Dental Care

[Nutty Nan]

I just wondered whether anyone had any experience of dental care for Alzheimer patients?
My husband has his own teeth, and I do my best to provide oral care as regularly and thoroughly as possible. His last visits to the dentist were very difficult, even getting seated in the chair was a challenge almost beyond him. Luckily, he has not had any problems with his teeth for many years.

However, yesterday morning I found two 'large' chunks of filling by the side of his breakfast dish - not a good sign, but he didn't seem bothered by anything. Today, he has been flinching every time he has had something to drink, he has clutched the right side of his face, and he is obviously chewing on the left. He is unable to communicate how he feels, so it's all guesswork on my part.

His own dentist passed away last year, and the practice has been sold. Even if they still had his records, I can't imagine how he would ever get there, as access is not easy. I have contacted a community dental clinic, and have to ring back tomorrow morning to discuss what they might be able to do for him. Thankfully, he has settled down to sleep and does not seem to be in any more pain at the moment.

If I do get an appointment for him, I know that he will not be able to co-operate. Does anyone know whether they might consider sedation in order to carry out an examination and possible treatment? What are the risks?

I know that he does have some small cavities and feel that, even if his pain doesn't get worse, this may be the time to have all his teeth looked at and 'sorted out', before we end up with bigger problems. Or should I hold back and hope that it all goes away without any treatment??

Any tips / suggestions welcome!

 

[Grannie G]

Hi Nan, If you can possibly get treatment, even with sedation, I would.

There`s nothing worse than bad toothache or even, heaven forbid, a gum abcess. If he won`t be able to communicate his pain, well it doesn`t bear thinking about.

How you organize it, is another matter.

Sedation is given to very nervous children at clinics for Blood Tests, I`ve seen notices. I`m sure you should be able to get some sedation foryour husband.

I think it might be in the Dentist`s best interest.

Good luck.

 

[jenniferpa]

If you don't have a current dentist, it might be worthwhile calling round any local nursing homes and seeing if they have a dentist that they use on a regular basis. That might giving you a starting point with dentists who are used to dementia sufferers. Then you can call them up and find out what they can do for you. Almost certainly, you're going to have to do this privately, bearing in mind the parlous state of NHS dentistry. Alternatively, you might ask your CPN or Social worker if you have either if they can suggest one. Or call your local AZ branch: they might have ideas as well.

Jennifer

 

[Skye]

I haven't had problems getting John to the dentist yet, we both go together, and he watches me have my treatment before he has his. I have to clean his teeth for him now, it's not easy. Flossing is out of the question, so he sees the hygienist every three months.

In your place, I would try everything to get your husband's mouth sorted out, toothache is a misery, and an oral infection could really set him back.

I have a friend who has a real phobia about dentists, and she goes to her GP and gets a tranquilliser to take before an appointment. It might be worth trying this.

Good luck,

 

[Nutty Nan]

Crumbs - you lot are certainly on the ball ....... I only went and emptied the washing machine and you've already responded - many thanks!

Sylvia, thanks for your encouragement: I was worried that 'sedation' might be a bit too simple a solution.

Jennifer, I tried the ALZ office, but they close early, and I asked the CPN for advice a long time ago, by way of a hypothetical question, but whilst she is usually very helpful, she had no experience of anyone else needing dental treatment.
The idea of approaching local care homes sounds very practical: if the community dental clinic can't help, then that's what I will try.

I am not looking forward to any of this, as I am not keen on dentists myself, and will not feel any better watching my man being treated. But it would still be better than toothache ...... I will keep you posted.

 

[connie]

Nan, I had Lionel's dentist come home to him for the last couple of visits when he was still at home. Impossible for him to go to them.

You may be able to find a dentist who does domiciliary work in your area. They can even be NH although Lionel always paid.

Coincidentally he is having problems with his teeth at present, but when I asked at his home they said that although they have a dentist who will come out to check "he was not able to do treatment there, only in his surgery". Well that's out for Lionel.

However Lionel managed to take his plate out on Saturday night, the carer found it on his pillow in the morning. I knew something was troubling him.

Will not be able to put it back in, but that is a small price to pay.
(Good to hear from you again, hope you get something sorted asap)

Love n'hugs

 

[Nutty Nan]

Thank you, Skye and Connie,
I had no idea it was possible to have treatment at home - that would certainly make things a whole lot easier, as the only way to get Tony anywhere is by wheelchair taxi: he is able to walk, but unable to get in and out of vehicles ..... (and dentists' chairs!).

