In caregiving, we are constantly triaging issues and crises. We quickly learn how to pick our battles and prioritize. That being said, I’ll give you the same disclaimer I gave everyone else—my grandma’s teeth were in terrible shape when I got her, okay? Between constant falls and colostomy biohazard cleanups, in the beginning, her teeth were low on the list of priorities when it came to Grandma’s health.
Besides, I always gave Grandma the benefit of the doubt and tried to allow her as much independence and dignity as possible.
Like anyone would, I just assumed she knew what to do and assumed she was brushing her teeth everyday. We all do that, right? Of course now I know she was not brushing her teeth. Like many other abilities and concerns, that one fell by the wayside.
Thankfully, she did not have any major issues with her mouth for quite a while. In early 2019, Grandma started experiencing serious mouth pain. I did what any dutiful granddaughter would do and I took her to the dentist. She had three teeth pulled because they were in such bad shape and we were urged to follow up regarding the rest.
She got so SICK from that experience I did not want to have anything to do with anything DENTAL from that point on.
I shrugged off any references to her teeth (as long as she was not in pain, we were taking a palliative approach, after all….). When that didn’t work, I was quick to remind her about how I’ll she was after the last dental visit (to no avail, of course — she would simply say, like she often did, “Well, I don’t remember that.”
I managed to avoid any further dental action until that fall when Grandma began perseverating on her teeth. She wanted to go to the dentist to see about dentures. “I just have to get something done about my teeth.”
So, I sent her with her Sidekick to the dentist for an exam.
We ended up with three courses of action:
- Do nothing, deal with issues as they come up, and transition to soft foods.
- Pull all of her teeth and get dentures.
- Pull all of her teeth and transition to soft foods.
It should come as no surprise that the option the dentist recommended was the one that he would profit from the most. I cringed when the receptionist told me he said it was the “same thing he would do for his grandma.”
I wanted to tell that lady: “With all due respect, he doesn’t have all the details. He is not me. His grandma isn’t my 82 year old grandma with Alzheimer’s. She doesn’t live in a facility. We are everyday people caring for her at home.”
When it came to her dementia and the repercussions of any of the options, it seemed like either way we went, we’d lose.
I wondered and worried: How is she going to feel when she wakes up every morning with no teeth in her mouth?
She was not able to retain new information and skills. That meant like all of her other care, the care for any dentures would fall on us (and by us, I mostly mean me).
It was a tough decision. I just didn’t know what was right. There’s not much out there if you consult Google on the issue.
I turned to my peers in a large dementia-focused group.
The consensus was that everyone’s loved ones hated their dentures. Many never wore them, because they weren’t comfortable or they were lost. A lot of frustration and disappointment was expressed over the wasted time and expense and the discomfort the denture ordeals caused their loved ones.
Ultimately, we went for Option #1.
Thankfully, she never had any more serious issues with her mouth and was easily redirected when her attention became focused on her teeth. She was eating a pretty much pureed diet within a few months of that fiasco anyway, mostly due to her colostomy. Since she didn’t have to chew any tough or crunchy food and we were constantly pushing fluids, her teeth didn’t come up much.
Until the end.
When she stopped eating and drinking, I worried it was because her teeth were causing her pain. Worse, I worried she was in pain and she wasn’t able to say so. When she tried to speak or upon waking, she’d start moving her tongue around in her mouth and all of a sudden her brow would furrow. I just knew she was freaking out because she could feel that she didn’t have many teeth left in her mouth. I can’t imagine how scary that was for her. I blamed myself. I accused myself of neglecting that aspect of her care. I told myself this was my fault for not taking her teeth note seriously.
Of course, now I know that this is simply part of the disease process, but it just goes to show how that guilt can creep up on you.
When it came to The Great Denture Debate, I opted for the course with the least amount of action. I was four years into caregiving and I was tired of having these debates. As long as she was comfortable, that was all that mattered.
I’m not telling you what to do if this describes your situation right now or in the future. Each person and family has to travel their own path. I do hope you can gain insight from my experience to help you with your own perspective. Never forget—you are the expert on your loved one and your family’s unique experience. Whatever you decide to do is what is right.