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Dec. 1, 2021

Dentures and Dementia are Oral Care Hell!

Dentures and Dementia are Oral Care Hell!

Zetty had dentures much of her adult life  but J never had to get involved -- until now.

As a caregiver, J Smiles is learning that it is not as simple as her brain-health mom made it seem all those years.

Because teeth are required to chew, Smiles is determined to master these objects to keep her mom properly nurishhed. But J loses many battles along the way. Who knew such humor and health care could be contained within denture debacles?  Get ready for problems putting the dentures in, taking them out, mishaps at church, near panic trips to the ER and more. The Snuggle Up® to the idea that it is more dentures and dementia are oral care hell!


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J Smiles:

I was in the kitchen preparing a snack for Zetty. I'll be honest, I was nibbling a little bit myself, but really, it was time for Zetty to eat. I have everything just like she likes it. She hates for there to be ice in her soda, so the can is perfectly chilled. I bounced up the steps into her bedroom, there's no Zetty. "Zetty Zetty, baby love." that's what I call her when I'm trying to get her to respond. Baby love? Huh? Huh? Where are you? Huh? Huh? Huh? Huh? I am quickly trying to follow the huh huh, I find her in her bathroom. At this point Zetty is somewhere moving out of mild into moderate dementia and often assisting with her personal care. She's in the mirror. What are you doing, Mama? Mm hmm. Her mouth is kind of close, kind of open. I'm like, turn around. Y'all. As soon as she turns around, I dropped the tray. There is this pink, reddy, substance. caked up in the side of her mouth. Mama, are you bleeding? More? I'm poking my fingers. She's biting me, (incoherent noises), that's Zetty. Lady open up your mouth, what is going on? I'm digging around in her mouth. I'm trying to see, are you bleeding, did you bite something, did you swallow a tooth, did you eat a nail? By the time I get through investigating, it is only an abundance of fix a debt may mixed in with a gaggle of her red lipstick. Zetty has overdone it in preparing herself for the day. Parenting Up caregiving adventures with comedian J Smiles,is the intense journey of unexpectedly being fully responsible for the well being of my mama. For almost a decade. I've been chipping away at the unknown, advocating for her, and pushing Alzheimer's awareness on anyone and anything with a heartbeat. Spoiler Alert- I started comedy because this stuff is so heavy, be ready for the jokes. Caregiver newbies, OGS, village members trying to just prop up a caregiver you are in the right place.


Hi This is Zetty. I hope you enjoy my daughter's podcast. Is that okay?

J Smiles:

Today's episode, dentures and dementia, our oral care hell. Zetty was not happy with me. She responded as if I were trying to choke her. I promise family I did not put my hands anywhere near her neck. I was using my pointer finger, the index finger only one at a time to try to figure out if in fact my mother was bleeding, but a bright red lipstick with bubblegum pink, fix- a-dent. Fix a dent is a brand name for adhesive that secures your denture to your gum. Now before you go into a panic, your ello will not automatically start to lose his or her teeth just because they have Alzheimer's or Dementia. Zetty had a dental issue well before anything happened with Alzheimer's, If I'm not mistaken, her first partial, occurred sometime in her 40s. The joke on my grandmother was that she did everything right during her pregnancy except drink milk. She hated milk, and she did not do anything else to enhance her calcium intake, and then my mother had soft teeth. Who knows if that was actually true, but what we do know is that Zetty had very soft teeth, and consequently, Zetty ended up with a partial very early in life. Anyhow the pink had a bubblegum flavor, and it looked a bit like your natural gum. I continued to purchase the same Fixodent that Zetty purchased when her brain was healthy. I had enough to figure out as a caregiver to reinvent the wheel. It was working for her before it will work for her now. But I tell you what, you mix that in with a freshly baby old face; yes, Zetty will just baby all up her whole face and she never gets any acne. So imagine a freshly baby old face with extra red popping lipstick and a whole lot of oozing of the bubblegum fixodent. Yeah, it looked like blood to me. So if you have children who want to figure out a way to create something really gory for Halloween, that's inexpensive, non toxic, fairly easy to clean up and will not smell; I'm thinking I just gave