I searched, but didn't find anything on this topic.
About 3 years ago, our last visit to the dentist showed that my DW needed some fillings and some routine work. That was about the time that going anywhere became a nightmare. So, it never got done. Honestly, with everything else, it just slipped to the back of my mind. (Guess you could say I 'forgot' it!! hee hee)
Anyway, fast forward, and the home says she needs a dental visit ASAP because her gums are bleeding and they suspect it is interfering with eating and may be painful. She can't tell us anything, of course.
I have not been able to locate a mobile dentist, so we're going to put her poor 84 pounds into the car and attempt a visit Wednesday. She hasn't been off the property in 5 months now. I am scared to death of this whole appointment.
She probably won't cooperate, sedatives don't affect her, and even if we do get in and find problems, how do I even begin to get work done? Multiple visits, oh no...anesthesia might do her in...it seems so hopeless to fix all this stuff, what's the point (although I will not let her live in pain, NO) but how can you not?
trisinger I am so sorry you are having this problem. I'm not there yet with my Dh, however, I do supervise a facility for individuals with cognitive impairments and I can tell you that dental needs and the inability to take an active part in their own treatment is a major problem for all. You may have to consider sedatives but even finding someone willing is not easy. An obvious suggestion would be that if you manage to get her there ... only the most severe probelm be considered. When we are talking about our LO we often think we can take care of everything , but because fo my work I am aware that sometimes there are no fixes. Although we continue to take our residents to dentists they are limited in what they can do or are willing to do without patient cooperation. I can tell you that it is amazing how much tolerance some of residents have to obvious tooth and gum problems. I know this isn't an answer, and I hope some of the others may have better ones for you....
Well I guess I have been there,done that, with about everything when it comes to this disease. I talked to our Dentist when my husband was still being treated because I could see it coming. I took him every 6 months for 7 years of the disease so that maybe just maybe I would not run into something like is happening to you. No guarantees that I won't though, the disease is so long in duration. The Dentist told me that when they get to where they cannot cooperate with them the only thing they can do is usually put them to sleep. I hope you don't have to do that.
Please keep us posted for I will want to know how this goes.
Jane, I too insist that my DH go to the dentist every 6 mos. but on the latest visit the hygenist said he is not brushing his teeth good enough, even though I insist he do so every morning, and that he needs to come every 3-4 mos. So far he is cooperative and the dentist said we would try to keep him going as long as he is cooperative. I don't know what I will do when he ceases to be so. Good luck. I too would just do the absolutely necessities and let the rest go for the time being. Talk frankly with your dentist, he should be able to advise you. Take care!
trisinger, if you've heard that anesthetics can sometimes worsen AD, that appears to be true for SOME anesthetics, but not all.
Local anesthetics do not cause a problem. Apparently, neither do general anesthetics that are administered intravenously. So a mild sedative administered intravenously to calm your wife down, coupled with local anesthetics to prevent any pain, should be just fine.
You would be wise to avoid general anesthetics that are inhaled, however.
MY DH just had his regular cleaning last week and they found he has infection in his gums from poor brushing. He brushes but apparently not too well (sure uses a lot of toothpaste!). There was an odor that I did not realize was coming from his mouth. He was prescribed a rinse to get rid of the infection. Now he's obsessed with it. He was crushed when they told him about the odor. They also want to see him every 3 months now.
I can relate to the dental problems because I have been dental phobic since I was a child. My dentist was similar to the one in the Marathon Man movie. I never got over it. I cannot sit in a dental chair, not even for a cleaning, without being drugged to the hilt. Lots of valium. However, before I graduated to maintenance cleaning, I had to have a lot of oral surgery - I went to an oral surgeon who was also a medical doctor. He gave me intravenous sedation, along with enough novocaine for an elephant- I was out - knew and felt nothing - and all of the work was completed in that one session.
