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So I was brushing my grandmother’s teeth for her for some time, but one time she had swallowed her rinse water. The next time I tried, she couldn't stick out her tongue for me to brush it, and she wouldn't/couldn't open her mouth enough for me to do it that way. Now she just closes her lips and tells me no. Her tongue is pretty much completely white and her breath smells very bad. I feel horrible but I don't want to force a toothbrush in her mouth and risk her choking on the toothpaste. I know an unclean mouth makes for a constant dry feeling. She isn't fully able to drink her water so I have been dropping small amounts on her tongue from a straw. The aid is supposed to bring some lemon swabs soon, Do those clean the mouth or just moisten it? I have no idea what to do! I know she would feel better with a clean mouth, but I don't know how to get her there.

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Is your profile correct regarding her health? Don't worry so much about her teeth, just be a loving granddaughter and make the time she has left enjoyable.
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lilliansims Jan 2023
well as of last friday, a nurse told me that based on her respirations and blood pressure/heart rate, she likely has about a week left. However a nurse came yesterday and had her blood pressure as fairly normal, her respirations regular and oxygen at 100%. The cancer spread to her bones first and then to her brain probably about two+ weeks ago. It makes sense to me that brushing her teeth seems frivolous, but i just wish i could because i know it would feel better for her.
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Do not worry about brushing her teeth.
Spend time with her.
Make sure she is comfortable.
The swabs you get, moisten them with water. and use them to moisten her lips and if you can her tongue.
If she does not want to drink do not "force" it. Offer and help her but do not insist.
Ice chips are also good but if she is having problems swallowing or is choking just use the swabs.
There are also products "like" some of the lip balms that will moisten the lips but they are not water and will not cause choking.
You mentioned an aide. Is this someone from Hospice? If so they can tell you exactly what needs to be done, or talk to the Nurse about it.
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lilliansims Jan 2023
i apply vaseline to her lips on a regular basis, and actually right after posting this i got her to sip her water by herself! Before that, as i was dropping cold water on her tongue, i asked if it was good and she said “i love it” So she still enjoys a bit of water it’s just a little hard to understand her at times as i will ask if she wants water and she gives me no response, but she tries to talk and sounds raspier than usual and puts her mouth together as if she feels parched? if that makes any sense.
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Have you tried Teepa Snow's hand under hand method?

https://www.youtube.com/watch?v=6gLrH8mioCw
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lilliansims Jan 2023
i watched the video and thats a great idea!! i would love to try one more time to brush her teeth/tongue because i just feel as though it would provide her with more comfort & more natural moistness in her mouth!! I wont force it on her if it doesn’t work as i feel she may be a little beyond that point but i will absolutely give this a try! This is a wonderful community full of great ideas! thank you!!
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If she only has about a week left to live(your words not mine)why worry about her teeth? I mean really, let her be, and just enjoy whatever time you may have left with her.
And the hospice aide or nurse will show you how to use the swabs properly.
And make sure you leave nothing left unsaid.
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lilliansims Jan 2023
You’re right! I just felt as though i was doing her an injustice by not keeping her mouth clean as it used to be one of my responsibilities, and wasn’t sure if there was a way to do it that i didn't know about! But i feel better knowing that i should just leave that be because it would cause more discomfort to put her through that. Thank you! just felt like i wasn’t doing a good job as her caregiver in that way
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I moved in with my mom 3 years ago after my stepdad died. She has mild cognitive impairment, but doesn't have dementia according to her specialist. I have urged her in a nice way that she needs to brush her teeth at least once per day. She rolls her eyes at me & tells me not to worry about it. She only brushed them when I had to take her to a doctor appointment.

She developed a sore in her mouth (she wears dentures). Finding a dentist that accepts Humana Medicare has been a struggle. Two days ago, she was diagnosed with oral cancer. She'll be seeing a surgeon finally this next week. She has hardly any lower jaw left from bone loss because she never drank milk her whole life because she doesn't like it. Never took calcium either. This is not going to turn out well. Wish she wasn't so stubborn.
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Isthisrealyreal Jan 2023
Just so you know, milk doesn't stop bone loss and there is more to healthy bones then calcium.

I am sorry your mom has oral cancer. That is a devastating cancer to have and treat. I pray you get great medical guidance for her.
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Hi, I’m a dental hygienist. Anything to moisten the lips. Please do not use lemon swabs. They are very acidic and will dry out the mouth tissue even more. the tissue may be very thin and already dry, so they may actually burn her tissue. A very soft toothbrush dipped in Diluted baking soda in warm water with a bit of alcohol free mouthwash would probably be more comfortable for her. Even with gauze wrapped finger gently. ❤️🙏
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kjokjo Jan 2023
This one, for sure! ^ ^
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Sorry, I just read the update on her health, this would not be a solution I had the same problem with my mother as her dementia advanced. She wanted independence and didn't want someone putting something in her mouth. I found these toothbrushes on Amazon that are pre pasted but barely foam up and cause no issues swallowing "paste". Adult Pre-Pasted Disposable Toothbrushes - 144 per pack
She has hold them and play with them in her mouth at her leisure as she is sitting and it doesn't require any spitting out. She sometimes lets me get in there and I can do a real good brushing. https://www.amazon.com/gp/product/B00AU4LNBG/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&th=1.
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Brushing my husband’s teeth is the most challenging task for me. I cannot brush the top or the lingual side of the teeth; only the buckle side (the outside). Otherwise, he will bite down on the toothbrush and won’t let go. I only use children toothpaste because he doesn’t know how to spit out anymore. He only swallows the toothpaste.