you an option. All jokes aside, we were constantly having problems with Zetty's dentures, not because they all of a sudden stopped working. But because she could not give real time conversation to say yes, they're fitting properly or not. Dentures really are a fit, and feel and finished type product. When she was healthy, she knew how much fixodent to squirt on there, put on a little bit more, take it off. Oh, that's too squishy. How hard to press. I don't know if you all have dentures or have a loved one who has dentures, but that's a trick inside of itself. First thing is how much fixodent or denture adhesive do you put into the denture? Let me tell you, I didn't know what I was doing. I have all of my teet, thanks to the heavens. When I was a caregiver newbie, I squirted that stuff in there like I was lining the sides of a hot dog. Ketchup, mustard relish, I'm like if less is more, more is more. Because what I don't want teeth to come out. I don't want Zetty to bite into a chicken sandwich and then her teeth stay on the sandwich, that would be a mess. Zetty had no way of telling me girl this is too much. But when you put too much, oh my goodness, it is like Plaster of Paris. It was like I was building the Sistine Chapel in my mother's mouth. It was awful. One time that he had to keep her upper denture in at least two and a half, almost three days because they were stuck in when I was trying to pull them out. I could pry and wiggle and pry and wiggle and that baby was going no it was hurting her. And if I had pulled any harder, there was really the chance of potentially removing some of her soft tissue. You know the gums are very fragile. But how am I supposed to know they don't teach you that in caregiving school. Oh right, that's right, here is no caregiving school. After denture adhesive overkill, then I went to the other extreme. I felt so badly that her gums became so sensitive. They were raw. It was like a baby's bottoms almost like I gave Zetty denture rash. I don't know if that's a thing. If any of you are dentist, let me know about it in the comments. Like this is awful. So then I started putting just little pearl drops on the corners like the four corners where the molars would go, and the top two, like your dracula fangs and then that was enough. She ate eggs, soft scrambled eggs, we were good to go. Took a bite of a drumstick, the teeth came out and while it was a little funny the first time it happened. It was funny to me, which I mean I'm a comedian, it was awful. But poor Zetty, it was traumatic and it wasn't only the embarrassment because she was embarrassed. Even with the Alzheimer's she knew this is not right. Why are my teeth on the chicken? Now she didn't say why my teeth on the chicken but she was clearly disturbed and quite uncomfortable. A bigger deal was then she didn't want to finish eating. Even if I figured out a way to get the denture back in and get them stabilized. Her appetite was gone. It was a traumatic event. So that was over for the day. That was it. I could get her to sip on a protein shake maybe. But there will be no more chewing. Parenting Up family did you know that your gums can lose weight? Legitimately the rest of your body could stay the same weight, shoe size, your pants. If you're a woman, your bra. If you're a man your belt size all the same, but your gum could actually shrink. That also happened to Zetty. So then the bottom denture, the top denture was fine. We finally figured that out. It took about eight pearl drops. So my forehead was way too few but again, I did not need to line it like you would do a continuous string with toothpaste but her bottom jaw for whatever reason was shrinking. It didn't keep shrinking like help me i'm melting, it wasn't that. It wasn't like the Wizard of Oz, but it was enough that the measurement of the dental adhesive would be off from month to month. Give me a freakin break. I just want the sweet baby to be able to chew as all we're trying to do. So are there like injections for Botox for gums? Can I get Zetty's gums to get fatter in just like three areas on the bottom jaw? Who can I call, the Kardashians? Once the lowered denture was so ill fitting that it had actually rubbed a sore on Zetty's gum. But because she has Alzheimer's, she couldn't communicate that to me. By the time I figured out what it was, this baby had probably been eating slightly uncomfortable for several weeks until it got to the point where it was, No, JG, no. Now I thought it was the food. Turns out is because she was eating something that had a little more girth to it. I don't recall if it was steak, lamb chops, veal, lobster, but it was something that required a little more chewing. And she just kept