Heads up on monitoring oral hygiene

Not only that. A good dental hygiene leads to good general health. The opposite is true too.

I had an aide tell me that Mom would not brush her teeth. I asked if the aide put the toothpaste on the brush and handed it to her. I got that "look" that says no. From the time Mom came to live with me, I found that I had to get the toothbrush ready for her and then hand it to her. From that point she brushed her own teeth. It just boggled my mind. Me not being a trained professional figuring out "maybe Mom needed a little help" to an trained aide not figuring it out.

If a LO is on Medicaid, a dentist should be brought in every six months to check on patients. You can always take a LO to their own dentist.

I think daily dental care is one of the things that are commonly skipped over by hurried staff, likely because it isn't obvious whether or not it's been done. My mom hadn't been in the NH very long when I notice she had pocketed some of her lunch and I grabbed her toothbrush, it was immediately clear to me that she hadn't received any daily care from the bloody mess that resulted. The real jaw dropper was when the RN I complained to tried to convince me that bleeding gums were normal in the elderly - uh, no they are not!

Thank you for the warning. I'm sorry that this was your experience. I'm sure many on this forum can relate. In my family, I help an Aunt who just turned 100 and has mod/adv dementia. When she was younger, her teeth were never that good in spite of brushing (I lived with her for 20 years and know she practiced good self-care). She is being cared for at home by loving family and she does brush her teeth still at least once a day, yet she is missing some teeth, and the bridge of teeth she had couldn't be used anymore. The dentist adivised to allow him to file down her front bottom 4 teeth rather than pull them out. She can still eat pretty much anything. It makes her look rough and she does grieve her appearance when she looks in the mirror. I tell her a therapeutic fib that the dentist is working on her set of new teeth. This helps her through this moment, which happens every single night.

Some dental problems will happen just because we outlive our bodies and the treatments would be too challenging (or expensive!) at that advanced age. Some problems occur because dementia patients aren't cooperative and the facilities can't force them to brush their teeth. In other cases it's because they're on Medicaid and not many dentists accept that coverage (in my personal experience). My MIL is on Medicaid in a LTC facility. They have a mobile dentist come in once a year to do cleanings and check-ups. She is in a wheelchair from back problems and has a difficult time being leaned back enough for the dentist to work in her mouth, but they do what they can. And, like you said, some facilities don't ensure the staff is doing what they are supposed to do.

My 92-yr old mother has been borderline obsessive about her oral hygiene all her life. As a result she still has most of her teeth and they are in good condition because she brushes 2x a day and flosses, sees the dentist regularly. I replaced a bad cap with an implant, which will last forever, and am glad I did it. I've decided to avoid needing to repair/replace further crowns and caps, or need dentures, by getting implants as I think it is worth the investment and is one less thing to create a problem in my future, should I live so long.