Dh has a rotten tooth, black as can be. He is not complaining of any pain, but I feel it might effect his eating and chewing. He struggle to eat now, takes so long....As it is now he tends to chew and chew and then store the food on his right side of his mouth where the rotten tooth is. Sometimes he just spits it out after he has a mouth full. He has lost so much weight, his shoulder blades sick out. I'm sure he's not getting enough food, they give him Ensure drinks, I have taken in food. He has partial top and bottom plates. I spoke to the RN and she said it's a difficult situation as some dentists won't treat Alz patients for fear of their reaction, also an anesthetic if needed is not good for Alz patients. She said they could just keep an eye on it and treat it for any infection with antibiotics...
Is there one who can give me some advice on this please.
Dental issues are important. There are dentists who specialize in aka patients. Also, is there a medical school nearby, they might be able to treat him. Usually a big money saver but also procedures often take longer, which can be a problem.
As an aside, I took my DH from ALF to the dentist last week to have his teeth cleaned and checked. While the hygienist cleaned his teeth he fell asleep. She said this has never happened to her before. He has no memory of it.
in Florida there is an onsite dental service that sends a dentist to the Alzheimers facility. DH had his teeth cleaned with no problem, but in order for an extraction to be done he had to be sedated. As we all know, anesthetic of any kind can be bad news for Alzheimers patients. Two days after the surgery he became agressive, agitated, tried to hit the psychiatrist, was sent to a geri-psych hospital for one week for med adjustment. That was in March 2012 and was the beginning of his downhill slide that ended with his death in August 2012.
did he have a root canal on that tooth? Art has a tooth that had a crown on it. I have not made it to the dentist yet but I know it had a root canal, so there is no root to cause a problem
Thank you so much, yes I knew bacteria of an infected tooth can cause lots of problems, that's why I couldn't understand the RN saying they would just keep an eye on the tooth and treat it with antibiotics...I'm not happy with that! To be honest his teeth are terrible.
Paulc, There is a dental teaching clinic here that we used to go to, I'm going to ring them to see if they will see him. I just thought I would ask for advice here first.
MaryD, I am worried that he won't co-operate with the dentist, so all I can do is try and see what happens.
PrisR*, Reno spent 3 months in hospital at the beginning of this year getting his meds adjusted. The anesthetic is what's worrying me also, and any complications that may arise from that. Another thing is it will have to be extracted for sure, it's just a dead black tooth, how do they keep the hole clean and free from food deposits causing infection if he can't rinse and look after it himself...it's another thing to worry about.
lulliebird, thank you, I will do my best to get him to a dentist as soon as I can....I know this can get serious.
We have a dental appointment at the teaching clinic next Friday the 12th....now to get him there. I have no one to help me, I worry that if parking is so far from the door, I may have trouble getting him to walk,. He can walk a little, but they said I have to take care of that myself. I'm going to ring around, perhaps Alz Ass can offer me someone for a few hours to help.
Julia can you get a transport chair to wheel him in? its a huge help! many are lightweight and roll very easily. he would be quite comfortable if you can get him in one. I always moved my DH to and from drs apt in his transport chair from the minute I parked. much easier. good luck with the apt/
Might look into getting a handicap card for your car where he can't walk too far anymore. Might be too late this time unless you can get a temp one for the appt.
Divvi, so far so good, just back from the Nh and the NH will let me take a carer with me to the dental clinic, if they have a transport chair that will fit in my Mazda hatch that would be great also.
Charlotte that's a great idea, i will apply for a handicap parking card, we had one years ago when Reno had his back fusion. it may be too late for this time, but it will be handy to have in future.
i just hope he co-operates with the dentist...and the dentist is understanding..
Don't worry too much Julia, I am sure that it will be just fine. But if they can't manage the work the first visit they may come up with a better plan for a second visit. And if they have not treated an AD patient before you will be providing them with a great learning opportunity! Good news that the NH is sending a carer with you.
Hi Cassie, I am so happy a carer will be with me for anything that might go wrong. You know, I was really worried about the incontinence...and what if!
I over think and worry too much about everything..can't help it!