saying no, but she said it's so hard. And I put my best JG Angel when she calls me Angel she's really happy with me. I ate a little bit rubbed on her shoulders and she said no. And it wasn't until I kissed her on her cheek, she said hm and moved her head away from me that I thought, Oh, wait, wait a minute now. It's one thing to not eat, but if Zetty is refusing kisses from JG; ah what's going on here? That's where digging in as a caregiver becomes so important. Those are moments of frustration where you could miss it. The best of us can miss it on any given day. Maybe you haven't had a lot of rest. Maybe you had a tough day at work. Maybe you haven't had anything to eat. You just might be having a short fuse in that moment. You're trying to get your ello to eat, go to give them a kiss and they pull away, you think ah, Mama's just acting funny, whatever. I'll kiss it later. Let me just go put this food back in refrigerator and cover it up for later. But in my heart of hearts, I was like, well, not eating food okay, but not accepting a kiss on the cheek. So then what I did was I patted her jaw with my hand. I patted both sides of her face. One side she didn't care. The side where I tried to kiss her. As soon as I patted it, She flinched, said no, no, no, no, no, no, no. I'm no dentist, but that told me something was happening in her mouth that probably should not be happening. Parenting Up family- This episode is sponsored by circle of a new family caregiving app. When we're caring for our ellos sometimes we're not sure what to ask for. Circle of makes it easy to surround yourself with support from your community. It's thoughtfully designed with and for the caregiver. And it's totally free on the App Store and Google Play. Check out www.circleof.com/download for more info Then it got very interesting. I spoke with Zetty's dental office. They asked me to get a photo of the interior of her mouth. They understand that Zetty has Alzheimer's and we do the best we can not to take her into the office unless is extremely, extremely important. So they say well just first, J Smiles tried to get a photo or video of her mouth. Because potentially we can send medicine or a medicated rinse. Y'all have you tried to get your ello to open their mouth and keep it open for a photo? How about for a video? Please, I wish I could see your face right now. Zetty didn't understand what the hell I was talking about. Open your mouth, please Zetty stick out to tongue. So then it became me pantomiming and playing charades, like do as I do. Please Zetty, I'm hey so then I'm trying to tickle her but not too hard so that she won't punch me if you take it too much. She does get a little aggressive and that girl is strong. I never got a full video. Like I would not have won any award for Sundance or Tribeca Film Festival or any Golden Globe. My technique was very poor, a for effort; I definitely got an A for effort. What I ended up being able to do if I kept smiling Zetty I was able to get her to smile back. And then I would just say, do like me Zetty....aaahhhh. She will aaaahhhhh and then do like me Zetty and I stick my tongue out she stuck her tongue out. So I just put it on video. I gave up trying to do a photo I said, I'm just sending people a video, and they can do the best they can with it, but it was hilarious. Had the light on thank goodness, I thought to put the light on. They were able to tell that there was something so Zetty wasn't being dramatic. There was a sore that needed to be treated, the dentist believed that the best course of action would be a medicated rinse. I said " Doc, I really would prefer a pill, if not a pill do you have an oral jails something I could just place on the infected area?" Nah, J Smiles a rinse will do much better. And the doctor had all these reasons why rinse would be better. I tried so hard to explain, " Listen Doc this is what you don't understand, I can't control whether or not this lady will rinse because the rinse has to be timed. You supposed to swish (noise) all around for 30 to 45 seconds, get out of here. Everybody, shut the front door, walk outside, get in your car, take a nap, go to the grocery store, get married, get divorced, come back and call me tomorrow. Hello, 30 To 45 seconds, two to three times a day for three to five days. Sir, you've got to be kidding. My mother has Alzheimer's, she's not going to do that one time, not properly. Well, just you know, J Smiles just see what you could do because that will really clear it up the best and I was like I don't, I don't. It won't clean up the best if she doesn't do it. I'll tell you that, how about that? I said doc I know two things about my mother, when she puts it in her mouth if it