Visit from Dentist - Cracked Teeth and now not chewing well and diet problems
- Thread starter CraigC
- Start date
Craig, my mother's teeth are cleaned twice a year by a dental team which comes to the nursing home. She is given lorazepam prior to the dental work and so far, it has worked.
The staff do try to brush her teeth but it's very difficult. Mum bites down on the toothbrush - the chomp marks on it are very charming. Her breath can be very bad also. She hasn't any decay yet so the twice-yearly cleanings seem to be coping.
The staff do try to brush her teeth but it's very difficult. Mum bites down on the toothbrush - the chomp marks on it are very charming. Her breath can be very bad also. She hasn't any decay yet so the twice-yearly cleanings seem to be coping.
Hi All,
Just felt that some feedback may benefit someone sometime.
The home are using the electric toothbrush regularly now, so much that the heads keep wearing down ;-0 We are getting softer brushes for a bit more comfort but the heads are so easy to change on the electric toothbrush - so good result.
Unfortunately, dad is still getting problems with his teeth / cracking.
They are using corsodyl dental gel at the home but I'm still not convinced that everything is being done so continue to keep on top of dentist. I think we may well have to opt for surgery at some point as he must be in some discomfort. Getting a bit of conflicting advice.
On thing I have asked the home to do is use plastic cutlery as when I feed dad he bites on the fork or spoon which really cant help matters. These are available on the web or specialist shops.
Biting on a metal fork cannot do brittle teeth any good (we all know how that feels).
Many thanks for all you help and advice!
Craig
I'm still not convinced that everything is being done so continue to keep on top of dentist. I think we may well have to opt for surgery at
Just felt that some feedback may benefit someone sometime.
The home are using the electric toothbrush regularly now, so much that the heads keep wearing down ;-0 We are getting softer brushes for a bit more comfort but the heads are so easy to change on the electric toothbrush - so good result.
Unfortunately, dad is still getting problems with his teeth / cracking.
They are using corsodyl dental gel at the home but I'm still not convinced that everything is being done so continue to keep on top of dentist. I think we may well have to opt for surgery at some point as he must be in some discomfort. Getting a bit of conflicting advice.
On thing I have asked the home to do is use plastic cutlery as when I feed dad he bites on the fork or spoon which really cant help matters. These are available on the web or specialist shops.
Biting on a metal fork cannot do brittle teeth any good (we all know how that feels).
Many thanks for all you help and advice!
Craig
I'm still not convinced that everything is being done so continue to keep on top of dentist. I think we may well have to opt for surgery at
Hello Craig
Dhiren`s teeth are beginning to fall out one by one now and he is looking decidedly `gummy`. I`m not bothering, because he doesn`t seem in any discomfort and hates being examined. Nor will I get him fitted with dentures. The least intrusion into his life the better.
Is your dad in pain or discomfort?
Dhiren`s teeth are beginning to fall out one by one now and he is looking decidedly `gummy`. I`m not bothering, because he doesn`t seem in any discomfort and hates being examined. Nor will I get him fitted with dentures. The least intrusion into his life the better.
Is your dad in pain or discomfort?
Did the dentist say why Dhiren's teeth may be falling out?
One of the teeth at the front that has snapped is a little red and causes discomfort when he bites, the gel is helping. Speaking to other relatives, problems with teeth in care homes seems quite common. Particularly with people on the supplement drinks (these are quite sugary and can rot teeth).
Most relatives/carers (at dads homes) seem to agree that dentures don't work out.
I agree Sylvia that invasive surgery is a very last option. But if he needs surgery due to one tooth causing a lot of pain, then can do some other work. It would be under general to lots to consider. With his current decline this is not my main concern to be honest, other comfort issues take priority.
These issues are so hard to balance when you get no verbal feedback. I sit and watch dad for a long time to try and work out what is causing him most discomfort. Posture seems to be the main issues, we just adjust ourselves when we feel uncomfortable, get up, move slightly, lift our bum etc etc. Dad find it very hard to get comfortable - hence why I am looking at chairs etc.
