Mums teeth dropping out

Hello @cattleandcane23,

Please excuse the length of this, it could be long...... I hope some of it might help.... (I'm a former nurse and poor oral hygiene was inexcusably widespread and managing it well a challenge but essential for the wellbeing and comfort of patients, especially those with Alzheimer's/dementia). I'm sorry if your mum has not been receiving good oral care, tooth loss is really unpleasant at any age. Also cared for my own mum including whilst she was in a nursing home with Alzhimer's Disease, vascular dementia and cancer.

Do you mind me asking firstly if you've been able to talk to your mum about it; does she have early stage Alzheimer's and capacity (to make decisions?) Do you have a LPA for Health and Welfare? Would she be agreeable to having dentures?

Even if she doesn't have Pension Credit there is the NHS Low Income Scheme which can issue a HC2 certificate for dental costs, if your mum meets the criteria (it used to be if the person has less than c £23,500 in savings).

What I would do in the first instance though is to ask the care home manager for a meeting to share your mum's care plans with you, you can then see what measures they have put in place for her oral hygiene. I would expect to see very detailed care measures documented in that, including the 'minutia' - every step they take - especially as the manager has stated that your mum resists and it 'becomes impossible to do it'.....

The sort of measures I would expect to see, as a minimum, include how are they addressing or trying to overcome your mum's resistance? It often helps to have only a certain, select few staff who help to clean her teeth if she's nervous or fearful (not always possible I know). Have they sought advice from the dentist locally (do they have domiciliary visits to the Home, for instance, by a local Community Dentist). Have they used instead of a normal adult toothbrush, a soft, smaller toothbrush, even a child's toothbrush. Do they use gentle, circular movements rather than up and down. Do they stand to the side of her when helping not directly in front of her. Have they tried non-foaming toothpaste. Have they tried no toothpaste, just water. Does mum have any swallowing difficulties that may be impacting (if so, please consider asking for a SALT (Speech and Language Therapist) assessment. Is mum's mouth checked regularly to ensure there's no infection. Does she have any pain/toothache, ? pain relief. Toothbrushing doesn't have to take place in the bathroom either, mum may be more amenable to it if sat comfortably in her chair. It can be brief to, a minute only for instance.

Finally, is mum eating and drinking well. Good hydration is so important and helps too with oral health; have they considered 'Jelly Drops' if she has poor hydration (not if she has swallowing difficulties).

I don't know how long she's been in the care home but her care plans should be reviewed by the Home at least monthly and as often as needed to reflect any ongoing changes. The date of review should be clearly on the care plan.

If you'd like any advice regarding dentures please ask and I'm happy to share more information about that (my mum's Home lost her teeth but thats a whole other story!!)

With my very warmest and best wishes to you and your mum. Take care.

Sorry, one final thought re care and care planning that's just come to mind because of your point that your mum's teeth are falling out one by one ...is your mum on any medications that could affect her jaws/teeth? If she is, please consider getting her a GP appointment. It is Alendronic Acid I am thinking of, prescribed for osteoporosis which can (rarely thankfully) cause ONJ (osteonecrosis of the jaw). It is VERY rare but anyone taking that should be sitting upright for half an hour after taking it with plenty of water, including being supervised to sit upright not just left in bed to fall asleep within minutes after taking it.

Hope I'm allowed to say that Scope, if not my apologies and please delete this post.