Health Maintenance for Seniors: A Visit to the Dentist

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My Mom has always had beautiful, well-kept teeth. Last summer she had a root canal and crown put in, a rare event. Her dentist told us that she needed to brush her teeth extremely carefully and at least 3 times a day. It seems plaque is building up on her gums faster than in the past. She has dry mouth because of the medications she takes for Parkinson’s disease. This allows plaque to build up easily along the gum line. That is not a physical change. The change is that her dementia is increasing. She no longer brushes and flosses her teeth with care. She can’t focus well enough to do it thoroughly.

The dentist gave us an expensive tube of toothpaste and told us to use it well and often. When we returned to Mom’s group home, I spoke to each of her caregivers about the problems with her dental hygiene. I stressed how important it is to make sure she brushes well and three times a day. They promised vigilence.

Three months later we returned to her dentist for a cleaning. (We now schedule cleanings four times a year to catch plaque before it is a problem.) To my horror, at the end of the visit the hygienist took me aside and told me Mom had three new cavities since the last time she was there–three months ago!!!??? Both Mom and I were quite upset by the report. She told me Mom needed to brush very, very carefully.

When we returned to Mom’s home, I again spoke to each care giver. They all told me she brushes her teeth all the time. I requested that a caregiver actually brush her teeth for her one time day, at any time the staff could schedule it. They agreed. I even offered to pay extra, but they told me their service is all-inclusive.

Two weeks later we returned to have her three cavities filled. Because they were all along the gum line and hard to reach, it took a long time and was uncomfortable for Mom. The dentist took me aside at the end and gave me the same lecture the hygienist had given me two weeks before about brushing her teeth carefully and often. He said that a large amount of plaque had reappeared in the two weeks since her cleaning.

We scheduled her next cleaning for three months. When we returned to her home I sat with her and watched while she cleaned her teeth. She would start OK and then stop and just let the tooth brush jiggle in the gap in her mouth. So we practiced.

I bought her a super-duper Philips Sonicare toothbrush last year. It even has a little container for infrared cleaning after each brushing. I had toothbrush envy when I bought it, but I can’t afford one. I just had her hold the toothbrush near the gum for a few seconds on each tooth. After practicing she did better, but still not great. I told the caregivers that they would have to supervise the brushing at least once a day or the plaque would probably return again. Everyone agreed to take care with brushing.

I still do not know if someone is actually brushing her teeth for her once a day. When I visit, I have her brush her teeth while I watch and catch her with corrections. I am not sure what else I can do.

In my next blog I will write about my own emotional reaction to the situation. Hint: The blog title is “Caregiver Rage”.