The time to worry is if/when the patient is in pain from a tooth that needs to be extracted. Then you'll have to figure out how to get them to a dentist or oral surgeon for the work to be done. My mother lived in a Memory Care AL so I hired a traveling dentist/oral surgeon to come to her room and do the extractions when necessary. She was given Novocaine and a calming medication prior to the work being done. It all went off without a hitch, aside from the exorbitant costs associated with a traveling dentist. Before the dementia got bad and she was living in regular Assisted Living, I'd drive her to the oral surgeon's office to have 2 molars extracted that had gone bad. She was SO nervous and high strung, the whole event was horrible to be honest. But it had to be done b/c the teeth were infected and she was given antibiotics beforehand to treat it.
I wouldn't worry about routine dental care or cleanings, however; just treat emergencies as they crop up.
Hi, Lealonnie1. It is nice to get assurance from someone who has experience in this matter. I will follow the advice in your last sentence and will only worry about true emergencies. Thanks
I think it is important to address the difficulty in getting teeth brushed. When someone has advanced dementia they are often resistant to having their teeth brushed because they don't understand what you are doing and/or they think they have already done it themselves. In memory care facilities the staff rarely brushes teeth. I had camera's in 2 separate facilities my mom was in and never once did anyone brush her teeth even though it was in her care plan. I repeatedly requested they do it. Because I could not get in the facility during covid, she had dental issues once I was able to get in. When I took her to the dentist, he said "they never provide dental hygiene in those facilities, I see this all the time". I have my mom home with me now and bought these great pre-pasted toothbrushes from Amazon so she can use them in her bed or while watching tv and then her caregivers can get in there and brush also. No messy foam or having to spit (she also did not understand spitting out after brushing). It is easy to say that dental care must be done but the challenges of the process need to be addressed.
Thank you for the suggestion of pre pasted toothbrushes. My mom will be moving to LTC in the next few weeks. She will use her electric toothbrush with direction and reminders only.
I wouldn't. If the dementia is that advanced that they can't get dental care, then that's probably the least of your worries. If they end up in pain, I wonder if dentist can basically knock them out to do what needs to be done?
Really disappointed to hear these responses. Brush with fluoride toothpaste and electric toothbrush. Get regular dental cleaning if possible. Dental infection and pain can cause more suffering including delerium.
Are you kidding me-no dental care? Call the dentist and get some professional advice.An infected tooth can be deadly.Eating could be affected by poor dental hygiene.
My mom doesn’t brush but is open to direction. I got her mouthwash with hydrogen peroxide in it and toothpaste for dental disease periodontix. She brushes or rinses her mouth until no food in spit at least 1 time a day. The caregiver is excellent in directions. No questions -do you want to?- just directing to the bathroom. I was there and no caregiver. Mom and I came back from the dining hall and mom shot straight for the bathroom saying “Brush teeth, brush teeth”. I was so happy to hear that. Also she wanted to go lay down and this activity is done before bed! ;)
I think this is a time to consider the concepts of adequate vs ideal. I had a counselor suggest this to me when I was dealing with issues around my mother’s care and it really helped. Obviously, in an ideal situation, preventive dentistry and twice daily dental hygiene would be the standard. My father in law is in long term care for dementia. The facility said he needed to go to the dentist and called my 86 year old MIL to schedule an appointment to take him. This was beyond her capacity. There was no way to make this happen. We can’t transport him ourselves and managing him in a new environment. We couldn’t find a dentist to come to the facility. It was terrible and we were so stressed and frustrated. We engaged his care manager who helped us order an electric toothbrush through his benefits. We asked that the caregivers direct him to brush twice daily. I understand your situation and know how awful you feel. Dental care in the US Medicaid/ long term care space is lacking.
