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 What to do about dental care? 
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Joined: Tue Dec 19, 2006 4:38 pm
Posts: 12
Location: Evanston, IL
Post What to do about dental care?
My Dad is in mid to late disease stage and isn't talking, walking or eating himself any more. He has spit out bits of tooth and fillings over the past few months, but won't let anyone look in his mouth. He won't let anyone brush his teeth - stick a toothbrush in and he bites down on it. When he laughs, you can see briefly that he has several missing teeth and last time I saw into his mouth, I could see blackened gums. That scared me more than the missing/rotting teeth do.

Can anybody give me any sources or advice for dementia dental care?

I couldn't find anything by searching the internet. We could take him to the dentist and have them put him under to at least check things out, but long term care is not really possible at this stage. I guess my main concern is that he is not in pain from a cavity or an infection and I have no way of knowing what is going on with him because he doesn't speak. He doesn't act like his jaw or cheeks hurt. Now and then his face does scrunch up like he's experiencing pain and we do have him on a Tylenol regimen.

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Diane
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Mon Apr 12, 2010 1:11 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
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If you do a search here, you'll see probably two articles posted about dental care -- one by a PD organization and one by the Alz Association.

Probably your local Alz Association knows about a local dentist that uses laughing gas. (That probably has to be done in a dentist's office.)

There are also dentists and registered dental hygienists who may come to your home, even taking xrays and pulling teeth. It would be best to have a dentist look at the mouth to assess the dangers looming there.


Mon Apr 12, 2010 5:44 pm
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Joined: Tue Dec 19, 2006 4:38 pm
Posts: 12
Location: Evanston, IL
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Thanks, Robin. Dad is in a SNF and the family dentist has been to see him, twice, and Dad wouldn't open his mouth for him either time. I read the Alz.org article and he doesn't exhibit any of the "in pain" signals they listed.

He is still eating, albeit slowly - even though his food is pureed. I guess I shouldn't worry too much until he signals pain or stops eating.

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Diane
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Mon Apr 12, 2010 6:13 pm
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Joined: Sat Mar 28, 2009 6:01 pm
Posts: 101
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Diane,

My husband is more cooperative, but it still sn't easy to get his teeth cleaned. One thing we tried that he will do himself is to use an electric toothbrush. He seems to enjoy the vibrations. I put mouthwash (like Listerine) on it and he swishes it around. Once a day I do insist on cleaning his teeth and mouth properly. It is really important to control the bacteria. Instead of a toothbrush, I use a foam swab that gets at his gums and tongue. we make it into a kind of game and he goes along with it. Even with pureed foods, particles get caught in the teeth. Don't wait until there is pain and something seriously wrong.

Doris

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Wed Apr 14, 2010 1:32 am
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Joined: Tue Dec 19, 2006 4:38 pm
Posts: 12
Location: Evanston, IL
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Thanks, Doris! I will keep trying. I think if I ask him to open his mouth for me over and over and don't say anything else during that period, it might get through. His level of understanding is low, but if it is routine, that helps.

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Diane
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Wed Apr 14, 2010 9:27 am
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Joined: Thu Jul 03, 2008 11:05 am
Posts: 150
Location: Raleigh, NC
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Diane,

I have a similar problem with my mother. She will not open her mouth for brushing, either manual or electric, and she'll spit mouthwash (I've tried several flavors) right back at you. The best we can do is swab her mouth.

I was giving her sugar-free gum in hopes that was helping clean her teeth and massage her gums, but she enjoys it all together too much. She won't give it up, even if it's time to eat, take her med or go to bed. One evening, when she was clearly choking on her saliva as the health care worker was changing her in bed, I finally had to risk being bitten and stick my fingers in her mouth to get it out.

Since she got to this point, I haven't tried to take her to the dentist. I worry. I can see tartar building up, and sometimes her gums look inflamed. But I don't see much else to do.

Garnet


Wed Apr 14, 2010 8:44 pm
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Joined: Tue Dec 19, 2006 4:38 pm
Posts: 12
Location: Evanston, IL
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Hi Garnet - yep, sounds like you're in the same boat. All I can think of is to try to make a game out of it . . . and repeat the attempt often so he gets used to the idea.

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Diane
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Thu Apr 15, 2010 8:16 am
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