Does there come a point when you give up on dental care?

I'm interested in hearing more about this situation. My mother is having problems too. She has partial dentures and doesn't brush on a regular basis either. She has a fungial infection under her plate due to it not being removed. I'm sure it's mizerable, but I'm in another part of the state and can't remind her constantly either. Sigh. . .

I think I would seek a second opinion. If you can get him to go.

I think dental care is very important and I think it should be addressed up till death. I am not talking about getting crowns or implants, I am talking about teeth cleaned often, since he forgets to clean his teeth, schedule every three months. I make sure my mother washes her teeth very well each day at least once and use Listerine. I would take care of all the cavities and take care of the tooth that needs an extraction. I would pay special attention to his teeth and gums, he does not need painful gum disease since it is very bad for his overall health and heart. Take it slow. His teeth are his way to enjoy his food and should be taken care of now and always, and also he is only 74! Sheesh, never thought I'd say it but 74 is not that old today and he could live to be a 100. I take my mother who has dementia to the dentist to have her teeth cleaned every six months and she is 85, it was funny she said, look ma no cavities. If you can't care for him from a distance get someone who can help him.

My mom is 78, when she was a child she loved to eat lemons. As long as I can remember she had capped fron teeth and went to the dentist 3-4 times a year to treat (contain) gum disease. When my dad died, my sister and I were torn in all directions worrying about trying to keep her happy and safe. A year went by without a visit to her dentist. The dentist discovered that she had a molar that had come out, but instead of telling us, she just kept reinserting the tooth. We were stunned and guilt ridden. Today, she is no worse for it, but, she could have choked or developed an infection. The dentist suggested pulling the rest because they are all hanging on by a thread. Her jaw bone has deteriorated to a point that implants won't work and there are no teeth strong enough for bridges. The problem with pulling them out is that she won't remember she doesn't have her teeth and that she needs to put in dentures. My sister brings her to the dentist and when he asks my mom how things are going, she says everything is fine.

you brought up a good point. Mom has ALZ. and she won't let us take her to the dentist and we need to!! Is there dentists that can work on someone with ALZ?? i hope the best for you in your decisions in caring for your father. I hope you find the right help. The best to you!

There is a natural gum with xylitol in it that will help keep the mouth clean and help reduce cavities it the folks do not have problems chewing. I had to do this with my Mom. It some how also kept her busy and had something to focus on. There is a good book at the PPNF . Otherwise it can be a frustrating battle for hygiene and you have to figure out how far they have progressed and what it acceptable. Look at something they can drink to wash the sugars off. Sugars and soda pops are tough on teeth.

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By all means, your Dad does require dental care.
This will get much worse eventually & cause him to suffer much pain , possible infection, etc. if the problem is not attended to.
Unless your Dad has a separate Dental insurance plan, Medicare will not pay for dental .
Most Seniors do not have Dental insurance because it is much too expensive, therefore we need to use our savings ,which yes, is very costly but very necessary.
There are some Dental plans that offer Seniors,etc., without questions, a reduced cost plan which may be helpful to offset the cost.
The plans are at a reasonable cost.
I hope that you will consider this concern to be very important & necessary to prevent a much greater suffering for your Dad.
Best wishes.

I would think if a tooth has gone far enough to where extraction is the only option, then he must have pain, at least when he eats or drinks. Taking him to get a cleaning to remove plaque is a start, however plaque returns almost immediately so regular brushing is very important to slow down the process. If he is in a home he should be receiving this care twice a day, in the am and before retiring for the evening. You are right about as the dementia progresses it will get to be a chore, but for now he is co-operating which is great. His clean teeth are an important of him being able to enjoy the flavor of his foods. I would have this taken care of asap as well I would speak to the head person who over sees that things are being done to your specifications. You have a right to speak up for your father and make these demands, Good luck

I found a dentist that will come to the assisted living where my husband is. He is experienced with dementia patients and will examine and clean his teeth every 6 months. I brush his teeth for him. Hope this helps.

