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Dental Care

Isabelle95
Isabelle95 Member Posts: 6
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in Caring For a Spouse or Partner

My DH is in the very late stages of Alzheimer's and it is virtually impossible to clean his teeth. He is totally immobile, cannot walk, talk, is incontinent, and has been a Hospice patient for some time. Cleaning his teeth is a problem, as he cannot understand any instruction about opening his mouth. He has lost one tooth (it just fell out), and his gums are always red and sore. I have been using one of those little red sponges on the end of a stick by dipping it into mouthwash and rubbing it over his gums. He keeps his teeth clenched and has no idea what we are talking about when we tell him to open his mouth, so brushing his teeth is not an option. Hospice has not had any suggestions other than what I was already doing. Has anyone else encountered this problem with dental issues? If so, I'd like to hear your experiences. By the way, for those of you who have a patient who is still somewhat mobile, there is such a thing as a MOBILE dental care service. Here in the Phoenix area, there is more than one company that does this. They bring a large motor home to the patient's location, fully equipped for dental work, including dentists and assistants, and have a wheelchair lift to get the patient inside. Anyone can use their services, not just Alzheimer's patients. Not sure what is available in other cities, but I am willing to bet that this service is available in just about any large metropolitan area. Unfortunately, this will not help my hubby at this point in his care, as he won't open his mouth and cannot be sedated. I just wish I had known about it sooner....

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  • Iris L.
    Iris L. Member Posts: 4,478
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    Could you use a Water Pik to squirt water or diluted mouthwash onto his gums?

    Iris

  • harshedbuzz
    harshedbuzz Member Posts: 4,578
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    @Iris L.

    My dad always used a Water Pik, but in stage 6-ish, he couldn't follow the instructions to slightly bow his head to allow the liquid to drain from his mouth. It was a real mess, but the bigger concern for me would be the risk of aspiration.

    HB

  • Caro_Lynne
    Caro_Lynne Member Posts: 371
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    Thanks for the tip on mobile dental care, I will definitely look into it. Just today I made appt. to take DH for cleaning. He still kind of brushes and flosses; I'm just glad he is still agreeable to going to dentist for cleaning. HB, I can relate to the water pik mess, my LO can no longer do it by himself so I have to help him.

  • Iris L.
    Iris L. Member Posts: 4,478
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    HB, I understand about the risk of aspiration. He would still have to lean over the bowl and spit or let the water flow out safely.

    Iris

  • Isabelle95
    Isabelle95 Member Posts: 6
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    Unfortunately, my DH is totally immobile, so there is no way he could "lean over and spit." Using a Water Pik would be problematic, as squirting water into his mouth could result in aspiration pneumonia. Things are progressing so rapidly that he is only on small amounts of thickened liquids now....

  • gampiano
    gampiano Member Posts: 330
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    Dear Isabelle,

    I feel what you are going through. My husband was in that state last month, he died on the 14th. The most important thing right now is comfort for your DH.. I needed to adjust my focus to only that, and it was difficult but necessary. It got to the point that even pudding was no longer an option, as he would not swallow it. Mouth care was a swabbing to keep him moist, and chapstick or vaseline for lips. The body does what the body does. Hospice knows this, and will help you navigate this if you let them.

    Peace,

    Maureen

  • Quilting brings calm
    Quilting brings calm Member Posts: 2,557
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    edited November 2023

    Crest used to make disposable teeth cleaning clothes that had toothpaste ( or something) soaked into them. I don’t know if those are still available or not. Even then, you’d only be able to clean the front if he keeps his teeth clenched.

    can you use a sponge or long Q-tip to rub Oragel or a similar substance over his gums that will ease any discomfort for him?

    His body is breaking down, and that includes his teeth, gums etc. Please give yourself some grace here as his mouth could be in the same condition even if you were able to clean his teeth and gums several times a day.

  • Isabelle95
    Isabelle95 Member Posts: 6
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    https://alzconnected.org/discussion/comment/187317#Comment_187317
    https://alzconnected.org/discussion/comment/187317#Comment_187317

    So sorry for the loss of your husband! I know this is not far off from us right now. Hospice had no other suggestions for me re: dental care than what I'm already doing. I know part of the problem is that my hubby cannot get sufficient nutrients in his diet to have healthy gums and teeth, and this will just continue to worsen. I just don't want him to suffer pain from his inflamed gums. It's hard to sit by and watch these changes, as I'm sure you know. Wish I could give you a hug....

  • ghphotog
    ghphotog Member Posts: 686
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    edited November 2023

    I'm entering the same dilemma. My DW used to be an avid flosser but she has pretty much forgotten how to do it correctly. On our last dental cleaning appt her gums were getting enflamed and I explained why. Our hygienist knows our circumstanses in is great.

    Since my wife can still follow instructions from the hygienist we decided cleaning her teeth every four months instead of six would be helpful. We will pay out of pocket for it but it's only a 100.00 or so. Much better if this helps keep her teeth in good shape longer. Dental bills are so very expensive, even with insurance. I've been wondering alot about what to do when the time comes she can't obey instructions or cleaning or brushing becomes impossible.

    Teeth are important and I'd like to avoid a huge dental bill in the future if her teeth need pulling and / or dentures of some kind.

Commonly Used Abbreviations


DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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