Aggression & visit to the dentist

Vegpatch

Registered User
Nov 3, 2016
24
my dad is in a care home, and has become very aggressive over the last year or so, especially around personal care. He hits, kicks, spits, screams - he is extremely strong and can really hurt those around him.

Unfortunately, he lost his dentures mid December (whole left side of his top palate), and we’ve decided to try and get some new ones for him. The mould from his precious set are not available to use, so we need to start again.

If he becomes very violent at the dentist, we will of course stop - he’ll have to do without dentures. But i’m Concerned about the impact on his speech and eating (he is already on a weight plan due to weight loss).

I will be taking him to the dentist tomorrow, along with a carer from the home to support me. Does anyone have any tips on how to make this visit as easy as possible for him ? i’m Going to put classical music on the car radio (he loved classical music), and will be constantly reassuring him and talking to him. The GP has also prescribed diazepam for this visit.

I don’t know what the dentures process will entail, but am presuming they’ll need to put something in his mouth - am very worried that he will become violent.
 

canary

Registered User
Feb 25, 2014
11,344
South coast
I think the diazepam is the stuff - give him maximum dosage 15 - 20 mins before the appointment and be very careful to watch over him going home as he will be very unsteady on his feet.

My OH has to have this before seeing a dentist - not because he is violent, but because he has uncontrolled epilepsy and its to make sure that he doesnt have a seizure while work is being done. It really knocks him out, but at least there havent been any problems, so far. If you have problems getting him there or getting him back, you can get referred to community dentists, who will come out to the home.
 

Vegpatch

Registered User
Nov 3, 2016
24
Thanks canary....we looked at the community dentist, but there’s a 6 month waiting list ! ..which for new dentures is a bit of a problem !
Hopefully the diazepam will work it’s magic...x
 

nitram

Registered User
Apr 6, 2011
19,707
North Manchester
If you are considering asking the dentist to sedate it could be worthwhile asking before the visit if (s)he is prepared to sedate a PWD without reference to a GP.
 

anxious annie

Registered User
Jan 2, 2019
248
Do the community dentists come to the care home to do check ups, or treatments? ( Sorry to just ask a question, Vegpatch, I don't have any experience or advice on sedation. Hope all goes well for your visit tomorrow.
 

Vegpatch

Registered User
Nov 3, 2016
24
I haven’t seen any evidence of them doing check ups at the home...but a good thing to check ! Dad gets missed off a lot of things due to his aggression...
 

Jessbow

Registered User
Mar 1, 2013
2,952
West Hertfordshire
As a denture wearer, the process for making a new plate is a bit of a faff.
I do wonder if he will be able to do it.

Basically the dentist will fill a plastic mouth shaped *thing* with quick set rubbery stuff ( sorry, cant describe it any better!) and insert it in his mouth, when he will be required to bite and then release, and the dentist then removed the plate/rubbery stuff gently, with the impression on it.

it has to stay in his mouth a couple of minutes while it sets, and he'll need (ideally!) to breath thru his nose, rather than his mouth. Being sedated might make it more difficult, as he does need to close down and bite, to align the bite properly.

If he has been a long time denture wearer , he may suprise you and recognise what happening and comply

Good luck!
 

Vegpatch

Registered User
Nov 3, 2016
24
So..quick update. Dentist wasnt a successful trip. He got quite fretful and agitated, so dentist stopped before it could get violent. She's referred him to emergency community dentist. (They def dont have a dentist at the ch)

Dont think it's going to be successful either.
 

Vegpatch

Registered User
Nov 3, 2016
24
Sorry to hear it wasnt susccessful
You might eventually have to just change his diet to soft foods
Yes..I think that’s the way it’ll go. Unfortunately seeing others eating the food he wants to upsets him, and he’s getting quite agitated at mealtimes
 

Quizbunny

Registered User
Nov 20, 2011
107
My mum refused to allow her denture to be reintroduced to her mouth following cleaning one day. For the last 3 years she has managed very well without. Mind you for the last year or so she has been on a puréed diet due to aspiration risk.

I am a denture wearer and the process with moulds when I have needed a new plate is not very pleasant, I am quite sure that my mum would not have complied.
 

PJD

Registered User
Apr 4, 2019
13
My mum refused to allow her denture to be reintroduced to her mouth following cleaning one day. For the last 3 years she has managed very well without. Mind you for the last year or so she has been on a puréed diet due to aspiration risk.

I am a denture wearer and the process with moulds when I have needed a new plate is not very pleasant, I am quite sure that my mum would not have complied.
 

PJD

Registered User
Apr 4, 2019
13
My wife`s denture was out when she woke and she has complained that it hurts. I know and the dentist agrees that taking an impression is not an option, she resists all treatment and would not cope with the process so he is checking whether there is a dementia friendly orthadontic service. I don`t think short of a general anaesthetic there is an options. My wife has shrunk and thinned even more but remains amazingly strong and at times fights against personal care. It takes the carer and me working together to clean and change her sometimes easily other times a struggle, so I think she will now be denture free. Make feeding more difficult,
 

Helly68

Registered User
Mar 12, 2018
542
In our part of North London, care home cannot get community dentist to visit - I asked and they really had tried.
They were looking into getting a private dentist to visit, so a number of residents could have checkups and the cost shared. Not sure about any ongoing treatment.
Like many commenting, my Mum is very ASBO about personal care and although her teeth look pretty grotty, as she regularly bites the staff, i can't really expect them to be successful in cleaning her teeth.
If she had pain or a problem with eating, I would push for treatment. As it is, I am afraid it would be unlikely that they would be able to treat her unless very much sedated, which would probably bring its own issues.
Just FYI I have noticed a number of residents in Mummy's dementia unit regularly remove their dental plates - I do wonder how much benefit they actually get from them. I can see they should wear them, but like so many things with dementia, getting a person to want to or remember to, is quite another thing....