiver can help the person brush the care receiver's teeth, at least lots of water could rinse teeth. If raw apple can be eaten without danger, I've read that apples can help cleanse the teeth. Let's hear from the community on this, since I didn't (thankfully) have this issue to cope with. Who has ideas?
Carol
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I have tried and almost give up. Mom argued when we went to the dentist to get her teeth cleaned and would not let them do it. When I get her to wash her hands after toileting (and that is a fight) I just hand her the toothbrush. Sometimes she will brush and sometimes not. I used to try it before bed and she would never cooperate so I tried it in the morning and am getting better results. If she is obstinate I just don't do it. There is only so much one can do when the care receiver is adamant.
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I am a mobile dental hygienist. I come to the facility or home and perform preventive dental care for residents. Sometimes a mild sedative must be used. There are also mobile dentists to provide dental care ie extractions, fillings, etc so the resident can stay in the comfort of their usual surroundings. Otis a challenge for daily oral care. Sometimes two caregivers must be utilized. While the resident is sitting, one from behind cradles the head while one in front holds their hands or uses blanket/plush toy. The one from behind can the brush the teeth. Sometimes a electric toothbrush is too stimulating. I am looking into a xylitol gel made by "spiffies" to give a spoonful to the resident after meals. It is fruit flavored and the xylitol prevents decay. Google mobile dental hygienists or dentists on your area for help.
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My sister loved the water pik with warm water. LOL water all over the bathroom, but she had fun.
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I also was haveing trouble getting mom to brush. She has dental implants and an upper plate. I take her to a periodontist where the hygienist specializes in older peoples teeth. They will sedate also if necessary.
If I let her clean her own teeth she would just take her plate out scratch it with her fingernails to get off the built up gunk and rinse and put back in her mouth.YUCK!
I got her an electric tooth brush when she moved in with me and she will use it if I stand right there and tell her how to turn it off and on.I have to soak her plate in a 3 minute soak because she won't go to bed without her teeth. Periodontist said to soak them overnight. When I remind her we need to brush her teeth, she usually says she already has (NOT) or "I have been brushing my teeth for 50 years without you and I don't need you to tell me what to do,". I say "OK let's go in and you can show me" She spends about 3 minutes just looking for what she needs as I let her do it herself and of course she can't even find the tooth brush or tooth pastes. I have to be in there when she does it because she has tooth paste for her implanted teeth in her mouth and a stronger paste for he dentures. Plus the soak. Finally after she figures out she doesn't even know why she is in the bathroom or where anything is she says " OK what do you what me to do?, and she will then let me help. It is a struggle and I admit some nights it is not worth the fight. The first time I took here into get her teeth cleaned after she had lived in assisted living for 2 years, and I realized no one else was going to remind her or help her with her teeth, the hygienist said her teeth and dentures were so bad they had to double clean and it cost twice as much for the cleaning as it took longer. Now after living with me and 2 cleanings later in 2 years they say her mouth and teeth look good with no problems. It is a lot like taking care of a child and they throw tantrums and are a pain in the butt too. I raised 7 great kids so now I am just raising another. The only difference is instead of progression you see regression and it is sad to lose that person that once was.
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Have you tried giving the patient an electric toothbrush? Might be a physical reason for not wanting to brush... arthritis in hands? Or might be painful to brush!
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Remember you have to take care of bad teeth. If there is infection it can and will effect his life. I'm sure the dentist told you that. He can be put under so he will not fight the procedure. More money, but very necessary if infection is present. Don't wait on this one.
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He is on antibiotics and the tooth is feels better but I know it's a matter of time before it gets bad again. Hate to have to trick him into getting them pulled.
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Yes, the antibiotics will only be a delay tactic. Will not solve anything. Tooth will have to be pulled or repaired via root canal. Sometimes you just have to do what is right. Don't look at it as a trick.
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Funny this subject just came up with my dad. He has 2 really bad teeth and we went to the dentist and she said they one needs to come out the other could be a root canal and crown. But once my dad found out what it cost he refused. Problem is one is infected. $350 later and once it starts to hurt again it will be back to the dentist for more of the same and another $120 visit. I'd like to knock him out and have them all pulled but he is too proud to retain his teeth.
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