Ask the doctor treating the dementia about referrals or what to do. Also, local ALZ support group might also have a referral for a dentist.

Also, my mom has the best electrical toothbrush I could buy, that has kept the plaque accumulation low. I have to prompt her to turn it on and tell her to keep brushing all her teeth until the toothbrush turns off.

I also have the best mouth wash possible. Oxyfresh is expensive, but whenever it is on sale I buy it.

Also, it has been proven that baking soda is excellent especially before bedtime. It kills the bacteria while you sleep. I buy her Arm & Hammer toothpaste.

There are dentists specialized with treating special patients. For instance, I found one here in Miami. It is important that you get a good referral, because neither you or your dad have the time or money to visit multiple dentists.

Please keep us updated. As you can see many of us struggle with the same issue.

I would agree with getting a second opinion, as I've never heard of the treatment described to stop the cavities in their tracks, either. I realize now how fortunate my MIL was to have continued to have been able to address dental care until almost 90, despite her dementia. When she and her husband went into assisted living (at 90), a lot of her self-care went by the wayside. Her dementia worsened rapidly and staff did not seem to spend a lot of time helping her with personal hygiene other than a shower a few times a week. After her huaband died and she moved up to the "memory care" floor, it got even worse. After three months of further deterioration, we took her back to her home and cared for her for the last two years of her life. She was then always clean and well cared for, but dental care fell by the wayside the last two months of her life. Her sister, who will be 100 in a few months, has been in a nursing home for nearly 9 years. All her teeth have broken off and she has not had dental care in years. She doesn't complain of pain, though, but can only eat pureed food. I hope some better ways of dealing with these concerns will be discovered and the information widely shared. There is certainly a huge and growing need.

My Mom is 94 and chews her teeth constantly. I was brushing her partials the other day and notice they are worn down to the metal parts in them. It is a fight to get them brushed. She only has few teeth, maybe 4 or 5, just enough to hold her partials in. Any suggestions with something like this?

I went through this too. My husband has always had bad teeth even with meticulous care and when he got dementia his dental hygiene went out the window. He refused help with brushing and to make matters worse he started pocketing food in his cheeks instead of swallowing it all. Five years into his dementia he finally allowed my to start grooming him in the mornings and I was shocked at the state that his teeth were in. His dental implants had started falling out due to bad bones and almost all his natural teeth were rotted near the gums. I took him to a dentist, but he refused to let them look in his mouth or take x-rays. Two months later, I tried a different dentist with the same results. In frustration, I just about gave up. Then one of his natural teeth broke off at the gum line. In the meantime, he had started taking Serequel due to yelling episodes that lasted hours. I made an appointment at a dentist our daughter knew and gave him a dose of Serequel before we went in. He still didn't cooperate and I gave him another dose (I could give him up to 3 at a time but usually didn't do it). Fifteen minutes later he was calm and we got panoramic x-rays, impressions and an exam. The dentist told me he had about 6 teeth that need extraction and sixteen caps/crowns and the rest filled and he would remove the one remaining implant. An outpatient surgery room was arranged at Mercy Hospital, an oral surgeon found and both the surgeon and our new dentist worked on him for three hours under general anesthesia. Yes the cost was astronomical and thank God we had and IRA to draw from. The hospital took half off the bill after I talked to them and the oral surgeon discounted his fee. The dentist fee was put on a Care Credit card. It took me three months of pureed food and soups before I could get my husband back to eating soft foods. Any lumps would be pocketed in his cheek.
Anyway, I am very glad I did get his teeth repaired even though he refused to go back for any cleanings afterward. Since I was in charge of brushing, his teeth have been brushed and flossed and they are still in good shape 3 years later.
He is in end stage dementia now after 10 years and is bed/chair bound and at this time I wouldn't do all that again.

My husband also has forgotten how to brush his teeth. He keeps trying to put liquid soap on the brush. He had stopped brushing and I understand why if he was using liquid soap! That must be awful tasting! He won't brush unless I stand there with him an show him how. I have to show him how to do everything now!