Julia this is where those sani plastic pants come in handy with incontinence issues. you can put them over the depends with a pad in his depend, then the plastic pants over all that. it will contain any leaks while hes out and about with you. should keep him pants dry and any cushions ! best of luck at the apt, glad you have help. transport chair will help so much. you may want to contact the dr who will be doing the extraction and ask that they give you something to calm down DH an hr prior to the appt. he will be more relaxed and more compliant with the appt. again, Ativan, is a great choice but your dentist will know what to use. they have many patients, AD or not that need something to calm them down many have dental fears.
Julia, I had to take Dado down about 6 months ago to have a tooth extracted, and I was sooo worried if he would fidget or jump or yell. (In the past he has taken very good care of his teeth and did not mind the dentist) So when they did the extraction, I sat with him and held his hand , and talked soothingly, it was like taking a little child to the dentist. He did very well and I know he was glad to have me in there. Maybe they will let you do that, just don't look at the procedure and concentrate on Reno . all the best and I really hope it goes well.
Julia, do they not have a transport vehicle on the premises to take residents to their appointments? We are lucky in that besides regular doctors, there are also dentist and eye doctors who do come right to the facility. For those who need special appointments, like to a heart doctor, they have a transport van to take them.
I hope whatever they decide to do that is goes smoothly for you both ((hugs))
Divvi, I will ask about the plastic sani pads. They told me they will also double up the pads and put silicone pads over his hips in case he has a fall. They will order a taxi , but at a cost, but I can drive us there, it's just 10 mins away. Also get this...It will cost me $25 an hour for the carer to come with me, as if I don't pay enough for his care now! Anyway that better than single mum DD who is an hour away having to lose a days pay to come with me. Oh, i will certainly ask for Reno to have something to calm him down....i can just see him biting the dentist or the needle!
Coco, they really are like little kids again, I will sit and hold his hand if need be. He's usually a good patient, but of course this is different , I find at times the carers have a better way with him than I do....i can ask and ask for him to sit, walk, he'll just look at me with a blank look, but the carer can get him to listen to them.
Nikki, they have a bus for outings, but it's up to families to take them to appointments etc...which is Ok if i have help, everything is very close by. If they need to go to hospital they go by ambulance at no cost to me.. The dentist came to the Nh and checked all the patients earlier this year when Reno was in hospital for 3 months getting his meds sorted, otherwise it would have been picked up earlier. They give him Panadol over the counter pain relief 6 hourly for any pain, which I think may be masking the pain he may have from the tooth. Its a week away yet, but I just hope he's having a good day that day!
I hope he has a good day too!! Too bad you missed the dentist. Do they not come if needed? I believe ours comes every 2 month, but will come more if needed. Lynn lost his teeth due to a bad car accident involving a moose. The moose won....... The dentist does check Lynn's gums though, she told me I should be grateful that he doesn't have any teeth at this stage. I wasn't, but I guess it is one less thing you have to worry about it.
After years of seeing people every day you get close to them. One resident's husband also visits every day, we each look after the other spouse. His wife has two very bad teeth and a gum infection. Due to her present state they decided not to remove the teeth, to only treat with antibiotics and hydrogen peroxide on the gums. Sometimes the treatments just aren't wise for our loved ones. Keep that in mind if they decide not to remove his tooth. If the nerves are dead it might not be causing him pain. I hope whatever they decide to do it is painless for your DH.
Oh, and $25.00 isn't too bad, at Lynn's facility it is $50.00 an hour for an aide to go with the resident. They do also charge for the use of the van. Luckily I have never had to use either service with Lynn. Aside from Alzheimer's he is still very healthy. He has no other medical condition, not even high cholesterol, and is on no other medications. Go figure.
Nikki, The dentist only comes to check the residents when the RN asks for them to come, when this came up for us, she said perhaps it's time for another check over...good job I brought it to her attention then. Of course no work gets done at the NH.
The RN did say that the really advanced Alz residents would only be treated with antibiotics, it was not worth the stress for them...so I will ask the dentist about whether he /she would pull out any teeth or just leave be and treat with antibiotics...one just looks really bad to me, maybe the nerves are dead, that's why I thought it best to have his teeth checked over. Thank you Nikki for making me aware of that.
