As the months pass, I find myself increasingly involved in assisting with even the most basic personal tasks, including dressing, toilet hygiene, and now, tooth brushing. Until recently, she managed brushing her teeth independently after I prepared everything for her, going so far as putting the brush in her hand. However, over the past few weeks, I’ve noticed that she probably isn’t brushing all of her tooth surfaces. Her brushing time has gotten shorter, and for months I’ve had to pantomime spitting and rinsing actions to guide her. Otherwise, she might spit in the toilet or into a little stack of toilet paper she keeps on the edge of the sink, or just hold the toothpaste in her mouth, not knowing what to do with it. Recently, her brushing has deteriorated to the point where I’ve started trying to brush her teeth for her. But it’s not as simple as I thought it would be. She tilts her head down, closes her mouth, and generally seems uncooperative more out of just not understanding than anything else. Unlike with a pet, I can’t put her in a headlock; so it’s going to take some creativity to figure this out.
Three weeks ago, she had a dental checkup. Although the X-ray process was challenging because she couldn’t understand the request to bite down, the dentist found a spot on a molar. When I asked the hygienist if it was a cavity, they said not yet but it could develop into one and needed to be monitored. I asked if the dentist would drill and fill it, and got a somewhat unclear response, possibly due to my own overwhelmed state of mind at the time.
If Heather develops a cavity, should I get it treated, considering her current inability to follow basic instructions and the potential for fear or upset in the chair and with needles, or do I take the approach of thinking it won’t be an issue within her remaining life time? Ideally, I should increase her brushing in an effort to stave off further decay, but the reality might end up being the opposite. As her comprehension declines, it will likely only get harder to brush her teeth. It’s a downward slope in every respect.
Holy smokes… this is a heavy burden to bear. We’ve had to make such decisions for pets before, but to now be in this position with my wife is overwhelmingly heavy. Writing this, I believe the best approach is to have any cavities treated. Perhaps the dentist feels the same. I was a bit disoriented when discussing it with the hygienist.
Looking for information online, I see many pages on reducing anxiety in dementia patients, explaining things to encourage their cooperation, and even guides on how to do the brushing. However, I haven’t found much on navigating these “playing god” decisions. This is what’s tough for me. How do I transition from being a husband devoted to supporting his beloved wife to a husband who might think, “she’ll be gone before this becomes an issue, so let’s just forget about it”?
I found one article on dental decision-making for persons with dementia that begins with:
“Although there is concern that dental decision-making for persons with dementia can be challenging in many situations, we believe that no valuable articles have systematically reviewed this issue.” So I’m not alone in this challenge.
Source: (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10798713/)
Heavy, heavy stuff… I’m doing my best.