Yes. The silver nitrate will work as nothing grows around silver (a microbiology class experiment I will never forget). If he is not having any symptoms of decay, any dentist would love to work on his mouth $$, and you do not mention any dental insurance. You can purchase a dental discount plan where you get a discount on procedures (dentalplans). A root canal might start giving him pain, so maybe that one might be done now since he is still pretty agreeable. Your caregivers during the day are going to have to brush his teeth because he is going to forget. Do not buy any sweets and leave them in the house. That includes sodas, and fruit drinks. (I am in the process of dental implant work, but because of the U.S. dental prices, I travel from AZ to Los Algodones, Mexico where a lot of Americans and Canadians go for their dental work.)

I have the same question with toe care...mom has had nasty toe fungus for many years.. I mention it a lot to her dr and he doesn't say much, kinda dismisses it...it bothers me cuz it looks ugly but I have been hearing snippets here that It is really not important at this stage.
Any thoughts

It is a struggle, I know that mom does not brush as thoroughly as she once did and does have to be reminded to brush at all. Bad teeth can end up poisoning ones whole system. I remember back in my day as soon as a woman became pregnant the doctor always advised her to go to her dentist and have a thorough check up and get any cavities taken care of because any infection would end up in the blood stream and affect the baby...so knowing that, I have always made sure that my family, including mom now, take care of their teeth. Especially knowing how infections can affect the mental state of someone with dementia too! Nobody said it would be easy!

Mom is 91 (92 in another month) and sees her dentist every six months. She has developed OCD as a result of her vascular dementia so she grinds her teeth when she gets anxious. She's lost her two lower front teeth due to her grinding. When she starts to grind, we give her a half of stick of sugarless gum--I've heard chewing it can also help prevent tooth decay. Although during her cleanings she may clamp her mouth completely shut, the hygenist is able to clean the outer parts and check for any kind of infection. About 2 years ago, she did have to have an infected molar extracted by an oral surgeon and she handled it quite well. He also used Computed Tomography to take her x-rays which made it easier since she grinds and gnaws -- can't keep still. After meals, she rinses her mouth several times before brushing--then I brush the outer teeth and ask her to brush inside top/bottom, etc. Sometimes she will but oftentimes she will just bite down on the toothbrush. I tried using a water pick flosser to remove food from her teeth but she was very uncomfortable using it. So we do the best we can and at this point I won't give up helping her with her dental care---too important.

@jujubean - for nail fungus try coconut oil (solid type). It worked for a nail I had damaged that became infected, and it has worked for several others I know. Just apply it twice a day. The coconut oil can be bought in any grocery store, or online cheaper some places. I out some in a small container for my nail and for friends, and used the rest for cooking. Chapman farms is the cheapest I have found.
@ferris Would you mind letting me know where you go in Mexico for dental treatment? I am Canadian and the prices for implants and other work in my area are horrendous.
PaulaK - re infected teeth - infections can travel to other places in your body e.g. your heart and cause trouble. I do think it is better to get them dealt with properly. You might want to Google silver nitrate treatment for teeth. I gather it is done in some cases. A second opinion doesn't hurt. Good luck!

Thank you all for the answers ... Yes, absolutely, I am pursuing treatment for Dad's current dental problems, and have his first appointment set up for tomorrow. The reason he is not having pain from the infected back molar is because the nerve is dead. I asked if a course of antibiotics would wipe out the infection, but the dentist says no because there's no blood supply back there anymore. She says it's the most difficult tooth to work on in the adult human mouth, and because he already has a metal crown on it to boot, it is even more challenging due to an inability to get light back there. She has referred him for this particular work to the only endodontist in his town. I will be talking to that doctor sometime today or tomorrow for his impression on whether a root canal or an extraction makes the most sense in this case. The good news is that the dentist says the best predictor of pain following surgery is current pain ... the fact that he is in zero pain right now makes it likely that he will not experience a lot of post-surgery pain. Fingers crossed!