If an AD patient can tolerate that type of sedation without adverse long-term effects, I would think that would be the way to go. The only way to maintain a clean, healthy mouth after the oral surgery is constant flossing and brushing with a battery operated toothbrush - mine has both rectangular and circular brushes. I doubt an AD patient in advanced stages could tolerate someone doing that to them, so that is the reason for the 3-month dental visits.
More than two years ago the dentist agreed we would only do what is necessary and pull any teeth that got too bad. So, I canceled his dental insurance and we go every six months. I know my DH does not brush as well as he did. Those electric toothbrushes go off after two minutes, but he can't remember that. They get so gross we have those battery operated ones that give up when they are worn too much. Wouldn't you know all his dental problems have been with the teeth that show so we have done the minimal to keep that up. Obviously, you can't pull a front tooth in the stage he is in! One dentist also prescribed a rinse, but my DH said he had never done that before and made such a fuss I just gave up. I'm trying to remember if I read it here that tooth decay and infection can lead to death. At this point, even that sounds better than dying of stage 7 AD. I think hydrogen peroxide works quite well to keep the gums in better shape so I wonder if dipping a toothbrush in it would help in this situation. Just a thought...
Frand, yes Hydrogen Peroxide does work on the gums. I have used it myself for years, per one of my dentists, years ago. My DH started to get swollen gums around two of his teeth two weeks ago, and I took the hydrogen peroxide, diluted with some water and began brushing his teeth with it. My dentist recommended that you dilute it alittle. In about 3 or 4 days his gums began clearing up and look great now. After I finish brushing with the peroxide, I then put a little toothpaste on the toothbrush and finish brushing. My dentist also recommended that I swish it around in my mouth and then spit it out. The reason I cannot do this with my DH is that he can no longer brush his own teeth or swish it in his mouth and then spit it out. I would be afraid he would try to drink it, so, I resorted to brushing his teeth with it, by dipping the toothbrush in a cup of the solution. This seems to work just as well. This way, if he does swallow a little of it, it is diluted, so, I am not worried about it. Since he had only the one area that was swollen and red, I just concentrated on that one area with the peroxide and it cleared up. They also make a peroxide and baking soda toothpaste, but, I just prefer to do the solution of water and peroxide myself, as it seems to work better and faster.
So far my DH teeth look pretty good, but, I also am afraid if I ever have to take him to a dentist, he would not be able to do anything that they ask him to do, so, I know he would have to be sedated and that scares me. Oh well, I guess I will worry about that when the time comes. So far, so good.
OH, no, just as I'm getting used to shaving him, I might have to brush his teeth, too!! I know he doesn't brush as well as he should....and if I don't put the toothpaste on the brush, he doesn't brush at all. We're going to the dentist every 4 months for a cleaning and I hope that will be enough. I didn't realize that he wasn't brushing until we went to the dentist and he told me...I just hadn't thought about it.
And soon I will have to go in and shower him since I know he doesn't do that very well. He's not even completely wet when he comes out. But he's not really doing anything to get dirty and we go in the pool every couple of days, so I hope that will help.
Thank you for the H2O2 suggestions. I have never tried it, and actually will on myself as well.
The dentist called today, personally, to ask about her and get caught up on her situation. I just about teared up...he was so caring and sweet about the whole deal. He said that we will not pre-sedate her, but just take the visit as it comes. I expressed my fear about the massive work that may be in there, but he said that often bleeding gums is due to great amounts of plaque building up, and let's see what we find before I go off the deep end. He kept saying, "We'll be gentle and patient, very gentle with her"...isn't that a great man?
Appointment is Wednesday at 2 in the afternoon. Think of us! Report to follow...
Sounds lile you have found a great dentist. Best of luck to you. With his willingness to take time and be very gentle, perhaps good things will happen.
Do try the H202. I also started using years ago for a my own gum problem. Took care of the problem quickly. Kept using it because it certainly makes your mouth feel clean and I never liked the strong almost candy flavor of mouth washes.
We got her there in the car. I had borrowed a wheechair because she shuffles so slowly. Also, in a wheelchair there is no refusing to go in the office! No choice!
