I am having a problem lately that I haven't seen discussed previously. My wife is refusing to brush her teeth. At her last visit to the dentist last month she would not open her mouth for the hygienist, but was still brushing her teeth at home. The last couple of nights she will just suck on the tooth brush, on which I have put the paste. If I try to get her to brush, or try to do it myself, she just clamps down harder. She still has all her original teeth, but she has worked hard over the years to keep them in reasonable shape. She has several fillings in every tooth. So, I am afraid that her teeth will deteriorate rapidly if she doesn't brush. I don't want to push too hard since I could easily break a tooth. Any suggestions would be appreciated.
We have the same problem at our house; so if anyone has tricks, I'm ready. Used to brush his teeth 3 times a day minimum. I have "unsugared" gum available, and he likes to chew that.
Marsh, I am having the same problem. I did purchase a child's toothbrush & toothpaste, also, I make sure I have wet the brush to where it is really soft. He will not brush himself, but, sometimes he will allow me to...sort of. My husband had beautiful teeth, never a cavity.
For a long time, we used an electric toothbrush which she would generally hold in one spot. I would try to get to other areas. Then I would use a floss pick and let her swish with a floride mouthwash. Of course, that ran its course near the end.
I remember reading somehwere that if you brush your teeth together, and you go slowly, you may be able to get your loved one to copy you.
Here are some suggestions from an ALZ website:
Have professional backup: Visit a dentist twice a year to check for cavities, gum infections, dangerously cracked teeth, ill-fitting dentures, and the like. Make sure the office knows the person has dementia, to book adequate time. For tough cases, ask for a referral to a geriatric dentist who has experience working with Alzheimer's patients.
Incorporate toothbrushing into the daily routine, such as when getting dressed or ready for bed (ideally both). If it becomes a battle, pick the person's most cooperative time of day. Try brushing your teeth at the same time.
Use the same brand of toothpaste the person has always used, if you can. Apply it to the brush for him.
Provide a thick-handled, easy-to-grip toothbrush. The noise of an electric toothbrush may cause distress.
If the person doesn't recognize a toothbrush, slowly insert your own toothbrush in your mouth to model how it's done.
If the person clenches her teeth and won't open them, brush what you can see.
Dentists recommend flossing, but unless the person is cooperative about oral care, it's not worth the battle or risk of being bitten.
Clean dentures daily. Don't leave it up to her. Ask her dentist the correct way if you're unsure.
Minimize the number of products in the bathroom. People with dementia may use shaving cream for toothpaste, for example. Avoid mouthwash, which may be swallowed.
Marsh, I just made a phone call to my Dentist's office regarding your challenge. Dr. Gatewood is an excellent elder-care dentist and in our case, he would see my late husband every 3-4 weeks and gently cleaned his teeth. I asked him today what he suggested for the majority of caregivers who (he said) always will have this challenge in their daily hygiene care.
First of all, he said that toothpaste is not all that necessary. It can choke the patient as it foams up and gets thicker in their mouth = and spitting is complicated. He said a good soft toothbrush that is wet is fine to use. IF there is a way you can get the patient to put a soft bristle (or small) electric toothbrush in their mouth, this would be the most effective. A little mouthwash is also good for fighting bacteria in the mouth if you can get them to squish and spit.
If all other fails, he said some patients are given an extra Ativan before the appointment and generally speaking, that is sufficient to relax them. He has used the nitrous oxide (laughing gas) - and then oxygen afterward ,which will dispell the nitrous oxide in their system. This is NOT anesthesia and not to be feared. He suggested I tell all of you that dentists are more than willing to share in an Alzheimer patient's unique dental requirements and that he had about ten AD patients himself. He urges everyone to discuss this with their own dentists.
If all else fails, try playing some of her favorite music - something with a good rythym. I am amazed at how some dementia patients respond very positively to music.
Re: My earlier post. Perhaps because we had dental insurance, I rarely paid more than $15 for the extra cleanings, if that!!! I suppose the insurance company picked up the difference, if there was any.
mine has done this for over a yr now even now while on hospice. we use a combo of the toothettes swabs with glycerine that bluedaze mentioned provided by hospice but you can find them online byn the bags in quantity plus alternate a VERY soft childs toothbrush with light sensodyne toothpaste to begin to develop less sensitivity to the teeth over the long haul. i find putting a clean finger in DH mouth to hold out the cheek and then run the toothbrush inside over and out while holding the cheek open. he cant clamp down this way usually. do the other side the same way. i also use a good small spritzer breathspray after . this is quite a challenge when they decide to clamp down on anything you put in the mouth. divvi
marsh, your wife sucking the toothbrush is exactly what my husband does, this tells me your wife has forgotten what a toothbrush is for. I took my husband for the dental cleanings as long as our dentist could clean DH teeth. I have been using the ORAL B battery power toothbrush with children training tooth paste, not harmful if swallowed. He does want to suck but once I get it into his mouth he allows me to brush, the power of the tooth brush cleans more thoroughly than the manual brushes and he allows this where with the manual brush it was a no go.
Thanks for all the suggestions. Tonight she sucked on the brush, but then, reluctantly, let me brush her teeth. I plan to discuss it with her dentist this week. We don't have dental insurance, so frequent visits could get expensive.
This is especially difficult when the patient is a fromer dentist. G will still use an electric toothbrush, but not very effectively. Will not use the perio rinse he needs, however. We are fortunate that the very nice guy that bought his practice provides cleanings for nothing, and only charges for perio cleanings every other time. Surely never dreamed G would have perio problems....he would be very upset if he really understood. Future doesn't bode well if others' examples hit here also. :-(
I was advised to help with so called perio problems (don't trust the dentist who said DH had them - wanted $1500 up front for treating him. Never mentioned perio problems during root canal/cap) to use the perio mouthwash before brushing and after. Don't have problems YET with DH refusing to brush; actually he's obsessed with the whiteness of his teeth and wants to buy ALL advertised tooth whiteners.
It’s amazing to me how one LO will do something just the opposite of another LO one. Kathryn carry’s her tooth brush every where with her and bushes every time she thinks it is time. Sometimes she will put it some where safe and I would have to help her hunt for it. Last time we were at Sam’s Club I got her 48 tooth brushes. Now every couple of weeks we have a tooth brush hunt to see who can find the most tooth brushes. We are down to about 16 or 17 brushes now and are going to Sam’s again this week end and pick up another 24. Some day I will find them all at once and there be over 100 brushes maybe more.
Our dentist recommended an apple a day and frequent dental cleanings. I don't know whether I'll be able to get him into the office, though, it was hard the last time. He loves the apple.