Kind Regards
Craig
One of the teeth at the front that has snapped is a little red and causes discomfort when he bites, the gel is helping. Speaking to other relatives, problems with teeth in care homes seems quite common. Particularly with people on the supplement drinks (these are quite sugary and can rot teeth).
Most relatives/carers (at dads homes) seem to agree that dentures don't work out.
I agree Sylvia that invasive surgery is a very last option. But if he needs surgery due to one tooth causing a lot of pain, then can do some other work. It would be under general to lots to consider. With his current decline this is not my main concern to be honest, other comfort issues take priority.
These issues are so hard to balance when you get no verbal feedback. I sit and watch dad for a long time to try and work out what is causing him most discomfort. Posture seems to be the main issues, we just adjust ourselves when we feel uncomfortable, get up, move slightly, lift our bum etc etc. Dad find it very hard to get comfortable - hence why I am looking at chairs etc.
Kind Regards
Craig
Dhiren seems to be stationary now, leaning strongly to one side. The home carers place a pillow against the arm of the chair to support him and when I ask, he says he is comfortable.
Occasionally he shifts and leans slightly forwards but does not appear to be uncomfortable. He also lifts his feet/legs, but if I give him a footstool he doesn`t stay with it for long.
It`s hard to watch .
And he is still confident he can get up and walk.
PS. Dhiren hasn`t seen a dentist Craig, and I haven`t asked for one. It`s not a cause for concern at the moment.
Occasionally he shifts and leans slightly forwards but does not appear to be uncomfortable. He also lifts his feet/legs, but if I give him a footstool he doesn`t stay with it for long.
It`s hard to watch .
And he is still confident he can get up and walk.
PS. Dhiren hasn`t seen a dentist Craig, and I haven`t asked for one. It`s not a cause for concern at the moment.
Update.
Hi All,
Just wanted to post an update in case anyone else has similar dilemmas. Spent a while with the dentist today and dad's main carer.
He examined dad's teeth and explained what is happening. It seems that teeth get more brittle as you get older and as dad has been in care for a while dental hygiene has not been as good as it would be if you looked after your own teeth. Although his teeth are chipping and wearing away (and it does look disturbing to be honest), there is still enough teeth to allow dad to chew. He checked for pain by putting pressure on each tooth at front that was cracked and dad did no wince. It is difficult to do a thorough examination though.
We decided that doing something like a plate for dad would be disturbing as the cracked and damaged teeth would need to be removed. He also said that although you can see a little red on some of the teeth, as you get older the nerve shrinks and it is less painful as the nerve is less sensitive as you get older. He also felt that dad would let us know if he was ever in extreme pain.
He felt that we should carry on with electric toothbrush as it is not cracking teeth.
He recommended using soft plastic cutlery as dad can bit very hard and metal does not give at all.
So kinda of put my mind at rest. Dad did smile a couple of times and opened his mouth when asked to by the dentist. Sometimes, at the oddest moments, he is understands instructions and even nods his head before doing something.
I'd recommend that anyone as worried and concerned as me spends time with the dentist or indeed any medical professional, it is always best to ask questions first hand and not get it passed down.
It is very sad as dad was so routine with personal hygiene and particularly looked after his teeth, but it is something else I just need to come to terms with. You just do the best you can just try and focus on comfort at this stage.
By the way, does anyone know of a dentist in the Surrey / Middlesex area that is willing to come out to care homes? Dad is based in the London Borough of Richmond but on the Middlesex border. Please PM me with information rather than posting on thread. It just took ages to get this company to come out and I don't want to have to wait this long in an emergency.
Kind Regards
Craig
Hi All,
Just wanted to post an update in case anyone else has similar dilemmas. Spent a while with the dentist today and dad's main carer.
He examined dad's teeth and explained what is happening. It seems that teeth get more brittle as you get older and as dad has been in care for a while dental hygiene has not been as good as it would be if you looked after your own teeth. Although his teeth are chipping and wearing away (and it does look disturbing to be honest), there is still enough teeth to allow dad to chew. He checked for pain by putting pressure on each tooth at front that was cracked and dad did no wince. It is difficult to do a thorough examination though.