The dentist explained to me that older people can be more susceptible to cavities forming at the gum line (all of Dad's cavities are there) because as the gums recede, they expose tooth with softer enamel. Add in the not brushing and the not flossing and the sugary foods, and it's a recipe for trouble.

I am proceeding with the silver nitrate treatment, after having spent some time reading up on it on the Web and talking further with the dentist. At the end of the treatment, we may have some small fillings if any of the dark spots bother Dad cosmetically, or if any are causing food to get caught ... but the dentist says this treatment process is so much less overwhelming to elderly patients with some mental impairment (and less expensive than traditional fillings), so it's where we're going to start.

I loved the suggestion about taking him in for cleanings every 3 months. I think I will do that. I've also got his caregivers cueing him now at the start of their shifts to brush with the prescription toothpaste, and that should work for at least a while. Basically, I asked this question because while my Dad is having short-term memory issues, he's still mostly "there" -- he knows who I am, he knows who his caregivers are, he manages his daily routines, and so on. But I know this will not always be the case. It has been challenging to talk about dental treatment with him ("If I die tonight, I won't have to see the dentist," and so on), but I can't imagine how much harder it must be with a patient who truly does not understand what is happening and is frightened and upset.

I am VERY fortunate in that it turns out Dad DOES have dental insurance through his former employer. I thought he did not, and was researching dental insurance to buy ... but he said he thought he did, even though he couldn't remember the name of the company or whether or not he had a card. I talked to the benefits department at his old company and got the info. Insurance won't cover the silver nitrate treatments, which will run about $500, but Dad would prefer these treatments to the traditional fillings that it will cover. It should cover (or at least 80%) of the extraction or root canal, and also contribute to any follow-up fillings that are necessary for the treated cavities.

Thank you all so much for your thoughts, suggestions, and insights ... I'll get him through this first round of work, get him on a three-month dental cleaning schedule, and see how things are going at that point. I feel reasonably confident I can "hold" him at the current place for a while ... I just got a little overwhelmed thinking about the future! :-)

OMG: teeth.

My mother passed 18 months ago after my caregiving her with dementia for eleven years - 5 in my own home. Teeth were a pivot point in our relationship. MOST of the answers I have read here seem to be still in prioritizing the doings of caregiving. My lessons learned were (and are) about prioritizing important places of being with your loved one. Let me explain.

I am not to minimizing the functional, but attempting to give some perspective from the other side of this herculean task you all are living.

When my diva mother, finally shed her (final) pride - it was about her teeth;she no longer cared (at about 88 and 9 years into my caregiving) it revealed that not giving here dental care was MY PROBLEM with my own pride. She had (mysteriously) lost (like she had misplaced it) her front tooth. The transformation was stunning. I took her to the dentist, and she rightly suggested it was not a good idea to worry about it. I agonized about this and found it exasperatingly difficult to let go of MY pride about being a "good" daughter. My mother, after several conversations with her about her front tooth, just did not care. Why did I care, if she did not?

I came to the point of respecting the process of her letting go, her dementia, her teeth and my story about what the world would think of a daughter that did not look like she cared.

Just be aware, dear, caregiving, sisters and brothers what are the important things. INHO, it is finding the more loving path in a changing landscape of uncertainty.

Just wanted to add....mite be helpful to someone!
when I took ma on, she had dentures for many years that she never wore cuz they hurt her too much. She kept going back, over n over, I remember then just gave up??? anyway I would make her wear em in public cause I was embarrassed..all that did was cause us to lose one somewhere...
her doctor sed if she can eat fine, getting proper nutrition etc.... don't even bother replacing them they will get lost again...I agreed with that and she hasn't had teeth since... ours was easy cause low threat of infection, so far????
I just give her mouthwash everyday but now she is swallowing it sometimes, ickkkk, so I need to look for those sponge/swabs to cleanse her mouth.

mongomay I am very interested in your answer. What is PPNF? Please inform about the product. I am scheduled for a root canal. Thanks

Hope you are feeling a little bit calmer now that you have enough advice from this panel of well-wishers, and hope teeth issues get resolved. I forgot to mention if anyone else is interested in Mexico dental prices. In AZ, I was quoted at least $30K for implants and crowns, and my fee is going to be $5500 when I finish in Los Algodones, Mexico. Here' looking at you kid!