Mom is bedridden now and cannot move herself without a lot of help. It is impossible to get her to a dentist much less transfer her to the dental chair. She had an infected tooth last year when she was able to travel to her dentist. After the antibiotics no pain at all. She has 2 teeth that need to be pulled. I had made two appointments that had to be cancelled due to illness. Another hospital & rehab stay followed. If she has pain I don't know how this will be managed. Easier said than done. Does Medicaid cover dental visits to the nursing home?
My husband is in a memory care facility and I take him to the dentist for hygiene every 3 months (recommended for dementia patients.) They book a longer appointment and numb gums to make it easier. They ordered a prescription toothpaste for nighttime which is no rinse. The more the staff does it, I think the memory pattern returns. There are sonic and electric tooth brushes which work well if used. A waterpik is essential to remove plague. Bill has been cooperative. We had both been very attentive to our dental health every six months. He has a tooth we are monitoring, a cavity under a crown which may require an extraction. Dental health is extremely important. I firmly believe you don’t wait to emergencies occur from decay or broken teeth. Infections from mouth issues can poison your system.
Some localities have "mobile dental offices." Not sure if these dentist offices on wheels are available where you live, but worth checking it out.
Many Medicare/Medicaid long term care qualified facilities have mobile dental vans come to the facility. No need to travel to the dentist office. The VA also has this in may localities too; so if one is a Veteran, that may be an option. Dental care for those on Medicaid Long Term Care, may or may not be a benefit in your state. Worth checking on that too if your LO is on Medicaid.
At my mom's facility (nursing home) -- she is 86, has dementia and a host of other medical/mental issues and is on Medicaid Long Term Care coverage -- the mobile dental van comes when there is a group of residents in need of dental care. The social workers handle scheduling. A huge 18 wheeler van comes, with a back lift. Folks can be wheeled onto the lift in their wheelchairs and once up at the level with the "office" they can enter. There are aids of course to help maneuver folks.
Inside the van is a full dental office and it is set up for folks who may be in wheelchairs. They can handle most everything inside the van (including X-rays). I do not believe "oral surgery" -- which requires anesthesia -- is included. The van is heated and air conditioned, so time of year does not matter. The service that comes to my mom's nursing home; has a team specifically trained to work with those who have dementia and/or elderly folks physical limitations as that is their business. The van travels to many nursing homes around our area.
There are also private pay dental vans (at least where we live), that will come to your home if a LO is not in a facility.
I wouldn't worry about routine dental care or cleanings, however; just treat emergencies as they crop up.
Brush with fluoride toothpaste and electric toothbrush.
Get regular dental cleaning if possible.
Dental infection and pain can cause more suffering including delerium.
Easier said than done. Does Medicaid cover dental visits to the nursing home?
Dental health is extremely important. I firmly believe you don’t wait to emergencies occur from decay or broken teeth. Infections from mouth issues can poison your system.
Many Medicare/Medicaid long term care qualified facilities have mobile dental vans come to the facility. No need to travel to the dentist office. The VA also has this in may localities too; so if one is a Veteran, that may be an option. Dental care for those on Medicaid Long Term Care, may or may not be a benefit in your state. Worth checking on that too if your LO is on Medicaid.
At my mom's facility (nursing home) -- she is 86, has dementia and a host of other medical/mental issues and is on Medicaid Long Term Care coverage -- the mobile dental van comes when there is a group of residents in need of dental care. The social workers handle scheduling. A huge 18 wheeler van comes, with a back lift. Folks can be wheeled onto the lift in their wheelchairs and once up at the level with the "office" they can enter. There are aids of course to help maneuver folks.
Inside the van is a full dental office and it is set up for folks who may be in wheelchairs. They can handle most everything inside the van (including X-rays). I do not believe "oral surgery" -- which requires anesthesia -- is included. The van is heated and air conditioned, so time of year does not matter. The service that comes to my mom's nursing home; has a team specifically trained to work with those who have dementia and/or elderly folks physical limitations as that is their business. The van travels to many nursing homes around our area.
There are also private pay dental vans (at least where we live), that will come to your home if a LO is not in a facility.
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