But she didn't complain, and got into the dental chair, and even opened her mouth when prompted. The dentist saw no major problems, only that the plaque has built up so much that it has irritated the gums. We're scheduled for a cleaning on Monday, and I am a lot more at ease. yay!
this is also a subject worries me, husband has good teeth but i saw yesterday after reading this he had red gum around one tooth. using the Hperoxide i swabbed the gum. i dont think mine woud cooperate at dentist either unless sedated which is of concern. its always something new to worry about. divvi
After reading all of these comments, I have a question that has not been addressed & I need help with...My husband has begin NOT being able to brush his own teeth, but he REFUSES to "open up" so I can help him. Previously, I would put the paste on the brush (electric one), he would brush & "Swish" with water...I was also able to do the floss on his teeth & we have "little brushes" that are cone shaped for the "large spaces" between some of his teeth. He's always had bad gums & had them scrapped prior to AD and even once about 2 years ago...the inflamation of gums seems to be a problem for him, even with appts for clngs every 3 mths. What do I do if he won't let the brush in? It is so maddening!! I am so frustrated and I know that doesn't help. I just get to the point where I say "oh well, maybe later"...but as y'all know, "later" many times is forgotten for that day as so many other things seem to come up & then I just don't like the conflict of the whole ordeal. We just cannot "make him" do anything, that's for sure. Any suggestions?
natsmom - Somebody suggested dipping a Q-tip in hydrogen piroxide (I would say half water, half H2O2). Would that work? Also, I sort of remember some sort of mouth wipe which was like a HUGE Q-tip Hospice used for my Mom. Maybe that would help. Good luck!
Years ago they gave me some of those "huge Q-tips" when I was in the hospital and I recently saw them online in one of those home medicine catalog places. I don't remember which one. They should be easy to get from a local drug store or online. The real question is will he let you use them.
My own husband has stopped brushing his teeth completely. Instead he is picking at them to clean them. I think that is probably what they did when he was a little boy in Europe during WW II. This disease regresses people.
That's what I was wondering about -- "not brushing at all" -- Starling, do you take him to the dentist regularly for cleanings? Or do you just not worry about it?
He went to the dentist recently. I've warned the dentist that he has dementia, but he cooperated beautifully, and the dentist didn't tell me that there were any additional problems. I might increase his visits while I can, but I'm not sure. Maybe every 3 or 4 months instead of 6, but I'm not sure I could get him to agree to it because I'll be staying on the every 6 month schedule myself.
As for not worrying about it, it kind of depends on what Stage the LO is in. Once he gets to Stage 7, whatever is, is. I'll just want to keep him comfortable. There is absolutely no way he can have any kind of operation, even dental. So yes, I do worry, but you have to pick your battles.
Yes, I agree on those "picking your battles" -- I try not to pick any! So, I guess I'll be content with when we CAN get them brushed & not worry so much about it...Thank you!
I have also stopped taking my husband to the dentist. I took him every 6 months for the last 7 years, knowing full well that the time would come when he could no longer cooperate. He is now in stage 7, I have brushed his teeth for him for at least the last 4 years. I still do this and he does allow me to. I would start brushing for your LO sooner rather than later so that they will be use to it. Hospice also told me about the proxide use in case he gets to a point that he will not let me keep them brushed. So far so good though and I think it is because I started early on doing this. Don't wait to long to start doing any of the hygeine part, the more they are use to it the easier it will go for you.
That's what the problem was with DW these last three years...she'd just refuse to let me in. But when she went to the NH, they didn't take no for an answer. They brushed her teeth.
A lot of refusal for stuff is because we allow them to get away with it. I know they're stubborn...you don't have to tell me. I KNOW they refuse a lot of stuff. But I can only give you the advice that I was surprised to get: get mentally over it. We don't like 'forcing' our LO to do stuff, because it feels weird. They're not children, and we are not their parents. But aren't we? Isn't that where we have been put? When I finally got over the mental hurdle of the refusals, I began to be less timid, and just brushed the teeth, like it or not. I had to sidestep a couple of swings and some angry looks and words, but honestly, 1) I was doing it for her own good, 2) she would have been angry at me anyway, and 3) she forgot it about pretty soon!