Food for thought. I'll see what tomorrow brings.
Night-night!

 

[DeborahBlythe]

Your local Primary Care Trust should be able to give you a list of all the NHS dentists working in your area. Look up their number in the phone book or ring NHS Direct 0845 46 47, or alternatively go to NHS Direct Online http://www.nhsdirect.nhs.uk/find/results/index.aspx and paste in your post code.

You might need to ring a few dentists to find out which ones will do home visits, if any.


Good luck with the community dental service. In my mum's last area the waiting time was three months for an appointment. Fortunately, ( if losing dentures is ever fortunate) my mum's dentures were lost during her stay in hospital and the hospital paid for the replacements.

 

[Lonestray]

Hi, dental treatment with regards my wife has been the best part of the NHS for us. Since I got her home I phoned the local dental clinic for people who are not registered with a dentist, and discovered there was a home service for people like my wife. I've come to know the dentist well, his office phones up to arrange 6 monthly checks. He has carried out treatment on her free of charge over the years.
She was never seen by a dentist while in a NH, in fact her oral heigine was non- existent.
Free home treatment may be part of the system but not publicisied.
Padraig

 

[sophie123]

Hiya,

My mum's teeth are in pretty poor condition after years of smoking and neglect, and we have made this top priority with the nursing home and in all fairness they have been very good about getting her appointments with the local NHS clinic. Due to a bad fall where she knocked out one tooth and made another wobbly, she had to have an extraction last month. They put her under sedation and everything went fine - they knew it was the only way to get it done quickly and as easily as possible. We were concerned that this would leave her disorientated and upset, but all reports are positive. Unfortunately, she now has a big gap in her top teeth, and dentures are certainly something we will have to consider in the future, as she is quite fussy about people brushing her teeth!

Soph x

 

[hawaii50]

I am just back from the dentist today - mum was complaining of two teeth for a few weeks now so I decided to take the plunge and take her. It took half an hour to fill them and she had an injection - she was quite literally shaking from head to toes when she came out and we had to sit and wait for 20 minutes before I could take her back to the car. It was pretty traumatic but two hours later after I put her to bed for a nap she woke up and told me she had been up for hours! I said she had only been in bed for an hour as she had been at the dentist prior to that - she said "what dentist!!!" She now has no recollection whatsoever that she went through the trauma and her teeth are now fixed. Only I have recollection of the trauma - but that is par for the course!!

Last year I had to take her to the hospital to have two teeth out and two roots of which had been left under her dentures (she is termed a bleeder so had to go to the hospital) That was her last two top teeth and she was then fitted with a new top set of false teeth - which fit beautifully - the other lot kept falling out because she had lost so much weight. Again that was a very traumatic experience for her but she had no memory of it within a very short space of time.

If you can do it I recommend to get it done - toothache must be awful for them to suffer from. I didn't know about home visits - worth looking into if you can't get them to the dentist chair!!

Elspeth

 

[Nutty Nan]

Again: many thanks to you all - you've given me hope for a good outcome, and I must admit I had already considered that however traumatic this experience may turn out to be, my husband would not remember it for long. The proverbial silver lining. I know we must get this sorted!

I have made a couple of small steps in the right direction: the community dental surgery are sending me referral forms by post and have agreed I may return them by fax to speed things up. They also said if necessary, they could treat my husband while he remained seated in his wheelchair. - When I complete the form, I will ask whether there is any chance of a domiciliary (brilliant word, Connie!) assessment, as this would obviously make life a great deal easier.

Sophie, you have reassured me re. sedation!

I can see that he is still uncomfortable, but he is eating and sleeping, which is reassuring, and I suspect it may be more a case of a sharp edge making his tongue sore, rather than proper toothache.

 

[Skye]

Sounds as if you're finding solutions. Well done! I hope it all goes well.

 

[Nebiroth]

AFAIk one of the effects of the sedation used for dental work is that you will have no memory of the events that took place whilst under it, even though you remain responsive and awake whilst sedated. Once the drug wears off you won't remember what happened.

It's not like a general anaesthetic, you don't "go to sleep". AFAIK generals are only done in hospitals now.