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We have side by side sinks with water picks. She will use a water pik, but doesn't move it around in her mouth like she should.

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If your loved one has Alzheimer's, you can't be sure that they are brushing or flossing properly.

You will have to assist. There will be days that brushing and flossing do not get done.
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Offered to help her. watch and point out the areas that she’s missing - let her do it. Be loving and supportive about it. If that doesn’t work perhaps mention there’s food in her teeth even if there isn’t just so that you can check her level of concern. Eventually you might have to do it for her, in the long run.
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lepleydm: Seek dental professional advice.
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I put a little mouthwash in my water pick as a back up to flossing. I also improved my gums by using PerioProtect (it works with trays, so I'm hoping the wife can put them in and you can remind her to take them out). I had a lot of gum problems and reversed it...........now the hygienist always complements me. Talk to her dentist about this: (copy and paste) https://perioprotect.com.

Hygiene is very important, but this is an uphill argument with someone who is deteriorating..............it's a sad situation, for sure. You can consider getting a "Visiting Angel" and see if she can elicit cooperation.
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In stead of water in the water pic, ask your dentist about a rinse. The dentist will be able to recommend something good. At least she can get that in her mouth, and believe me, if that’s your biggest battle, you’re doing great!

Like others have said, with dementia, you have to pick your battles. Eating right, taking meds, proper toileting, proper hygiene, a bit of brain stimulation exercises, as well as some physical exercise and last but not least, love and companionship are your priorities.

As dementia progresses, those get more and more difficult. You begin by “letting up” on let’s say, exercise, then hygiene starts to lax. Mind you, you don’t give up, just slack up. Brushing once a day is fabulous. When she starts to balk at the waterpic, then waterpic every other day or three times a wk. If possible, offer to do it for her, but be prepared for a battle. Battling cause every one stress, so, in time, you give up a little more.

Thats dementia…you give up a little bit at a time. Both patient and caregiver. There really isn’t a lot more you can do. Battling isn’t worth it. You can try to make things more “enjoyable” for her, have her sit in a chair, put on some music or TV, then waterpic or brush her teeth for her. You will need to try different things to see what works. However, be prepared, because eventually, nothing will work.

Then it’s just about making her comfortable and loved and safe. That’s the only part that you don’t slack up on and even that can be difficult, if the dementia person is hostile. But you do the best you can. Good luck. And if you find anything creative things that work, post it here to give others ideas.
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BeckyT Nov 2022
Wonderful reply!
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Have her try the Colgate Wisp disposable toothbrushes. They are mini pre-pasted disposable toothbrushes that require no rinsing and can be used anywhere and anytime. She can take her time without anyone standing over her. These small brushes also include a pick on one end.  https://smile.amazon.com/gp/product/B071DPCBQG/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1
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It may be time that you step in and help a bit with this.
It is difficult to floss someone else's teeth but you can try.
If it is a problem and she will let you help with the water pick then count that as a "win" and let it go. There is no need to stress you and your wife about that.
If she lets you brush her teeth you might be able to do a better job than she can. She may not be getting the backs of the teeth or behind the last ones.
Do the best you can.
I hope your dentist has suggested that you no longer use toothpaste with fluoride in it for her. If she is not spitting all the toothpaste out consuming fluoride is not good, I would also switch to a mouthwash that has no alcohol. It is less drying.
And a suggestion put diluted mouthwash in the water pick. I do about 50/50
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My LO is the same. He doesn't battle me about tooth brushing and flossing, and I get his electric toothbrush and waterpik ready for him at bedtime and stand with him while he uses them. If he isn't moving the pik around enough, I prompt him or help guide it, then he will do it.

He's prone to cavities/gum issues and I don't want him to be in pain (which could also lead to eating issues and right now he's a good eater). We go to the dentist 4 times a year for cleanings now, and they are fairly short visits; they use a mouth rest to prop his mouth open since that's hard for him. The cleaning visits are much easier for him than long procedures like crowns and filling cavities. So far he's stayed cavity/ gum disease free.
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Lucky your LO brushes teeth at all. Your LO has dementia and cannot learn anything any more.

My dentist tells me to brush teeth after eating and use toothpaste at least once daily with a soft toothbrush to save enamal. Gently brush teeth at the brush's angle toward the gums on the inside, outside and on top of teeth, also the tongue and inside of cheeks. Before going to bed at night, I also floss and use mouthwash. It should not take too long to do. The point is to prevent gum disease.
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Every day your LO is alive that she's not fussing, screaming, baring her teeth at you cussing, or ripping her incontinence brief off and making a huge mess with the contents is one day to be grateful for small favors. Let go of flossing and water piks and all the things you'd expect from a person without dementia and who cared about her teeth in the first place.

Consider yourself lucky if she can brush her teeth at all, or if you don't get a huge fit thrown when you try to help her with the toothbrush.

Pick your battles and let ALL the rest of everything go.
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MeDolly Nov 2022
Nailed it!
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How she does her teeth will not stop her dementia, I would suggest that you stop trying to control her let her be, she is doing the best she can under the circumstances.

Let her be, don't put her under any undo pressure.
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Maybe now you will have to help her.

I had an aide tell me Mom was not brushing her teeth. I asked the aide if she was putting the toothpaste on the toothbrush and handing it to her. I could tell by the look on the aides face she wasn't. I had been doing this for almost two years before Mom entered the AL. I thought it should be logical, if they can't do it anymore, you have to do it for them.

This is Dementia. They forget how to do the simplest things.

P.S. I don't brush my teeth for 2 min. Brushing for 2 min does not mean she is doing it right. As long as she is brushing every surface she does not need to brush that long. Actually, too much brushing and too hard can cause the gums to recede. I think a good brushing before bed is good enough. It is important to keep up on it but no need to be so strict.
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Not using a Water Pik properly? Really?

My mother never flossed her teeth a day in her life and died at 92 with one cavity.

Pick your battles, because if this is the hill you choose to die on, you'll be gone long before the war begins.
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lealonnie1 Nov 2022
Came here to say what you said a whole lot better than I would have.
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Also realize there is such a thing as "overkill". Recent studies show that regular brushing AFTER MEALS is actually dangerous as the enamel in the teeth is more vulnerable and just getting brushed away. There are some excellent dental rinses your dentist may recommend to prevent gum disease, the largest cause of tooth loss in elders. Periodontax would be an example. Speak with your dentist if this is of a concern.
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TouchMatters Nov 2022
Yes, that's what I see on the tv toothpaste commercials. "Don't brush after each meal." . . . not really. I've never heard of this and would need back-up research.

Actually, what I did hear decades ago "forget the brushing and floss regularly. Gena / Touch Matters
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According to your profile you say that your wife has dementia, so it's unrealistic that you expect her to brush and floss her teeth on a regular basis, as her brain is broken and I'm sure that she's forgotten not only how to, but the importance of it.
If you're wanting it done, you will now have to start doing it yourself or your son who looks after her as well.
And of course as with anyone who has dementia, it's important to choose your battles wisely, as not everything is worth fighting over, and this may just be one of those things.
When my late husband was completely bedridden with vascular dementia, I was lucky to get him to brush his teeth once a day, and I had to just be ok with that, as to me it just wasn't worth the fight anymore, as I knew in the big picture of things, whether he brushed his teeth once a day or 3 times a day, it wasn't going to change the final outcome of his disease.
So just keep that in mind when you're choosing your battles.
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Daughterof1930 Nov 2022
Well said
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