My husband hasn’t been since last year. He doesn’t brush unless I stand with him. He won’t let me brush for him. He will wash his mouth with mouthwash if I give it to him.
Do you think he will cooperate for the dentist if he barely cooperates for you? I would only take him to a dentist who knows this patient is impaired and has experience dealing with impaired people.
Sedated dentistry. There are several dentists who do that in my town.
It's probably best to continue dental cleanings and checkups if at all possible because gum infections or abscesses can cause a whole lot of undesirable effects in the rest of the body. (Which is what my dentist told me.)
How old is your husband? Does he have Alzheimer's and how far along is he? This has a lot to do with the answer. Until just this past 6 months, we used to pick dad up from the ALF and take him to doctor appointments. He started getting to where he didn't want to wait in the waiting room, and then he would get anxious during any procedure. This year we changed all of the appointments we could to Zoom type meetings. We stopped any scans or other procedures that may lead to surgery as we know we would not put him through that. But we are lucky he has no pains or issues other than losing functionality. Dad is 94 with advanced Alzheimers. If we don't prompt him, he won't brush his teeth. We help him to the bathroom and then I stop at the sink with him and have him wash his hands. While doing that I take his toothbrush and put paste on it and after drying his hands, I hand him the brush and guide him to brush his teeth. Sometimes it works, sometimes not. I am thankful for the successful times. We don't stress about every little thing anymore. We are just glad to still have him and enjoy the moments we can still laugh with him (even though he has no idea who we are but recognizes us as the nice visitors who love him)
A LOT of people who are perfectly fine have dental cleanings under light sedation. My BIL is so dentist-phobic he can only handle going once a year and they have to completely knock him out. All work is done in one (VERY expensive) visit.
Older people can usually handle the light sedation--beginning with a small dose of something calming before you leave the house. Make sure they can walk, or bring a wheelchair, as they can fall while slightly sedated.
Plan on being at the dentists' for longer than a normal checkup.
Just keep doing the best you can for their oral health. Some really nasty bacteria can enter the bloodstream via the gums and teeth need to be kept clean and maintained.
Some people find a gentle electric toothbrush does a better job than then trying to guide the brushing. You just keep trying until you find your niche.
I read an article by a dentist that stated, "if people used an electric/power toothbrush, I would lose 60% of my patients".
Some medical insurances provide as part of their OTC oral hygiene products. You may have to insist on perhaps, the manual toothbrush in the morning and the power toothbrush at night, as is the case with my mother.
Also, mouthwash with no alcohol is also good and the floss strips that you can get in there and clean--no nuts or anything hard to prevent going to the oral surgeon.
I'm going through this with mother. When they have the 5-year "full mouth" x-rays that's when they find little things that can turn into big things if you don't get it fixed right away.
Call ahead and tell them, husband not well, antsy in the dental chair and give tell them the you want the "short" version but a thorough cleaning.
My dentist lets me come in and sit next to mother or right outside the door. Make sure you tell them so they know what to expect. If the chair is too low, tell them. Some dentists want to do a piggy-back, basically too many procedures at once.
For example, my dentist wanted to do an exam wait and hour and then the do cleaning--basically mother would be there for 2 1/2-3 hours. I responded, NO, NO, NO. This will not work. We will re-book.
Watch their head when they are getting out of the dental chair since they can bump their head. My mother is on Eliquis. I think 1/2 the elderly population is on a blood thinner.
They don't really know you from a hole in the wall. Be assertive and inform them of any medications. I live this. The Pandemic threw everything off. Know your coverage as well. Some health insurances even off some type of dental along with $$$ on an OTC card. My mother has dental coverage since she has all of her own teeth. Let them know if husband has a partial plate beforehand.
Leave him alone and let him enjoy the rest of his life. This is one of our problems these days; we refuse to accept the fact that they won't live forever. It is OK to die esp when one has lived a long time.
I agree. My mother is 89. She and I both agree that death is a kind of healing. She's vocal about her DNR which starts at CPR. If her heart stops for any reason, let her go. She put this into place years ago. We've talked about it repeatedly. I know this is what she wants, so I tell every physician and facility to adhere to it.
My wife has Alzheimer's and can't communicate or understand but she goes to the dentists every six months . It's something she didn't like but now she's ok as long as I'm in the room next to her. The reassurance of me being there helps her overcome everything so far.
I’ve also wondered if I should take my 88 yo Mom for dental cleanings and care since the visits are usually stressful for both of us. In the end, I decided to keep taking her because she needs her teeth to enjoy food and because dental infections can kill her or seriously impact her life quality. To avoid long and painful cleaning, she goes 3x a year. I build up the past experiences a few days prior and offer her a treat (smoothie or shake) afterward.
I was worried about my mom going for her cleanings to her regular dentist when she was in assisted living, but she did just fine with me sitting next to her. Everything was explained to her as to what was being done. The memory care home had a visiting dentist and I was not there when that dentist worked on her, but I didn't hear of any problems. If you let the dentist's office know ahead of time, I think they will make sure your husband is comfortable. If he can't handle it, just make sure he is brushing at home like you are doing. It would not be good if he were to develop a serious dental issue where he would have to be sedated.