taste good, she's going to swallow it and say hm, that was good JG. If it tastes bad, she's going to spit it out and say yuck, either way doc, guess wha she didn't swish. If what you want her to do is swish Yeah, I got the wrong one baby bear. Anyway, I did not go to medical school. I don't know anything about dentistry. I gave it a shot. The miming, charades, showand tell worked marginally well for the video of Zetty's mouth so I said that's what I'm going to do with this gargling. I faked gargled with the medicated rinse say hey Zetty let's do this (swishing noise). I put it in her mouth say it's your turn she said okay (noise). Zetty made the noise, swallowed it. She may have gotten the Guinness Book World Record for fastest swish swallow. I said no, no, no, no, no, no noZetty, no, no. She said "Huh, what JG, as she steady getting water from the sink to rinse out her mouth and expel the water because she didn't like the taste; hmm puh, hmm puh. What's wrong JG? Nothing mama. Did I do it right? Yes. Are you sure? Because it's very important to my mother, she get it right. She wants to do all of her work. She wants to get the right answer. She wants to be a team player. And she always wants to make JG proud. So I'm not about to fuss at her or give her the booboo face that she didn't swish versus swallow versus spit. We need better words. Swish, swallow, spit, and gargle. What is gargle? There's no way you can know what gargle means, if you have dementia. Get out of her; gargle, garbage can, gargoyle, garlic ah. I talked to the dentist, II said, Hey, Doc, it did not work. What about this? Let's put the top denture in, keep the bottom denture out. Only give her very soft foods. Will you please give a pill antibiotic and some good old fashioned warm salt water? Because that way if she does swallow it, so what it's just warm salt water, she's not ingesting half the pesticides of the Western Hemisphere. What you think doc, that way, we're resting the infected area. we're not putting it to use, and we're not putting as much debris on it. He's like okay, well, it may not heal as quickly the blablabla and like, you know, Thanks, doc, will you send the antibiotic? I appreciate it so much click. Parenting Up family, I'm the advocate for my mom, you are the advocate for your ello. Now that dentist doing the very best he could, but it's also very obvious to me that he has had either zero or very few Alzheimer's patients and likely doesn't have anyone in his family with a disease. Therefore, he couldn't relate to what I was describing. I did a little wicky noodling on my own and asked him for a solution that could bend into the needs of my mom, a woman with a sore in her mouth, who has dementia. Every night trying to get the dentures out was always a spectacle. It depended on if Zetty was tired or she was full of energy. And you did not know until you went in for the kill because she would either acquiesce or she put up her fist. Like it was a boxing match. And I couldn't imagine that if I had Alzheimer's and I forgot that my teeth are fake, I would wonder why in the world are you putting your finger in my mouth? Try to take my teeth like what are you doing? I honestly believe that Zetty forgot every day that those teeth were not permanently affixed to her gums. Every night y'all the look in her eye and her facial expressions screamed What are you doing? Leave my teeth work why what do you do when I'm about to go to sleep? Just leave me alone like what? Why you disturbing me? That's actually when she had energy because she liked the way they looked. Who doesn't prefer the way they look with attractive dentures versus you gumming it out? My my my my mom that's me gumming it out. But if she was exhausted and you could get her to actually lay down and her eyes are half closed, so almost like sweeping up under your couch with your hand trying to find your remote or your car keys or your cell phone you just do a quick sweep with my finger shop boop pop it out like getting the old school ice cube out of a non automatic ice cube tray. Anybody remember those? That's how easy it was by literally every night you didn't know which one you're going to have to do. I remember several times Zetty would have reapplied the fixodent sometime during the day on the sneak tip so it's the end of the night. I'm ready to remove the denture, it's bedtime that thing is on there like Gorilla Glue. It is holding together Fort Knox. It could hold together the walls of the Hoover Dam and then she'd had to sleep in them because I'm like this seal is so tight. Are you kidding me? The zip lock people would make a commercial about this sealed Zetty made there's no water getting through here. There's no air