Be firm. If you want it done, do it. It worked for us, fairly often!
My wife,who is 100% care in nh grinds her teeth at times.She recently cracked a back molar.In the past 3 years I have taken her by ambulet to 2 different dentists,both of whom deal with patients with handicaps. This time we were not successful due to not being able to pry her mouth open to even start. My anticipation far out weighed the final reality.By the way my wife does not move her limbs,must be fed and was transported in gerry chair.Both these dentists were compassionate and patient. I would suggest you contact dental board in your area and ask if they can reccomend a dentist that has experience with alz patients. I go to nh at least twice a day and feed my wife puree lunch and dinner,after which I brush her teeth.Years ago one doctor said as the illness progresses it will become easier for both of us.Now thats a statement which is so wrong.Its 11 1/2 yrs now, shes 62 and I have a big hole in my heart.Long goodbye
I used to work with abused children. Virtually all of them had serious dental problems. For the children who were too combative due to severe behavior disorders, the dentist would admit them to the hospital for day surgery, use a twilight anesthesia and do all of the work at once, including cleaning. It usually only took 3-4 hours of total time depending on how extensive their needs were. Could this work for our LO?
made an appt for dental visit this thurs..at 2pm. xxx fingers. its not going to be easy at all! think i see a cavity starting at the gumline in a molar so a visit is necessary. i will have to see course of action and decide after getting there how or if to proceed. if he cooperates good if not we come home...sigh.. divvi
divvi-can you get Valium or a similar drug to help keep your husband calm? Good luck. Make sure the dentist numbs the area with a gel before starting the actual needle numbing process.
divvi, remember the "big tooth brush under the counter" that my DH used? Well, he developed some sort of breakout in his mouth. I know it was from whatever cleaning stuff I used on that brush! But he did very well at the dentist. Just medicated it, swished with salt water for a week or so and it cleared up. What a scare that was! Good luck with yours!
Divvi, I hope you are as lucky at the dentist as I was! My husband (who can do things he has always done, whether he actually remembers what he is supposed to do or does it by rote) sat in the chair and held his mouth open while the dentist repaired three teeth! (The dentist and I didn't want to have to make three trips, so he did them all at once) I was pleasantly surprised, and I hope your husband's visit goes as well as ours did!
dentist appt was a over and done within minutes, mercifully! his gums were a little red in spots and the dentist told me to make a paste of hydrogenperoxide/baking soda and brush with that til it clears up the gums. no xrays or fillings for now but he said once a yr checkup would suffice unless something comes up and we would deal with it then! yeah...! my kind of dentist. haha. if you arent able to get your spouse to dentist as a precaution you could use this paste to brush with as well a couple times/week=, he said it flushes the gums/teeth and is natural way to avoid infection. i worried all week and i am exhausted! divvi
Tonight, my DH has decided he needs to pull the crowns off of his teeth. He hooks his fingernail on the top of the tooth and tries to pull it off. He wants to find a newdentist who "understands the fundamentality of angles and arches".... (?????) who is willing to discuss with him ways of dealing with his dental problems for less than $1,000,000.
This - dear friends - must sound very familiar to all of you, insofar as the jibber-jabber is concerned, but how, pray tell, am I going to keep him from pulling his mouthful of porcelain crowns off of his teeth??
This one is a new obscession with him. I'm calling the dentist tomorrow. If I have to take him to the dentist once a month, I will.
Nancy B Have you tried reasoning with him, or is that an option. If my dh was trying to pull the crowns off his teeth, I would try reasoning. I would maybe tell him if he continues to pull on his teeth they will start to bleed, etc. Hope you find a solution.