Mom is 95 years young. She was never a fan of dentist. When she complained of a tooth hurting, the Memory Care facility called me and off to the dentist we went. She had two abscess teeth and 5 broken teeth. Dementia patients sometimes don’t feel pain or the symptoms are short circuited. Well after 7 teeth were extracted, I asked about future teeth cleaning and prevention. Her doctor said as long as her teeth are brushed well and often, she should be fine. Not to put her through general anesthesia or have her get upset.
My 100 yr old Mom with dementia has dental issues. She has lichen planus which has made her unwilling to brush her teeth and she won’t let anyone else do it. I take her to the dentist every 3 months and the dentist or dental hygienist must be firm with her as she will not cooperate otherwise for cleaning, X-rays, and silver diamine treatment. This has been working for her. For cavities, etc.,… she will need to go to an oral surgeon and be sedated. If your loved one is in a facility where a dentist makes visits, ask about the silver diamine treatment which stops or slows down decay.
I let auntie go without dentists when she began refusing to open her mouth for them. 3 weeks ago, the front teeth cracked off of the roots she had a lot of pain and refused to drink water or eat. She wouldn't open for x rays so the dentist wouldn't remove them. The first sedation surgery wouldn't do it without x rays and wouldn't they let me hold her in place to get them. The next surgery had to search high and low for an anesthesiologist who would perform on a 91-year-old. They took 5 top front teeth, and she drinks and eats again. She had such a look of surprise when I woke her this morning and found the teeth missing - pain is gone too.
My only goal with mom was keeping her calm and as anxiety free and happy as possible in Memory Care Assisted Living. Not to traumatize her with drills and picks and needles. The times I had to take her to the oral surgeon for extractions, before she went into Memory Care, was a true nightmare. She was up the entire night before stressing out. Crying in the car on the drive over (dh had to take a day off work to help w the chaos), then shaking from head to toe when we got into the waiting room. She schmoozed it up with the dentist right away, so he proceeded to numb her up and extract 2 molars with no pain to mom, all in 5 minutes.
When in Memory Care and a wheelchair, there was no way I was taking her off the premises to any dentists. Period. So I hired a traveling dental company who charged a fortune but worked on mom in her room on her recliner. Only when an extraction was required did I call this group or if mom was saying she had pain. At this point in her dementia, she was constantly insisting "little little little pieces of teeth are falling out every day." Which wasn't the case, obviously, it was sesame seeds on the bagels she was eating.
Taking 90 and 100 yo dementia sufferers to the dentist for cleanings every 3 months is cruel, imo. Leave them alone to enjoy some quality of life! There's enough misery for them to deal with as it is!
It all depends on the patient. My mother, super extrovert, quickly forgets the very short period of discomfort from the dentist which delays the chronic pain of a toothache they can’t verbalize. (Doing nothing….That, to me, is cruel…you know….do what’s easiest, damn the consequences. I can’t do that. I love her.) I recommend the silver diamine. If it was offered at my moms facility life would be easier for me.
If he is on a blood thinner, including even low dose aspirin, ask his doctor if he can stop it for a week before to minimize the risk of excess bleeding.
Anyone with swallowing issues should attempt to maintain good oral health when possible to minimize risk of aspiration pneumonia. It’s not simply when the food and liquid goes down wrong that causes aspiration pneumonia, the risk is enhanced when there is a lot of bacteria in the mouth.
How compliant is he with following instructions? Can he tolerate a dental exam? If he can not follow instructions, if he could not tolerate the exam then don't bother with the dentist. Do the best you can at home. It got to the point where my Husband would not sit in the dental chair. If I used a medication to calm him or relax him prior to the dental visit he would be a fall risk for the rest of the day and he still was not compliant in the dental office. His dentist said the only way to do an exam and do any work would be under a general anesthesia. That would have been fine except for the after effects of the anesthesia AND trying to do wound care in his mouth for the following several weeks. And getting him back for follow up that would have had to have been under anesthesia as well.
Brush his teeth if you can, stand by him and let him brush his own teeth. Use NON fluoride toothpaste and non alcohol, non fluoride mouth wash. If he is not using an electric toothbrush see if he would use one. They are more effective so even if he does not brush for long enough it may still be better than a manual toothbrush.
One thing you learn with dementia is Pick Your Battles. Even if he does a little, it is better than nothing. And with dementia things change, he may not let you brush his teeth this week but next week he might, if not next week, try next month.
Flossing is far more important than brushing. He needs to floss to the gumline and most people already don't floss properly, so I can only imagine if your husband with moderate dementia will floss properly. If you can't get him to use dental floss or brush, have you considered a water flosser/Waterpik? It's better than nothing. And if he sees you using it, might he be curious about trying it himself?
See if you can get him to use a waterpik system which uses pressurized water to clean his teeth. If he has medication for anxiety or agitation, give him some 1 hour before his appointment starts. Otherwise, find a dentist that does sedation.
