Brushing Teeth

Status
Not open for further replies.

starente15

Senior member
Joined
Oct 27, 2014
Messages
809
Reason
Lost a loved one
Diagnosis
10/2017
Country
US
State
NJ
City
Northern
Hi everyone. I heard from my mom yesterday that my father has stopped using toothpaste to brush his teeth. Once a day he's running a brush with water over them and using mouthwash. She said he didn't tell her why he's doing this.

He can still eat and speak so I'm not sure what's going on. He does have bulbar so my initial guess was that it's hard to breathe at the same time. Just wondered if anyone else has dealt with this. TIA!
 
i stop when my arms and hands got to weak to do it. i was using a water pick till i couldn't do that any more. now just water.
 
With bulbar onset especially, dental hygiene is extremely important. Because he is more at risk for aspirating, the bacteria in the mouth needs careful attention. I suspect it's just too much effort for him to do the dental ritual with flossing, etc. but with the danger of pneumonia and bacterial infection, you might want to encourage it. Sitting down while doing it will save is strength. At the end, I was helping my husband brush and floss.
 
The dentist recommended to my pals he get a water flosser. They also did a deep.cleaning and scaling while they could. He brushes with a presciption toothpaste by colgate called perident.
 
Thanks everyone!
 
After the PWC became necessary, Darcey no longer wanted to go to the dentist. She did, however, brush her teeth morning and night. She used toothpaste and gave it extra effort so as to prevent any future problems as much as possible. At some point (now months ago), she couldn't raise the toothbrush to her mouth comfortably. At that point, I took over the brushing of her teeth. Because I believed that her tooth health was so important, I purchased an Oral B Pro 5000 rechargeable toothbrush. It made it much easier for me to do a better job of keeping her teeth clean. In fact, I honestly believe that her teeth are whiter than when she was doing the brushing. It should be noted that Darcey doesn't have any swallowing difficulties. And there are times, now, when she's actually more comfortable with her nasal pillows in (connected to her Trilogy) so she can breathe better while holding her mouth open while I work on her teeth. I don't know if any part of this is a help. Perhaps it is simply time for someone else to help with the teeth cleaning.

My best...

Jim
 
My advice applies more to advance ALS or perhaps Bulbar. Here's my experience.

Star, I examined my PALS mouth and found that brushing teeth doesn't cut it. When the tongue can't sweep the mouth anymore, lots of trash lays around in there. I found bits of pills, skin, old food, etc.

I wouldn't worry about using toothpaste. It's a choking hazard. So I told nurses they were not to "brush the teeth" anymore. This is ineffective and just contributes to the mess. You just need to inspect and clean out the mouth by judicious use of a dry toothbrush and prevent germs from building up.

We ignored dental cleaning. But there is one caveat: If a tooth gets infected, it can possibly lead to body infection. There was a famous case of a boy dying of a brain infection because his mom couldn't afford a dentist. So a dental exam is still a good choice.

So that's one possibility. Your mileage may vary.
 
When the tongue can't sweep the mouth anymore, lots of trash lays around in there. I found bits of pills, skin, old food, etc.

This is interesting. I heard that last night he had his worst choking episode ever, hours after eating. I wonder if not everything is going down and somehow getting stuck.
 
I know that if I use too much toothpaste it can trigger my gag reflex (which I never had before) for some odd reason. So I use a minor amount (BTW, my dentist told me most people use way too much toothpaste anyway, you can use no more than a dab and it's fine).
 
I have been brushing my PALS teeth for over a year now, using a power oralB and a dab of tooth paste. Tim can swallow but has to have his head in a particular position, and has no difficulty opening his mouth. Since he is totally reliant on his Trilogy he takes a breath, and I brush until the Trilogy alarms, allow him to spit and give him his mouth piece again. I then brush his tongue with tongue brush and scraper, give him a sip of water and allow him to spit again. He is still able to swish the water in his mouth. After that I floss his teeth and he swishes again. There are times that I have to use my finger and get any particles he feels stuck between gums and lips. Flossing is not as important now that he is taking only smoothies as there is rarely anything stuck between his teeth. I never use mouthwash any more as it is very hard on his mucosa and makes his mouth sore, and oddly his breath gets worse when I use it. I have used coconut oil on his dental floss and toothbrush and it keeps his mouth moist without increasing his saliva, and actually prevents bad breath.
Paulette
 
I know that if I use too much toothpaste it can trigger my gag reflex (which I never had before) for some odd reason. So I use a minor amount (BTW, my dentist told me most people use way too much toothpaste anyway, you can use no more than a dab and it's fine).