We decided that doing something like a plate for dad would be disturbing as the cracked and damaged teeth would need to be removed. He also said that although you can see a little red on some of the teeth, as you get older the nerve shrinks and it is less painful as the nerve is less sensitive as you get older. He also felt that dad would let us know if he was ever in extreme pain.
He felt that we should carry on with electric toothbrush as it is not cracking teeth.
He recommended using soft plastic cutlery as dad can bit very hard and metal does not give at all.
So kinda of put my mind at rest. Dad did smile a couple of times and opened his mouth when asked to by the dentist. Sometimes, at the oddest moments, he is understands instructions and even nods his head before doing something.
I'd recommend that anyone as worried and concerned as me spends time with the dentist or indeed any medical professional, it is always best to ask questions first hand and not get it passed down.
It is very sad as dad was so routine with personal hygiene and particularly looked after his teeth, but it is something else I just need to come to terms with. You just do the best you can just try and focus on comfort at this stage.
By the way, does anyone know of a dentist in the Surrey / Middlesex area that is willing to come out to care homes? Dad is based in the London Borough of Richmond but on the Middlesex border. Please PM me with information rather than posting on thread. It just took ages to get this company to come out and I don't want to have to wait this long in an emergency.
Kind Regards
Craig
Craig- does the NHS in your area have a community dental team? I had lots of problems with mum's dentures. She did visit a dentist but the dentures were very poor fitting.
When she lost her last set I phoned the community dental team and explained the problem. By this time she was virtually room bound. They told me to self refer her and came out within a month. The dentures they made for her were excellent and she managed to keep in the upper set until a few months before she passed away. Because they're NHS it was free as well.
Tarika
When she lost her last set I phoned the community dental team and explained the problem. By this time she was virtually room bound. They told me to self refer her and came out within a month. The dentures they made for her were excellent and she managed to keep in the upper set until a few months before she passed away. Because they're NHS it was free as well.
Tarika
Hi Craig
I have had a lot of problems with my mum's teeth as she hasn't been to a dentist in 15 years. Her teeth are broken, rotten and chipped, and I think she has only 2 useful ones left. The problems with the broken ones are that they catch her gums and she complains that they hurt. She has had a couple of nasty abscesses for which the doc and then the dentist gave her antibiotics but when the pain subsided she then decided she was cured and refused to have the offending tooth extracted! While she had the pain she was begging me constantly to get her a dentist like NOW!!
She was referred to hospital twice for a full clearance last year but refused to sign the consent forms and was returned to the home. I did not know of complications with anaesthesia in AD patients till I read this thread.
The dentist who saw her at the hospital did say he would keep her on his list and if she changed her mind we could get an appointment "quickly" but I think this means within a week.
She also has corsdyl gel which she refuses to use as she blames it for causing the abscesses.
Sometimes she will agree to use a sensitive teeth toothpaste which she applies with a cotton bud as her gums bleed if she tries to brush them. I haven't seen her use a toothbrush in years.
It is a pity that she complains so much that the teeth catch and she has to have a soft diet. I would not try and force her to have the teeth out but it is a fine balance between dental health and overall health.
I am waiting for a dentist to come and see her again and he did say he would but has now gone on holiday. Seems to me dental care is poor for old people with AD or VD.
Good luck I have followed your thread with much interest.
I have had a lot of problems with my mum's teeth as she hasn't been to a dentist in 15 years. Her teeth are broken, rotten and chipped, and I think she has only 2 useful ones left. The problems with the broken ones are that they catch her gums and she complains that they hurt. She has had a couple of nasty abscesses for which the doc and then the dentist gave her antibiotics but when the pain subsided she then decided she was cured and refused to have the offending tooth extracted! While she had the pain she was begging me constantly to get her a dentist like NOW!!
She was referred to hospital twice for a full clearance last year but refused to sign the consent forms and was returned to the home. I did not know of complications with anaesthesia in AD patients till I read this thread.
The dentist who saw her at the hospital did say he would keep her on his list and if she changed her mind we could get an appointment "quickly" but I think this means within a week.
She also has corsdyl gel which she refuses to use as she blames it for causing the abscesses.