getting through here. You win Zetty, you get to sleep with your teeth catching Zetty after she found gum, or chewy candy was hilarious. Zetty, what are you eating? She would keep chewing. Zetty, what are you eating? Keep chewing, Mama? Huh, she turned around her teeth look like a box of crayons. You pick any colors you want. That's what I was looking at. All her teeth are the color of whatever she's eating because the denture isn't made for all chewing gum and it definitely in made but like Laffy Taffy, or Peanut chews. And that's the only candies that Zetty would happen to find around the house. Zetty has always had a sweet tooth. But to see her devour the candy or the gum and not realize that all the evidence, sweetheart is soon as you open your mouth. I don't care if you swallowed it, it's all of your teeth. And now I'm going to have to soak these things for like two days, which means you're not going to be able to chew anything which means you can't eat any real food and you going to be hungry. And the other thing it means I got to keep you away from the mirror because family, Parenting Up Family trust me when I tell you if that Zetty saw herself without her dentures is (gasps) it was actually like she saw a ghost. JG let well, she actually didn't say my name that clearly because we you don't have your teeth; your enunciation goes down the drain. J me well, well that it was a mess. So in the times when I would have to super soak her dentures to remove the candy gook, now I also am having to play hide all the mirrors in the house. Some version of Candyman Halloween Jason all the horror films because if she sees herself we could have a spiral meltdown of an enormous magnitude all because that baby has a sugar fix. Somewhere along the way, Zetty developed a tick I'm going to call it a denture tick. I don't know if it's the dentures fault or if it's Alzheimer's fault. I know she didn't have Have it before Alzheimer's. Even though she had the denture before, she didn't have the tick before. What in the world do you mean by tick J smiles? Well is this movement that she does with her lower jaw, she just kind of twisted is not really left to right. Sometimes it's up and down, sometimes is left and right, sometimes she juts her jaw forward. It's usually while she's awake. And it has nothing to do with if she's in pain. Or if she's hungry. Or if she has to go to the bathroom. Or if she's uncomfortable. She could be watching TV. She could be reading, she could be listening. I spoke with her neurologist about it and they said sometimes it happens. It's a neurological advancement of the disease, but because Zetty was having this problem with the denture, I couldn't tell if that was a sign of pain, or an indication that something else was ill fitted. Like, ah maybe she does recalls that he used to hurt and this is a trigger. But because Zetty's general well being and comfort are my top priorities, I'm trying to figure out if this tick movement thing is a sign. Every single time I'm digging in to see if it's a sign. I get obsessed with it. Come on family you know how I am about Zetty. And then it happens, I can't recall if the first time was at church or the Cheesecake Factory, it was one of them. And Zetty started flipping the denture up and out of her mouth and back into her mouth and up and out of her mouth and back into her mouth with her tongue like it was hydraulics, this is the lower denture. Lady what are you doing? Now she did it both places, church and the Cheesecake Factory. I can remember it distinctly because I couldn't act a fool in either place. You can't just, well I can't just shove my hand in my mom's mouth. And you can't just put the denture back. I got bare hands. I'm not just walking around with gloves, an extra fixodent in church and she's just up there, popping it up and sliding it back, like is a bubble from chewing gum. I said is this lady playing? As a you know what? This is her fidget bit, Zetty has figured out how to dislodge this damn denture and it's become her fidget minder thing a toy. We went for a new fitting the very next business day. I told the dentist I don't care what you do, but that thing needs to snap down on her gums, such that that little tongue can't pop that baby out so easily. Let's face it, dentures and dementia are hell. At least that has been my experience with Zetty, but they might be a necessary evil for your ello. What do you mean J Smiles? If your loved one does not have any natural teeth, then dentures may be required so that they can eat. We want to make sure that your ello gets enough nutrition, just had to stay on top of the dentures, cleaning them, keeping up with them. People with dementia lose the dentures a