Mom went to the dentist today.
At 96, that It isn’t exactly an easy task. Nevertheless, the two of us were game to try. We made it to the appointment on time. While we waited Mom caught a little nap.
When it was our turn, we walked down the long hallway (nearly a mile, we were sure) to our room. It was no problem seating her in the dental chair, especially once they reclined the chair. Almost like her recliner.
First step, the assistant asked Mom if she was in pain. She smiled and said yes. Asked where it hurt, she said yes. She is the sweetest thing, I wouldn’t tell you this with any disrespect for her. It is strictly with fondness and acceptance of where she is right now.
The Difficulty of X-rays
So…Next we moved on to x-rays. This was the first time they were unable to get X-rays. It’s easy to understand why. Bless their hearts, when someone has Alzheimer’s they generally don’t even remember their daily routine. Then a dental assistant asks them to open their mouths wide (which they don’t understand), allow the tech to put a very awkward cardboard like contraption in their mouth, then ask them to bite down. It’s sort of foolish when you think about it.
Frustrating perhaps, at least for the dental office, but still a little funny. Don’t you wish you could tell the dentist that no, you won’t bite down? X-rays aren’t exactly comfortable for any of us.
Anyway, Mom couldn’t do the bite down part, so X-rays were skipped. We went to plan B. That’s definitely will be one of my tips: Always have a plan B. While we waited, Mom had another little nap.
The very kind dentist came in, got mom to open her mouth, looked around gently, acted very impressed that she still has all her teeth, then made suggestions. Besides a needed cleaning that is now on the schedule, he suggested silver nitrate as a treatment that will arrest any decay in her mouth and hopefully prevent more.
It’s an easy treatment, covered by her medical insurance. That sounds much easier on Mom. We hope it will protect her teeth for her remaining years.
What to Expect with Alzheimer’s
Dental care is a difficult thing with late stage Alzheimer’s at least. At Mom’s age, our concern is for cleanliness and to prevent infection. When a loved one has Alzheimer’s, they often resist tooth brushing, especially when someone else is attempting to do it for them. Some will bite down so hard on the toothbrush they break it.
The process can be very hit and miss, depending who is doing the brushing. If they still do it themselves, it is doubtful they can do a very good job. Yet it is important to their overall health. Cavities, bacteria, and infection in their mouths and teeth, can cause infection and illness elsewhere in their bodies as well.
Dentures—or Maybe Not
If someone has dentures it must be very difficult. Unless they are very good about keeping them in place, the mouth does some reshaping over time when they are not worn. Then when you try to put dentures back in, the fit may be off, causing pain. Since they are usually unable to explain what is wrong, you don’t know if the dentures are hurting, uncomfortable, or just a nuisance to your loved one.
Some end up going without because of fit or discomfort. At some point with an alz patient, it may be too difficult to get them to let you put their teeth in, let alone keep them in. I’ve seen a few who would often be moving them in and out of their mouths. There are some who will just refuse.
At their age and in their condition, that may get to a point where it’s not worth struggling with. Many are still able to eat food that is cut into small bites, that isn’t too hard—meat even. They should be watched when eating to be sure they are able to swallow properly without any choking. At some point they may need to eat a pureed diet. Nearly any regular food can be run through a blender. When they reach that point, they still seem to enjoy eating. That is the main thing.
Have a Plan
It is a good idea to get with your family and decide how you want to handle dental care issue for your loved one. Personally I’ve gone back and forth on care. I’ll often see residents who have lost a tooth now and then. Up until now, we’ve let her dentist do crowns instead. At some point it gets to be a harder choice. Knowing the difficulty of that appointment for Mom, I don’t know if we would put her through it again.
Some considerations include:
Is a back tooth needed for chewing?
What are other options, if any?
Will the tooth have to be pulled?
Will a crown stay on and be effective?
These are questions that may come up. I’d suggest you discuss it with other family members if possible before it becomes an issue. Each situation is different. Certain teeth may still be necessary to maintain their current lifestyle. Costs may be an issue as well. It’s smart to give it some thought before it’s needed.
A Few Little Tips
Be sure you find a dentist who is accustomed to working with Alzheimer’s patients. If they have a regular dentist they’ve seen a long time, staying with that person may be fine. It takes extra care and understanding. If their dentist isn’t a good fit, then try to find one who is more used to treating seniors.
Let your dentist know what stage your Alzheimer’s patient is in, ahead of time if possible.
I believe the more information they have going in, the easier it will be on your loved one.
Don’t forget to bring a list of medications with you. There are various reasons a dentist will need the information.
For instance, if your loved one takes coumadin or another blood thinner. For that particular medication, you should let the dentist know ahead of time.
Personally, I would ask the dentist to arrange the cleaning at the same time, unless you are going in for an emergency treatment. If you can get both over with in the same visit, it saves your loved one from having to go through it another time.
For our family, it is hard for mom to walk far, or get up and down. One trip saves on that stress for her as well.
Try to have a plan B! In our case, it will be silver nitrate.
For some it may be non invasive x-rays some dental offices have available.
If you expect something major to be needed, see how much can be done in one visit. For instance, many dental offices now make their own crowns.
If they can accomplish that in one visit, it not only relieves any pain your loved on may be in, but also gets it done faster.
Bring a throw blanket for them while they are in the chair. That could just be me, but it seems seniors are so often cold.
It’s a little thing to have a light little blanket you can put over them while they are there. it provides comfort as well as warmth.
Go for a treat afterwards, just for fun. Unless their teeth hurt, that is. We’ll usually drive through somewhere for lunch, then drive down to the beach. We can eat in the car while we enjoy some very fresh air.
I know fast food isn’t the best choice, but Mom eats well nearly all the time, so as a treat, it’s okay. She has her favorites. Ice cream or a shake works too instead of lunch. Even a root beer or a favorite soda is a treat.
Caring for the teeth is still very important, as difficult as it may be at times. With dental picks, perhaps electric toothbrushes, there are ways you can help. As the spouse or family member your loved one may respond better to you if you are able to help them with teeth cleaning.
For as long as your loved one is able, do try to get them to the dentist for cleanings at least a couple of times a year. The longer they can keep their own teeth the better their quality of life.
Probably the best book you can buy if you are facing or dealing with Alzheimer’s Disease. It’s a go-to book for questions, from pre- and early stages to the final days. I would highly recommend it. You can read my review of The 36-Hour Day here.
My second favorite (so far) for Alzheimer’s is this quick book Learning to Speak Alzheimer’s. It covers a lot as well, but includes something I have found is very helpful in Alzheimer’s. That is meeting your loved one where they are. It is much less stressful for the patient and for you when you are able to reach that point. Here’s my review.