....and here's me thinking $25 was too much, it's good that you haven't had to use that service. In future, I will try to make appointments for a Monday when DD has a day off and comes down every week on that day. I was lucky to get Reno in so quickly, as it's a government clinic, us pensioners only pay a 1/4 of a normal dentist fee...so there's a huge waiting time.
Julia--since my husband has been living at the ALF (2 yrs) I have the visiting dentist come in every 6 mos. to clean and check his teeth. I make the arrangements privately (the ALF recommend him) and pay him. One hour before he is seen, they give him an Ativan to calm him down (he's already on a boatload of psych meds). During the winter, he had some swallowing issues and was banging his head against the wall. Someone suggested they might be due to a dental problem--so I had the dentist come in. Yes, there was a cracked tooth--so they gave him an Ativan, he was in bed sleeping, and the dentist did the extraction right there! The dentist gave him a couple of shots of local anesthetic (he said it was a more fast-acting kind than is usually used); I held Steve's feet down and an aide held his arms; the tooth came out quickly. There was minimal bleeding and no after-care required; no problems occurred. Steve squirmed a little but was so groggy, he really didn't put up much fuss. About a month later, the dentist came back and checked and said all was ok. It solved the swallowing issues and the head banging. I was quite concerned about how it would go because Steve is still very strong and mobile, although probably very late stage 6 or early stage 7. Sure glad that it solved the problems.
Oh MarilyninMD, I wish it could be like that for us here. It was good that it went that well and solved the problem.
the visiting dentist here, when they can get one to come is only to check the residents teeth, no work done. The clinic is government run for pensioner and low income earners, and has a 2 year waiting list. We are fitted in between appointments...as we dropped off the list when Dh went into care. I'm sure he has a tooth that needs to come out, maybe even more than one. He tends to chew and chew, swallow some of the food, but still manages to keep some on the side of his mouth where the bad tooth is. I took him to his room after lunch yesterday to rinse his mouth out and clean his teeth, get rid of the food left in his mouth. I think Reno is also stage 6 going onto stage 7...has trouble walking, and very frail, lost a lot of weight. He was on Clonazapan but slept / knocked him out too much so it was stopped.
I'm to see the Rn the day before we go to the dentist, and I will ask about Ativan or something to calm him. i know dental issues can cause a lot of problems, so I hope we can get his teeth sorted. It may take more than one visit to the dentist, he teeth are really bad.
thanks so much, I hope we have a good outcome too.
I hope you can work this out. I know this disease is so hard. Best of luck. On a lighter note.Last time we went to the dentist, we had our teeth cleaned. Don had his first. He was given a stool in the corner while I had mine cleaned. It went very well, I thought. When we got home he began to empty his pockets. They were full of toothbrushes and little tubes of toothpaste. He may be gone but he continues to make me laugh.
Ocallie36, thank you, oh I hope it goes well too. You know what's freaking me out a bit, is that what if he needs to toilet while we wait to be seen to....he'll be well padded, it's a bowl movement that worries me. I know silly me for worrying about that, if it happens , it happens!
yes the things they do, it's good that you can still laugh about it.
I would not worry about the tooth unless it is causing him pain. I never worried about anything unless it caused Lloyd discomfort. I didn't let them test for anything else either. For God's sake, he had Alzheimer's and we all know how that ends...sad to say. I avoided all sedation if possible. In the end he was on limited sleeping medication (1/4th of what the doctor prescribed), Neuronton and liquid Depakote (really minimal amounts). Any kind of sedation affected him and sometimes the recovery was not complete so I didn't care to take the risk unless unavoidable.
Linda Mc*, it's hard to know if it's causing him pain as he's on 6 hourly Panadol for pain relief for his neck. It is effecting his eating though, seems like he can't chew on that side, as he takes ages and chews all his food on the other side. I think the first app. as it's fitted in between other patients apps will most likely be to see what needs to be done , we'll see what happens on Friday..