Try to take the time to stand with him daily if you can, and if he will tolerate it. If he will use a water pic, squirt some peroxide in the water as a disinfectant. If you make the dental appointments and go with him, will he go? Once a year dentists usually want to take xrays, and they may find cavities or other problems. Would he accept follow up visits that may be painful? Make sure that the dentist gives him local pain killer. Good luck. This happened to my mother, who had advanced dementia. She was in a memory care facility. She was on soft foods by that time, so we decided it was not worth trying to force her to brush or go to the dentist.
Look for a traveling dentist in your area. I found a dentist in the San Francisco area who came to my husband's memory care facility and cleaned his teeth while he was in his wheelchair.
It's probably best to continue dental cleanings and checkups if at all possible because gum infections or abscesses can cause a whole lot of undesirable effects in the rest of the body. (Which is what my dentist told me.)
Older people can usually handle the light sedation--beginning with a small dose of something calming before you leave the house. Make sure they can walk, or bring a wheelchair, as they can fall while slightly sedated.
Plan on being at the dentists' for longer than a normal checkup.
Just keep doing the best you can for their oral health. Some really nasty bacteria can enter the bloodstream via the gums and teeth need to be kept clean and maintained.
Some people find a gentle electric toothbrush does a better job than then trying to guide the brushing. You just keep trying until you find your niche.
Ask yourself why? Dying with perfectly clean death won't stop the process, more important things to worry about at this stage of his life.
Just my opinion, he doesn't need any more stress in his life, nor do you.
I read an article by a dentist that stated, "if people used an electric/power toothbrush, I would lose 60% of my patients".
Some medical insurances provide as part of their OTC oral hygiene products.
You may have to insist on perhaps, the manual toothbrush in the morning and the power toothbrush at night, as is the case with my mother.
Also, mouthwash with no alcohol is also good and the floss strips that you can get in there and clean--no nuts or anything hard to prevent going to the oral surgeon.
I'm going through this with mother. When they have the 5-year "full mouth" x-rays that's when they find little things that can turn into big things if you don't get it fixed right away.
Call ahead and tell them, husband not well, antsy in the dental chair and give tell them the you want the "short" version but a thorough cleaning.
My dentist lets me come in and sit next to mother or right outside the door. Make sure you tell them so they know what to expect. If the chair is too low, tell them. Some dentists want to do a piggy-back, basically too many procedures at once.
For example, my dentist wanted to do an exam wait and hour and then the do cleaning--basically mother would be there for 2 1/2-3 hours. I responded, NO, NO, NO. This will not work. We will re-book.
Watch their head when they are getting out of the dental chair since they can bump their head. My mother is on Eliquis. I think 1/2 the elderly population is on a blood thinner.
They don't really know you from a hole in the wall. Be assertive and inform them of any medications. I live this. The Pandemic threw everything off. Know your coverage as well. Some health insurances even off some type of dental along with $$$ on an OTC card. My mother has dental coverage since she has all of her own teeth. Let them know if husband has a partial plate beforehand.
I hope I was of some help. You're a good woman!
Well after 7 teeth were extracted, I asked about future teeth cleaning and prevention.
Her doctor said as long as her teeth are brushed well and often, she should be fine. Not to put her through general anesthesia or have her get upset.
When in Memory Care and a wheelchair, there was no way I was taking her off the premises to any dentists. Period. So I hired a traveling dental company who charged a fortune but worked on mom in her room on her recliner. Only when an extraction was required did I call this group or if mom was saying she had pain. At this point in her dementia, she was constantly insisting "little little little pieces of teeth are falling out every day." Which wasn't the case, obviously, it was sesame seeds on the bagels she was eating.
Taking 90 and 100 yo dementia sufferers to the dentist for cleanings every 3 months is cruel, imo. Leave them alone to enjoy some quality of life! There's enough misery for them to deal with as it is!
Anyone with swallowing issues should attempt to maintain good oral health when possible to minimize risk of aspiration pneumonia. It’s not simply when the food and liquid goes down wrong that causes aspiration pneumonia, the risk is enhanced when there is a lot of bacteria in the mouth.
Can he tolerate a dental exam?
If he can not follow instructions, if he could not tolerate the exam then don't bother with the dentist.
Do the best you can at home.
It got to the point where my Husband would not sit in the dental chair. If I used a medication to calm him or relax him prior to the dental visit he would be a fall risk for the rest of the day and he still was not compliant in the dental office. His dentist said the only way to do an exam and do any work would be under a general anesthesia.
That would have been fine except for the after effects of the anesthesia AND trying to do wound care in his mouth for the following several weeks. And getting him back for follow up that would have had to have been under anesthesia as well.
Brush his teeth if you can, stand by him and let him brush his own teeth.
Use NON fluoride toothpaste and non alcohol, non fluoride mouth wash.
If he is not using an electric toothbrush see if he would use one. They are more effective so even if he does not brush for long enough it may still be better than a manual toothbrush.
One thing you learn with dementia is Pick Your Battles. Even if he does a little, it is better than nothing.
And with dementia things change, he may not let you brush his teeth this week but next week he might, if not next week, try next month.