dental health Multiple Sclerosis

Multiple Sclerosis does not make dental care easy.

Long story made short Patti was less than cooperative at her last failed checkup. Fortunately there is a positive end to this story.

Believe it or not there’s at least one dentist who prefers the freedom of not having an office practice, traveling between care facilities and nursing homes.

Rather than just leave it alone he called me with a plan.

What if … he revisited after Patti had been given a dosage of Ativan/Lorazepam beforehand, the proverbial “chill pill”. Adding me to the mix could improve success because in the care facility era “no means no” for professionals, only family/POA can ‘persuade’ a patient.

Arriving I transferred Patti to a geri-chair, a recliner on wheels.  I was blown away by the mobile dentist office set up, it had everything except musak.  (Rummaging about I found a boom box and a CD of new age music and fixed that.)

Patti (under the influence of Ativan) was a model patient and the dentist was a godsend. Patti’s dentist prefers the life of mobile dentistry. He loves its freedom and its focus on patients.

Patti’s teeth were cleaned, polished, and cavities filled. Only the high speed drill which sprayed water seemed to agitate her. I quipped it was just the tooth fairies waterboarding her. “Little bastards” she mumbled and with a smile her calm returned.

Afterwards, we talked about new solutions because status quo is not working. Apparently an electric toothbrush is a win-win because in a pinch it can be used simply with water, eliminating the whole rinse and spit challenge. Regardless of MS and all its challenges, dental care cannot be trivialized. Brushing teeth is social behavior. Visiting or outings should include teeth brushing rather than depend on staff, remember staff can be told ‘no I don’t want to’. Thinking outside the box is a must.

Since it was 60˚F (15.6˚C) afternoon in February, and the geri-chair fit in our wheelchair accessible van, I took Patti to the park in her rolling recliner for a reward before a well-deserved afternoon nap.  

Related previous entries:

a trip to the dentist (Jan 2006)

teeth brushing smiles (Feb 2009)

dental care Multiple Sclerosis (May 2010)

Caregivingly Yours, Patrick Leer 

videos: www.youtube.com/daddyleer

dental care Multiple Sclerosis

While a day in the life of caregiving rarely has epic moments you can still find yourself pumping your fist into the air over moments atop the Mundane Mountains of life.

Receiving a glowing report card call from the visiting dentist at Patti’s care facility Saturday morning was just such one of those moments. With his mention of “no cavities” I could not help remembering the good ol’ Crest advertising slogan.

Living with Multiple Sclerosis it’s not easy to keep up with a daily dental hygiene routine. Above and beyond fatigue and weakness, progression of Multiple Sclerosis symptoms including wheelchair necessity, physical dexterity, spasticity, eye hand coordination, numbness, tingling, and cognitive / memory impairment all conspire against efforts to brush and floss teeth.

Plus some medications actually work against gum health.

Additionally, there are no such things as ‘routine dental visits’. Finding an accessible office much less an accessible dental chair is only the tip of an iceberg including socioeconomic factors (lack of dental insurance, inability to pay out of pocket), and assisted transportation to get there and back.

As Patti’s inability to participate in her own activities of daily living have diminished, dental care challenges have increased. Trying to help someone to effectively brush their own teeth, and/or brush their teeth for them, is more demanding than can be imagined.

Do not assume modern technology is an answer. If someone is already challenged physically to hold anything, legally blind, and way too easily confused just go ahead and hand them a buzzing vibrating toothbrush and see what happens. … You may as well have handed them a snake.

It takes time, commitment, patience, and respect to make the experience work. Having someone help you or brush your teeth for you a couple times a day is frankly damn intrusive. I find if I make a pinch of entertainment part of the caring mix it works so much better. After all a smile is far easier to brush no matter who is doing the brushing. 

Caregivingly Yours, Patrick Leer

web site: http://caregivinglyyours.com/ 

videos: http://www.youtube.com/daddyleer 

musings: patrick ponders