Sometimes she will agree to use a sensitive teeth toothpaste which she applies with a cotton bud as her gums bleed if she tries to brush them. I haven't seen her use a toothbrush in years.
It is a pity that she complains so much that the teeth catch and she has to have a soft diet. I would not try and force her to have the teeth out but it is a fine balance between dental health and overall health.
I am waiting for a dentist to come and see her again and he did say he would but has now gone on holiday. Seems to me dental care is poor for old people with AD or VD.
Good luck I have followed your thread with much interest.
Pureed food questions....
Well things have escalated unfortunately and dad has problems with choking on food. I've posted on the thread:
http://forum.alzheimers.org.uk/showthread.php?t=24700
But asking questions here as I don't want to hijack someone else's thread.
The home now want to change dad to pureed food, in fact they just called me yesterday to say they'd done it. We are waiting for speech therapist but my guess is that the change is due to risk/health and safety. It was us who pointed out issues with choking while feeding at first.
Obviously I'm concerned and a bit upset as the problem lies with dad struggling to chew solid properly as his teeth are not hurting when he chews or just functioning properly. The dentist told me not to worry and he will be able to chew for a long time even with teeth as they are .....grrrrr.
It is just upsetting that he could chew (if his teeth had been sorted) but is going onto pureed food because of neglect on his teeth. I knew this would happen sometime as many on his home are on pureed, but food is so important, one of the only things dad still enjoys.
Anyway, enough of my moaning, it is about the man. I have a list of issues to bring up today with home and want to be clear as possible to make sure we are doing the right thing..
So if anyone has any experience/thoughts on these specific issues I'd appreciate help. I've been told that minced food is a possibility instead of pureed - not by the home unfortunately.
Regarding pureed vs minced food.
I'll get more information off home today but want to get as much information as possible together before the SaLT referral
Thanks in advance for your help
Kind Regard
Craig
Well things have escalated unfortunately and dad has problems with choking on food. I've posted on the thread:
http://forum.alzheimers.org.uk/showthread.php?t=24700
But asking questions here as I don't want to hijack someone else's thread.
The home now want to change dad to pureed food, in fact they just called me yesterday to say they'd done it. We are waiting for speech therapist but my guess is that the change is due to risk/health and safety. It was us who pointed out issues with choking while feeding at first.
Obviously I'm concerned and a bit upset as the problem lies with dad struggling to chew solid properly as his teeth are not hurting when he chews or just functioning properly. The dentist told me not to worry and he will be able to chew for a long time even with teeth as they are .....grrrrr.
It is just upsetting that he could chew (if his teeth had been sorted) but is going onto pureed food because of neglect on his teeth. I knew this would happen sometime as many on his home are on pureed, but food is so important, one of the only things dad still enjoys.
Anyway, enough of my moaning, it is about the man. I have a list of issues to bring up today with home and want to be clear as possible to make sure we are doing the right thing..
So if anyone has any experience/thoughts on these specific issues I'd appreciate help. I've been told that minced food is a possibility instead of pureed - not by the home unfortunately.
Regarding pureed vs minced food.
- How would the home mince the food? Just not something I have seen others being fed unless I missed it?
- What are the advantages of minced over pureed. Is it flavour, avoiding constipation etc?
- Lastly, I'm trying to put a list of soft food that he can still eat - the sweet stuff if easy! but savoury is more limited.
I'll get more information off home today but want to get as much information as possible together before the SaLT referral
Thanks in advance for your help
Kind Regard
Craig
Hello Craig
Dhiren is on a soft food diet and eats;
Minced meat with gravy [shepherd`s pie]
Steamed fish in parsley/butter sauce
Mashed potato
Yoghurts
Custards/egg custard
Mashed poached or boiled egg
Corned beef [hash]
Soups thickened with barley/lentils.
I imagine there is the same fibre in pureed and minced food as long as the food is not sieved. If the food is sieved, the roughage should be mashed back into the food.
Good luck.