Sorry, "Here's looking at you kid!" (Casablanca)

One filling at a time, as in one day at a time, keep it in the here and now and all will work out fine.

MADEAA YOU SAID "I make sure my mother washes her teeth very well each day at least once and use Listerine. I would take care of all the cavities and take care of the tooth that needs an extraction. I would pay special attention to his teeth and gums, he does not need painful gum disease since it is very bad for his overall health and heart." Does your parent have ALZ. how can you get her to brush her teeth. Mom always said, "i did already" and wont let me help her. HOW DO you do it?? ;) *(do both your parents have dementia? you said 'he' and talked about your mom, your dad is 74 and your mom 85?)

Please et a 2nd opinion...a tooth that is so bad that it requires extraction is likely to become painful/sore at some point. Extraction is easy but i don't know your fathers overall health. My neighbors dad with advanced VD had an extraction...sometimes that's all you can do. Remember, if its so bad it is a candidate for extraction it could et infected, abessed (sp) and become painful.

I would also get fillings for cavities. Also, I've heard alot about geriatric care managers who might offer sugestions.

Oral health must be continued as it does affect overall health including the heart. We need our teeth for chewing as well as speaking. The ability to chew is part of the digestive process.

I had to discontinue the electric toothbrush with mom but she is compliant when i use a regular toothbrush. The trick for me was being at her level, explaining what i wanted to do, then approaching her slowly...when she resists which she sometimes does at the onset i wait and try again. This always works. Sometimes I have to do 2 or 3 tooth brushing applications as she doesn't always let me brush everything all at once.

My mom no longer knows how to swish so no mouthwash as it should not be swallowed. Only a minimal amount of toothpaste should be swallowed so i use a teenie tiny amount. I then use a glove and my fingers to apply water to the teeth to sort of wipe them off and then she can swallow any water in her mouth. I repeat to try to get as much of the toothpaste off as possible.

Remember folks...dental problems only get bigger, never smaller....Whatever you can do to encourage daily oral care can make a big difference in the long run. There will come a time where you or someone else needs to try to brush for them but at least try as long as you possibly can to have the patient brush with some kind of routine...such as "you brush while I make your bed..." or something like that....I am a dental hygienist with a husband with advanced dementia. It killed me that he had to have a molar extracted last year....ANYthing you can get them to do will help...Brushing is of the utmost importance, and the sugary snacks that are sticky or that stay in the mouth the longest, like hard candies...are the WORST. Perhaps sugarless candies can be substituted but use caution at first. Some artificial sweeteners cause diarrhea. Using the prescription strength toothpaste is an excellent idea! Also, having fluoride varnish treatments is totally painless and doesn't taste bad and are very effective. That does not stain the teeth. You must have meant that the silver nitrate stained the teeth. I am not familiar with that treatment. I just know I want my husband to be able to chew comfortably and have his teeth as long as possible. He has been robbed of so many other pleasures.... The fungal infection under a denture can be eliminated...but perhaps when your mother needs to have someone helping her at home...then they can have it as part of the daily routine. I know it must be very hard to manage everything long distance, certainly not brushing!! Good luck to you both. Be creative....this is a challenging job and you just have to invent new ways of doing things to help your loved one. You will never regret the love you gave them.

Go to the U K. Nobody there receives good dental care. They're not dying either. The average guy there thinks that Americans are obsessed with their teeth. Are we? I'm a believer in good dental health habits. I am not a promoter of dental implants, however, with titanium rods. Nothing wrong with an open space. An Orthodontist can help.