lot. And sometimes it might not be the dementia sufferers fault. The issue is that there are too many cooks in the kitchen, so to speak. If they're in a facility, the number of nurses or techs that are involved with their personal care and cleaning misplace them, or even if the ello lives at home, how many people are helping them bathe and get dressed, or maybe your ello puts them in one morning takes them out one night, they put them in a nightstand every day and night, except that one time and now no one can find them. One suggestion I have is to have a spare. Always have a spare like a spare tire. Alzheimers.org.uk suggest that if your ello is in a facility, you may want to mark the denture you can actually have the name engraved on one of the back teeth toward the molar area. The article also stresses the importance of disinfecting and cleaning the denture daily. In addition to eating your ello gains the benefit of speaking, their articulation will go through the roof when they have their dentures in and there's a confidence in their aesthetic. They know that they look better, and thereby may feel better because they're wearing them. Here are tips on cleaning the dentures based on an article I found with mayoclinic.org. First and foremost, remove and rinse the denture each and every time your ello eats. Now, remember all of the snafus I had with over adhesivifying, yep, I made up that word that is denture so don't do that. Handle the dentures with extreme care because bending them or clasping them too harshly, could actually stretch them in ways that make them fit improper around their gums. Have your ello clean their mouth while the dentures are out in between every meal. Brush the dentures at least once a day. Yes, with a toothbrush brush inside where their gums will fit and outside where the teeth are. Soak the dentures over night. In the morning, when you take the dentures out of the soaking liquid, rinse them thoroughly. Some people don't realize that soaking liquid should not go right into your ellos mouth. And remember that your ello still needs regular dental checkups even though they no longer have teeth. The dentures could become loose. The gums could have irritation, or inflammation. They could have bone density loss that could be a symptom of some other health impairment. Don't use hot water when cleaning the denture. Also, no whitening toothpaste on the dentures, and nothing too abrasive, or bleach containing materials. The crazy thing about the dentures with Zetty and I thought about this so often, every time things didn't quite work out with a meal or with cleaning, or with putting them in or taking them out, I would think dag J, this is not even a health crisis per se. There's no reason to go to the ER, this is not a debilitating disease. This has nothing to do with Alzheimer's, per se, Your Honor. But this is frustrating as hell and it has a lot to do with whether or not my mother can have her proper nutrition. It has everything to do with whether or not she will be able to sleep well. Because if she's in pain, she can't sleep well. If her mouth is not healthy, she can't eat or drink properly. And if she's doing somersaults, with her lower denture, how can I sit through mass, such as the life of a caregiver. But merrily, we move forward, figuring it out every single day. The snuggle up, Number One- try to save any natural teeth that your ello still hands. Really, try as hard as you can. Number Two- if your ello requires a full or partial denture, make sure to take the oral care hygiene very seriously of that device. If your ello lives with you, another family member or out of facility, have a spare denture. Make sure there is a very clear daily process for cleaning and disinfecting. Number Three- as much as possible make sure your ello wears the denture every day, not just for eating or when company comes around, but from the moment they wake up. It's good for jaw strength, for alignment, for their diction, for speaking, for confidence. Number Four- Parenting Up has a live internet talk show. You can come grab a spot and talk to me one video, ask questions, share your story and join the community of caregivers worldwide. As we lock arms and get through this thing together. It's on getvokal.com, Mondays at 7pm Eastern in the United States. We keep the Parenting Up caregiving content coming on YouTube, Facebook and Instagram. As well go to www.jsmilescomedy.com and sign up or Parenting Up newsletters, that's it for now. Thank you for listening. Please subscribe for continuous caregiving tips, tricks, trends. and truth. Pretty pretty please with sugar on top share and review it too. I'm a comedian Alzheimer's is heavy but we ain't got to be.