I am more successful at flossing. A caregiver helps me keep his jaws open wide enough to floss. But it takes two people to do that. If I am here alone, I give up flossing too.
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My dentist told me that if I tip my Mom back ( not sure I know how to do this), it would be easier on her to open her mouth and keep it open.

I notice that if I skip a day, it is harder for her to keep it open.

Can she spit out water? Just rinsing her mouth will help.
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Is it a matter of her not drinking and having a very dry mouth or are you attempting to actually brush her teeth?

With Daddy, the last month of his life, he was opposed to drinking anything. He had choked pretty bad and wouldn't take liquids. I brought up cherry popsicles one day and those were the winners! He couldn't really feed himself, but he could 'bite' small chunks of popsicle and let the liquid run down his throat.

Mom was busy grinding up all his meds (Have you any idea how NASTY most pills are? Mom was still forcing his cholesterol meds down him, daily). The Hospice Nurse said "those pills are not helping in any way. Just give him what he will and can eat/drink". Mom was trying to do her best, I know.


I keep those 'pre-pasted' toothbrushes in the cars and my purse. DH always forgets to brush his teeth and we'll get out the door and he's "Oh dang, I didn't brush my teeth" and I hand him one of these. They aren't magical, but will do nicely for a quick clean. You can swallow that tiny amount of 'toothpaste' and it's fine.

Daddy would chew on those and he'd chew on the foam brushes. But I know his teeth were not cleaned to a very high standard once he was totally bedbound.

We picked our battles, I guess.
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The Waterpik now has a toothbrush in it. Google "Waterpik Sonic-Fusion 2.0 Professional Flossing Toothbrush, Electric Toothbrush and Water Flosser Combo"

https://www.alz.org/help-support/caregiving/daily-care/dental-care

I have a vague memory of a very strange sponge toothbrush they gave me at the hospital. I Googled Hospital toothbrushes to see what would come up and this is what I found: (copy and paste) https://homecare.stryker.com/oral-care/?gclid=CjwKCAiAwomeBhBWEiwAM43YIAhU0F5eF7ZlN1g05jQyK8e87oVW5t5GpJrPx01QVh4Rq0suWryvIxoCuVcQAvD_BwE
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Lillian, is your grandmother continuing to live? I hope you have had quality time with her these last few weeks.
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Hi lilliansims,

First, I must say that you have a very big heart not only by helping to care for your grandmother, but by going the extra mile to research different ways to possibly address her oral hygiene.

You're right...a clean mouth means a lot and it does make most people feel better. I realize from the update that your grandmother appears to be weak and fragile, so at this point, its best to follow the nurse's advice that is assisting your grandmother.

If your grandmother had more strength and was able to open her mouth more, I would recommend a WaterPik on a low pressure setting such as 4 (out of 10). When using the WaterPik (WP), work on the mouth in quadrants, so as not to overfill the mouth with fluids. Use the WP to rinse her mouth with water first, then floss second, then use WP filled with only mouthwash, then brush gently for a couple minutes, then rinse with only mouthwash, then have a series of WP rinses with only filtered water.

This is what I do with my mother every other day, and her Dentist says that my mother's teeth are in great shape - no issues. It takes us about 40 minutes because my mother goes slow when swishing water around in her mouth amongst other slow movements.

Its good to read about how much you care about your grandmother's well-being--- right down to the things that most people overlook or wait too long before addressing such as oral hygiene.
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Sounds like you are feeling some guilt about her oral hygiene and trying to make up for it. I get it!
She is going to be just fine if you don't brush her teeth. But are you?
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lilliansims: I read that your grandmother is very close to EOL and I'm sorry. However, you may want to use a sponge toothbrush, typically found at an oral surgeon's office, pharmacies and Amazon.
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The white covering on grandmas tongue might be thrush or cancor sores. She may not let you in her mouth because it hurts! There is a medication for this, check with a nurse or doctor.
Can your grandmother swish and spit? If so try warm salt water . Mckesson has a sponge mouth swab that is mint flavored. Also, try ice chips to soothe and hydrate.
Wishing peace and comfort for you both.
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I found the same with my husband and I bought a child’s soft toothbrush and children’s flavored toothpaste that is safe to swallow. Let her help you do it so she buys into it if possible. I was then able to do it daily and I also used sponge swabs kid his mouth was sensitive. They are very disoriented and need lots of patience. Their world has changed as they knew and they go thru many emotions and scared is one of them. I put myself in his place and try to be as empathetic to what he is going thru. God save us from this horrible disease of dementia and Alzheimer’s as well as many more but this robs you of your mind and memories.
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Lillian's grandmother has recently passed on folks. No need to keep this thread going any longer.

My condolences on your loss, dear Lillian.
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Sounds like she’s being a bit difficult on purpose. I say that because my misses would be difficult with me sometimes. I would just try to be as quick as possible. She’s not going to choke on the toothpaste or the rinse water. My Mrs. would try to bite my finger sometimes.

For the health of her gums, I had a small toothpick shaker that I filled half with salt and a half with baking soda mixed it really well and then I would sprinkle a little bit of it on her toothpaste just before brushing her teeth. She did not care for it of course, but it’s the best I could do in between Dental visits.
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lilliiansims: I am so sorry that your grandmother has passed away. Deepest condolences.
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