DEAR ABBY: My mother has Alzheimer's. She has been in a nursing home for 10 years. I feel sorry for her because she can't verbalize that her teeth are killing her, but I can see the pain in her face and hear her grind her teeth. When I asked her if her teeth hurt, she rubbed my arm up and down, which I took to mean yes. I asked for her to be seen by a doctor, but at this time we have to wait at least six weeks to see one.
Something I would like people to know is there is little dental care available in nursing homes. Because of improved dental care by the general public, many more people arrive in nursing homes with their teeth intact than they used to. This sounds good, but the problem is that patients often refuse to allow anyone to assist them with oral hygiene. Eventually they may become too frail to withstand the stress of surgery or other treatment that comes with failing teeth.
As I understand it, not many dentists are willing to shoulder the extra challenge of caring for this "difficult" population, or the red tape of getting paid for the care of patients in nursing homes.
It is very important to take care of our teeth as we age. Once we or our loved one enters a nursing home, we need to continue their dental hygiene to the best of our abilities. We can help overworked staff by encouraging our loved ones to brush and floss. Take them out for a checkup every six months.
I can't stand a toothache for a day. I wouldn't wish that pain on anyone, especially someone with Alzheimer's who cannot ask for help. I wish I had been more aware. Please let the public know how important this is. -- NANCY C. IN WEST VIRGINIA
DEAR NANCY: As you noted, people are keeping their teeth longer. We now know that a healthy mouth is important for good overall health, no matter what your age.
In addition to dentists, there are now dental hygienists in many states who can provide care for people in nursing homes and homebound patients. Some specialize in treating the developmentally disabled and "difficult" populations.
Specially licensed dental hygienists can provide services outside of the dental office in the states that allow it, and can refer the patient to a dentist for further service. In the United States, individual states determine the scope of practice for providers, which includes what types of services dental hygienists may provide in that state.
Several states are currently working to expand their oral care workforce and improve access to care -- in part to meet the growing aging population who are retaining their teeth. In West Virginia, dental hygienists are permitted to deliver care in nursing homes and a variety of other settings. If you have additional questions, the American Dental Hygienists' Association (adha.org) can provide further state-specific information on this subject.