Dhiren is on a soft food diet and eats;
Minced meat with gravy [shepherd`s pie]
Steamed fish in parsley/butter sauce
Mashed potato
Yoghurts
Custards/egg custard
Mashed poached or boiled egg
Corned beef [hash]
Soups thickened with barley/lentils.
I imagine there is the same fibre in pureed and minced food as long as the food is not sieved. If the food is sieved, the roughage should be mashed back into the food.
Good luck.
Hi Craig
I had to have soft foods for a while following surgery on my tongue/throat last year, and there are some good guides online. One excellent one that I used before seems to have gone (http://publications.macmillan.org.u...x0=pnHesPR3PuI&fl0=__externalId:&raction=view) - you may be able to buy it , but here is a good one for ideas and practicalities - and it links to the dietary issues, not just the mechanics of eating.
http://www.cuh.org.uk/resources/pdf...aflets/PIN1473_eating_well_on_pureed_diet.pdf
I think the idea of minced food for as long as possible is a good one - your dad will still have the 'feel' of the food.
One of my favourites was pureed tinned peaches - the flavour is nice and strong, the colour is good - they are soft anyway, so I could change the consistency to suit as I got better. I could use just a potato masher for a while to help the breaking down of the food.
Hope this helps a bit
e
I had to have soft foods for a while following surgery on my tongue/throat last year, and there are some good guides online. One excellent one that I used before seems to have gone (http://publications.macmillan.org.u...x0=pnHesPR3PuI&fl0=__externalId:&raction=view) - you may be able to buy it , but here is a good one for ideas and practicalities - and it links to the dietary issues, not just the mechanics of eating.
http://www.cuh.org.uk/resources/pdf...aflets/PIN1473_eating_well_on_pureed_diet.pdf
I think the idea of minced food for as long as possible is a good one - your dad will still have the 'feel' of the food.
One of my favourites was pureed tinned peaches - the flavour is nice and strong, the colour is good - they are soft anyway, so I could change the consistency to suit as I got better. I could use just a potato masher for a while to help the breaking down of the food.
Hope this helps a bit
e
Morning Craig,
The first thing that came to mind for me is "why is your dad choking?". Is it because of a change in swallowing? If it is then precautions do need to be implemented to avoid the risk of any food entering the lung. Is it because your dad can no longer chew? This is entirely a different matter and can be dealt with in other ways such as having food that needs little or no chewing as Sylvia has put about Dhiren. There is plenty of savoury food that requires little or no chewing and finding simple recipes will be the least of the problems Let's hope that it is this and that it merely means a slight adjustment by the home and that your dad can continue to enjoy his food in a slightly adjusted format for as long as possible.
I do think that getting to see a SALT is a matter of urgency because it is a matter of quality of life and I hope that you are able to present the situation to the SALT yourself.
As to how the home will mince, there are mincing machines with various size holes and they will either have one or they will have to invest in one. They do not need to be expensive if not used for mass production. And as for recipes, if it turns out to be the case that you need recipes, I am sure we will all put our heads together
Love
The first thing that came to mind for me is "why is your dad choking?". Is it because of a change in swallowing? If it is then precautions do need to be implemented to avoid the risk of any food entering the lung. Is it because your dad can no longer chew? This is entirely a different matter and can be dealt with in other ways such as having food that needs little or no chewing as Sylvia has put about Dhiren. There is plenty of savoury food that requires little or no chewing and finding simple recipes will be the least of the problems
Let's hope that it is this and that it merely means a slight adjustment by the home and that your dad can continue to enjoy his food in a slightly adjusted format for as long as possible.I do think that getting to see a SALT is a matter of urgency because it is a matter of quality of life and I hope that you are able to present the situation to the SALT yourself.
As to how the home will mince, there are mincing machines with various size holes and they will either have one or they will have to invest in one. They do not need to be expensive if not used for mass production. And as for recipes, if it turns out to be the case that you need recipes, I am sure we will all put our heads together
Love
I can only say Craig what happened to Mum and that is that I thought generally:
* better if the home puree things separately eg puree carrots and beans separately and plate them as identifiable
* soft foods don't need pureeing at all eg stewed fruit so they still have some texture - so good if the cook can think it through and not just puree everything!