Called the dentist today and explained the problem to his "front guard" aka Receptionist. The soonest the dentist can see him is next Thursday at noon. I've tried all morning to redirect him into doing other things. It'll be OK, just keep thinking I've seen and heard of every thing any one could do, but MY DH seems to be writing his own chapter in the Book of Alzheimers. As you know, some things are easier to deal with than others...and this week has had too many distractions...from other pressing matters. I swear they do these tricks just to get us to pay attention to them again..first and foremost. *** Just like 3-4 year olds, right???
I've given him thin sliced apple wedges today (which seem to clean teeth, somehow) and he has been eating them all day. He has eaten almost two apples. Can anyone think of a reason he shouldn't eat apple slices? He doesn't remember the incident last night...so why mention it?
I'll confess: my husband has stopped brushing his teeth. He eats an apple a day, carefully cutting it up himself, and he uses tooth picks. And our hygenicist says that basically, that should be sufficient.
I didn't get to read every post here, but I can tell you, todays visit to the dentist was HELL. The hygenist could only do one quarter of John's mouth....he became complaintive, loud and obnoxious. Obviously, she quit. I have t0 schedule multiple visits or have him sedated in some manner before I bring him in again. Maybe it's best to simply forget it. It looks like he's not been brushing his teeth for months anyway, even though he says he does so twice a day. (remembering a time when he did, I'm sure) But, gum disease can lead to some pretty awful other conditions.
yes, but stuntgirl HE IS DYING IN ANY EVENT. PLEASE accept that! A lot of us try not to rock the boat in regard to dental care etc. We are not looking at long term outcomes here, just getting them through with as little discomfort for them as possible.
I'll second that motion, briegull -- we're no longer doing routine dental checkups, mammograms, Pap smears, eye exams, etc. But I can see that Jen's case might be different because of concern about possible claims of elder neglect or something like that from some of the hostile family members.
Two weeks ago, I took my husband to the dentist. He's been picking at his crowns with his fingernails and I feared he'd pop them off. He doesn't practice good dental hygiene and I was worried about his dental health, gum health and even freaking out that if he got a bad infection it could go into his blood stream...all of that... The Dentist sat me down and said, "I will be happy to let you bring him in once a month and we can clean his teeth. HOWEVER, you need to know that he doesn't need to use tooth paste to clean his teeth well, and if he likes to play with a toothbrush while sitting in his recliner, just be sure it's wet (I keep 3-4 regular tooth brushes and a cheap-o electric tooth brush in a large mug in his chairside table.)......that is just fine. If he were my Dad, I wouldn't worry so much about his teeth. As long as he is not in pain, he's okay. We'll keep an eye on him and take that worry off your shoulders. Repeating: He'll be just fine. (Translation: Chill out a little, Nancy! Stop worrying about the small stuff!!)
P.S. The Dentist said he bet me $100 that there was no way he could pick the crowns off his teeth with his fingernails. He said the glue they used putting them on require them to cut the teeth off with a dental saw when they had to remove them. Who knew??)
He loves this toothbrush. Odd. The dentist didn't mention this. He doesn't keep it in his mouth that long, and I thought it was better for his back teeth. We will ask again later this month when he has his next "cleaning appointment". Don't know about y'all, but I just love leaning back in the dental chair and having my teeth cleaned. It is so relaxing..and feels wonderful. -
If he loves the toothbrush, why don't you look into getting a good quality one -- the Sonicare brand is what my dentist recommends. Maybe you could swap it for the cheap one. A friend of mine did severe gum damage with one of those Crest cheapies.
Shanteuse, how do the cheap electric toothbrushes cause gum problems? We have them for my husband because he loves to hold it and turn it off and on. He rarely puts it in his mouth (unless he is using it as a fork or spoon). We have a Braun vibrating brush with separate heads that we have used for years to brush our teeth, and the dentist said our gums have never looked better!
This from an old dentist wife and "front desk" person...the newer electric Oral B is more user friendly than the sonicare...but neither would be too harsh for "play" use.