Most dentists stress the importance of dental care for elders. Realism for caregivers comes into play here, as many of our elders get so they can't be transported and lifted into a dental chair for major work. Some will fight even having their mouth swabbed out by a family member. This can become a huge issue for already guilt-ridden caregivers. We want to do more for their dental health, but what? How?
My Dad had to get dentures in his 30s as he lost his teeth because of a another health issue. He was always careful to keep his dentures in place, even at night. He hated being seen without them. As he aged, he lost more and more supportive bone, a natural thing when your teeth are removed since there's no pressure on the bone from chewing as you would have with natural teeth.
New dentures were purchased several times. They were relined. He kept at it. Then his brain surgery and consequent dementia put dental issues, for a time, on the back burner. That is until he managed to lose his lower dental plate. Many a nursing home staff member has dug through garbage looking for a denture plate that was thrown away with the uneaten food. We discovered that Dad's teeth were missing too late for that lovely chore, but did soon thereafter find out. So off to the dentist we went.
The dentist was wonderful with Dad, even though Dad couldn't be moved to the dental chair for a good exam. Also, Dad's dementia made doing a real exam extremely difficult, as he didn't understand what the dentist was doing.
However, the real problem was there was almost no bone left to support dentures, so the only thing to do at this late date was to order the best fit we could get from the skimpy exam and past records. Then we bought bonding products by the case.
Are natural teeth easier?
The question is, was Dad's experience worse than my mother-in-law's situation? She had her own teeth, but after a bout with pneumonia that took heavy duty antibiotics to cure, her teeth started to rot. She had an abscess, and that was taken care of by pulling the tooth and giving her more antibiotics. However, even that "cure" was traumatic for her.
She hated the looks of her teeth, but what could be done? She couldn't withstand the anesthetic and surgery to remove all of her teeth. Nor could she handle the physical or mental strain of a mouth full of root canals and/or implants. The nursing home kept her mouth clean, they checked for pain and swelling, but the teeth rotted away. I felt so sorry and totally helpless.
My mother had issues as well, though not as severe. I took her to her dentist to see what could be done about a molar that was snagging her cheek and bothering her. The very kind dentist said she was far too frail to handle the oral surgery she would need, as at her age the roots were grown so deep they would take extensive surgery to remove. A new substance had just come out that was like a temporary filling and he used that to smooth out the tooth.
The bottom line to me, as with so much of our elder's care, is their comfort. The actual route to find the best comfort zone for them varies. What can be done is often limited by their other health issues, physical and mental. This is especially evident when it comes to dental care.
My best advice is to see a dentist you feel has the patience to work with elders, but is also realistic. Ideally, nursing facilities could offer this service but most can't. Get the best professional advice you can. Do as much as you can realistically do. Continue to go for cleanliness, even if it means swabbing out the mouth with water a couple of times a day. This problem has no easy answer. So, what's new? Caregiver's often have to wing it. Just keep doing your best and understand that's all you can do.
Published On: October 18, 2009