* meat needs special care
* important to try and retain textures and tastes so you don't end up feeling it's just baby food all the time
Mum is coping on a soft diet in hospital but is choking very occasionally.
Good luck Craig - thinking of you.
* better if the home puree things separately eg puree carrots and beans separately and plate them as identifiable
* soft foods don't need pureeing at all eg stewed fruit so they still have some texture - so good if the cook can think it through and not just puree everything!
* meat needs special care
* important to try and retain textures and tastes so you don't end up feeling it's just baby food all the time
Mum is coping on a soft diet in hospital but is choking very occasionally.
Good luck Craig - thinking of you.
Hello Craig
It is good that a SALT is being contacted, as it may not be dads teeth or problems chewing that are causing dad to choke,
How would the home mince food, probably using a blender for a shorter time ,like you do for babies, some foods can be mashed with a fork , for example banana.
I have no idea if pureed /minced food causes more probs with constipation. The taste will be the same providing the foods is not mixed together . If they do mix it all together it will look horrid and m
It is good that a SALT is being contacted, as it may not be dads teeth or problems chewing that are causing dad to choke,
How would the home mince food, probably using a blender for a shorter time ,like you do for babies, some foods can be mashed with a fork , for example banana.
I have no idea if pureed /minced food causes more probs with constipation. The taste will be the same providing the foods is not mixed together . If they do mix it all together it will look horrid and m
Look horrid and may put your dad off.
Minced food for as long as possible may be good as its not only taste but texture as well that is important ,
In my experience most food can be minced or pureed.
Mum was on soft, minced food for a long time as she lost her dentures , I cut her meat up very fine and she managed well.
Eventually i had to puree mums meals coz chewing became a problem.
I found porrige for breakfast best or redy brek.
Mum eventualy start to cough wen eating n drinking , sadly it was a swallowing problem
Minced food for as long as possible may be good as its not only taste but texture as well that is important ,
In my experience most food can be minced or pureed.
Mum was on soft, minced food for a long time as she lost her dentures , I cut her meat up very fine and she managed well.
Eventually i had to puree mums meals coz chewing became a problem.
I found porrige for breakfast best or redy brek.
Mum eventualy start to cough wen eating n drinking , sadly it was a swallowing problem
Craig,
It is the standard here in Ontario to have regular, minced and pureed meals. My mother is currently on minced and has been for at least a couple of years.
Minced food looks like food, unlike pureed food which looks like weirdly coloured wallpaper paste. My DH assures me that pureed buttered toast tastes just like it should - he once tried his mother's when she was still alive.
Pasta is a good soft food, easy to eat and easy to vary.
It is the standard here in Ontario to have regular, minced and pureed meals. My mother is currently on minced and has been for at least a couple of years.
Minced food looks like food, unlike pureed food which looks like weirdly coloured wallpaper paste. My DH assures me that pureed buttered toast tastes just like it should - he once tried his mother's when she was still alive.
Pasta is a good soft food, easy to eat and easy to vary.
Hi Craig,
Lionel has been on minced food for the past three years. Only recently has this been changed to pureed as he has a choking problem. Last December when the SALT team visited they said that this would be the best thing to do, and reinforced their finding again when they visited about 6 weeks ago.
He has never had any problems with constipation etc nor loss of flavour. I always tried a spoonful first of anything that I was putting into his mouth, however the home does provide exceedingly good food, expertly cooked.
In all that time, considering he is bedbound he has not had the slightest suspicion of a bed sore, and his skin is good. This comes from the nourishment taken in.
Thinking of you, and dad too.
Lionel has been on minced food for the past three years. Only recently has this been changed to pureed as he has a choking problem. Last December when the SALT team visited they said that this would be the best thing to do, and reinforced their finding again when they visited about 6 weeks ago.
He has never had any problems with constipation etc nor loss of flavour. I always tried a spoonful first of anything that I was putting into his mouth, however the home does provide exceedingly good food, expertly cooked.
In all that time, considering he is bedbound he has not had the slightest suspicion of a bed sore, and his skin is good. This comes from the nourishment taken in.
Thinking of you, and dad too.