Hey Brad, snap! One thing I find a huge help on this forum is comments like that.
I find I gag, too, if I use too much toothpaste. Not saying mine is a product of All This, but to know it's quite possibly 'normal' is a good thing.

God bless, Janelle x
 
At the beginning toothpaste was a challenge for my husband because of the cap. I remember having to buy toothpaste tubes with a flip top lid instead of a screw top. This is much easier to open when fingers are not nimble anymore. Now I brush my husband's teeth twice a day with an Oral B rechargeable toothbrush with a little toothpaste. He recently developed thrush and has had two different meds trying to clear it up. The Hospice nurse advised us to use mouthwash on a piece of gauze wiped on the gums and tongue. This does away with the need to swish and reduces the risk of swallowing it or choking on it. Works well for us. It is the rinsing with water that is a challenge but he is still managing by leaning over the basin resting his head on the sink and having the water run through his mouth.
 
I have been brushing my husbands teeth for years. we use a sonic electric TB which is much easier for pals whether they are still doing their own brushing or the cals is handling it. Agree--only a tiny amount of tooth paste is necessary and more can foam up and cause a gag reflex or choking/coughing. Husband has only been to the dentist once in the last 7 years as that is just too hard. I took him in because I saw a cavity starting to form and wanted to handle it quickly.

my dental tools are the electric toothbrush and a Reach flosser which fits easily in the mouth and is great for getting food particle out from between teeth . no way can I floss all his teeth (mouth doesn't open wide enough) but I can get the front teeth easily and since his jaw shifted from spasticity his teeth are crooked now and catch particles which he has no way of removing with his useless tongue. I also have a tongue scraper which you can get at walgreens. it is great for when food or yuck gets stuck on the back of the tongue and the pals cant get it down. I also bought an inexpensive dental kit with the mirror and pick. every once in a while I look around in his mouth, which is how I found the cavity that was starting. I brush his teeth twice a day. Put a towel over his chest and he just lets it all dribble out. afterwards, I use a rinse cup with a straw and a spit cup.

Dental care is very important and a pals might start letting it go because it is so hard to do by yourself, and another loss. you mom probably needs to start stepping up and offer to help out.
 
Hey Brad, snap! One thing I find a huge help on this forum is comments like that.
I find I gag, too, if I use too much toothpaste. Not saying mine is a product of All This, but to know it's quite possibly 'normal' is a good thing.

God bless, Janelle x

Agreed, the wondering "is it just me?" is the worst part and hearing other solutions is invaluable as well.

How goes it BTW? Hope all is well with you and yours.
 
As Chris's hands and arms weakened he moved to using and electric toothbrush and loved it for a couple of months. Then he found it caused an immediate jaw clamping and terrible salivation.

I took over brushing his teeth. Well actually he started to get worse at managing it and developed a terrible smell, so I took over. As Mike said it's so important as it's amazing what gets trapped in the mouth when the tongue doesn't work and then aspiration of saliva becomes aspirating a bacterial soup.

I had to be so careful, and I used very little toothpaste but made sure that his mouth was clean. I would also then clean out his nose with a saline nose spray as he couldn't blow his nose.

It made a huge difference once he accepted having it done and became something that left him feeling so refreshed.

Choking some time after a meal is finished is really common when there are bulbar issues. It's often the worst of the episodes as they can't drink water - learning to remain really calm makes an enormous difference in getting through it as well as tucking the chin in as this helps clear the throat without aspirating.
 
Status
Not open for further replies.
Back
Top