Dental Care Options/ Ideas

My DW is in stage 7. She used to take such great care of her teeth that cleanings were just routine. Anyway, it’s been a while since she’s been able to brush her own teeth. My research, and hospice agrees, is at the very least wipe the teeth off with a tooth swab or even a washcloth. No toothpaste required. This gets 80% of what’s needed. Depending on how much longer the patient has to go the concern is not necessarily cavities. It’s more about inflammation or infections. At this point for us unfortunately it’s down on the list but important. I asked my hospice nurse to take a look and everything looked ok. One sign to look for is bad breath. Hope this helps.

Sea Jay, are there any other MC's close to you? Another option might be to place your mom in a care home vs. a facility.

Thank you for this post. It is a worry for me as well. I was taking my dad from MC to an outside dentist (mine) until about eight months ago. For a variety of reasons I canceled a recent appointment. There is a facility dentist. I suppose we could switch to that person.

I do not visit every day, but very often. If he is awake, I help him brush his teeth, regardless of time of day. I get the toothpaste and brush ready, I get a cup of water, I stand with him by the sink while he brushes. I offer encouragement. It still works. When I am not there, I think there is one nurse who helps him brush, but I don’t think others are doing it. And he certainly isn’t able to think of it or go through all the steps without being cued.

This is his third facility in two states. Only in the first one was he brushing consistently, and that’s because he was still able to remember it himself.

Sometimes the squeaky wheel approach works. I would start by kindly and respectfully talking with the evening shift aides. Tell them her teeth are not getting brushed and it's important to you that she has that done. Keeping in mind they are over worked, under paid, and sometimes PWD just refuse to do things and they only have so much time to spend with each resident. But worth the conversation. If nothing changes you might want to escalate it to the head nurse or request a care conference. That being said, pick your battles. Many PWD get to a point where daily hygiene routines including teeth brushing go by the wayside due to their disease, they just can't manage it. I think most of us who have watched loved ones go through all the stages of dementia would say eventually teeth brushing goes. Perhaps try those disposable tooth brush picks that require no extra paste or spitting as a stop gap (like the Colgate Wisp.) Dental work becomes about comfort and pain control instead of preserving teeth, appearances, or use for the long haul. There are great dentists out there, and then there are some who will always drill and bill because it's money in their pocket. I would tell the dentist you are looking for more of a palliative approach to any dental work. I personally would not be saying yes to all procedures. Look at each one through the lens of what does it accomplish. If she is in pain then yes. If it could be delayed or if it is just something a person without a terminal disease would want, then no. My mother had almost no dental work done after early stage 5.
Swallowing, chewing, and eating problems come with the disease regardless of the condition of the teeth so her eating habits will likely change anyway. They become unable to deal with many textures and eat easier things, slowly moving towards only liquids and pureed stuff. The muscle memory for chewing and swallowing is slowly forgotten, and this combined with the digestive system also not working/absorbing the same leads to weight loss in the later stages. I only mention this so you know it's a normal part of the progression.

Good luck. I know how hard it is to balance your own mental health/time and your loved one's needs and how memory care staff can be a real mixed bag.