Dear Julia, I so agree with Linda Mc* If it is not hurting him, then let it go. So very hard...I know...my husband got a blood clot in his right thigh. After much discussion with my boys and his mom...we collectively decided to do nothing. (John was bedbound and totally unresponsive at this point...in a NH.) The blood clot went away on it's own...over a year and a half after John died at home. Whatever you decide is OK...because you are his wife and love. Love, Leigh
Leigh. it is very hard to know what to do for the best for him. My daughter and the boys say I should at least let the dentist look at it....so I feel I should at least do that. If it's going to be a big thing, anesthetic, etc...it might be best to let it go. I'll see what the dentist says The more I think about it the more I don't know what's best!
Thank you so much for your comment, it's good to get opinions on what others would do.
Remember that if you need to buy a transport chair that the best price is at Walgreens, because they buy them by the thousands. Same brand, same model that was almost $400 at the med supply store was $150 at Walgreens and the day I bought it there was a one week sale and I pd. $99. DH's extraction, done at the ALF, took a long time because of course the dentist had no power equipment to use and DH had such strong bones that it was quite a job. They propped his head up in bed and the dentist worked from there. Sedation had been necessary to get the job done, but the aftermath was bad.
PrisR*, I'm down under, Australia, we don't have Walgreens here, but I'm sure I will be able to borrow one from the NH.
We'll be going to the dentists clinic, so if Dh needs an extraction it shouldn't be so stressful like that your Dh went through...well i hope it won't be!
Julia, yes I agree with your children, a visit to at least assess the situation is needed. You can't know what is best if you have no idea what you are dealing with. I hope the appointment goes well and I will be thinking of you both ((hugs))
And try not to stress too much over if he has an accident, that is what the aide is there for :)
Well, dental appointment is over, and I have to say it was a very special day in more ways than one. As soon as I walked into the Nh Reno saw me and called out my name, "Jul." as he calls me, and beckoned me over to him...my heart skipped a beat, it was like he was back to his old self,. It was a moment I'll never forget, I could tell he was having a good day!
Lindy a carer came with us, she especially asked to be the one to come, which was good, as she has a special way with Reno and he seems to trust and relate to her so well. We had to wait 30 minutes to be seen, I was getting a bit anxious, but it couldn't have gone any better. Reno sat in the chair while the dentist checked his teeth, cleaned his teeth and did a little filling called "surface adhesive rest direct" no drilling at all. He had to have rests as the work was done, but he really was such a good patient. The tooth I thought was bad is just discolored. No pain, and is to have another check up in 6 months, just to keep an eye on his receding gums.
Oh Julia, I am so happy that your sweetie had such a good day and that he called you by your name, such a gift! One I know you treasure. ♥ Glad to hear Reno's dentist appointment went so well, whew! ((hugs))
Oh Julia, so glad that Reno's dental appointment went so well. I'm sure you were stressing about it, but I find that MOST of the time, the things I stress about most usually go OK! It IS good for the heart when you hear them say your name. Tom rarely says mine anymore, but I can tell when he recognizes me because he winks at me & says, “I love you!”
Thank you so much everyone. ElaineH, that's so true, that we can stress and tie ourselves in knots, only to find it was not such a big deal after all!
Nikki, Linda Mc*...whew, horray...is right,!
Cassie*...that's the first time that Reno has said my name without being prompted. Only us here know how special little moments like just calling out our name means to us. Hugs...
Julia, I am so glad that the appointment went so well, and that the dentist didn't find any serious problems with Reno's teeth. What a relief you must be feeling, how special that he called you by name!
Julia--my Mom always said that the things we worry the most about generally never happen. Glad it went well. (By the way, my Mom's name was Julia and also went by Jul.)
I had a special moment too this week when Steve used my name. It hasn't happened in so long--I thought he had forgotten. Amazing how such a small thing can mean so much.
bqd..Thank you, yes, it's such a relief, now that's out of the way for at least another 6 months.
MarilynnMD..My Mum used to say, "worry about it when it happens", I wish I could be like that. How lovely for you that Steve used your name too...that's so special, I'm so happy for you, I hope it happens often! Nice to know your mum's name was also Julia...