Edentulous Patient (No Teeth)
This should be the easiest individual to care for, but if they have some form of dementia, it can be extremely difficult!
If the individual you are caring for wears dentures, it is up to you to remove and clean them at night, putting them safely away in a see-through glass or specified denture case. You are in charge of their dentures, and heaven forbid they lose them on your time.
They are extremely expensive to replace and ridiculously difficult to re-fabricate on a dementia patient. It’s not easy for any elderly patient to get used to a new prosthetic device and almost impossible for the dementia patient.
If they do lose their dentures, their ability to eat the foods they live to enjoy has become compromised.
So never allow them (nor should you) to wrap the dentures in tissue or paper towels and never, ever lose sight of them when they are ill. I can’t tell you how many dentures I have replaced because they were flushed down the toilet after vomiting. It happens all the time.
And as hard as this subject is to broach for me- it must be said, “Take the dentures our before getting into an ambulance!” The emergency medical team and first-responders have one job only – to keep the individual in crisis alive. Things happen quickly, and keeping the airway clear is their top priority, so they will need to remove the dentures.
Think quickly as a caregiver and remove the dentures before leaving the house! I am telling you this to be prepared. I hope it never happens, but if it does you will write me a thank you note later. You can bring the dentures to them later once they are settled in a hospital room.
Another important life lesson learned the hard way…ambulances are NOT responsible for lost dentures but hospitals ARE responsible. No matter, you do not want to misplace or lose anyone’s dentures. Take them out and only give them back once it is safe.
This also applies to partial dentures. Remove them before the ambulance arrives. I know things are in disarray and teeth are the last thing on your mind, but think about it like this, would you bring your valuable diamond ring to the hospital? No, that you would remember to remove for sure. Dentures are even more important and much more difficult to replace.
Removing Dentures & Cleaning The Mouth
Complete Dentures are removed by placing your index finger between the denture and the gum line midway back on the cheek side. Pull it down quickly if it is a top denture or pull it up quickly if it is on the bottom.
The suction is broken, and the denture usually drops or pops up. If the individual uses a denture adhesive, it may be more difficult to remove. But do not despair… quickly pull down or up, and it will definitely come out.
I only recommend one denture adhesive, Adhesadent from www.DrBDentalSolutions.com, the ONLY denture care system to earn the American Dental Association Seal of Acceptance.
I cannot tell you how many times caregivers are fooled and don’t realize their individual wears dentures. I usually get a call that the patient is complaining of pain and that pain is from dentures that haven’t been removed for ages!!
If you do not remove the dentures every night, it is possible that the tissue in the mouth can grow around the denture, causing tissue overgrowth (dentally known hyperplasia of the tissues), causing an infection and or swelling that causes a lot of pain. Sometimes the patient will be forced to stop wearing the denture(s), and this event will change their quality of life. The denture can usually be adjusted away from the area where it is rubbing against, but you want to only adjust as a last resort.
So remember to remove the complete or partial dentures at night and let the mouth and tissues rest.
The dentures are extremely fragile (made of a special type of plastic), so be careful not to drop them. They can and might break in half. Should that occur, LISTEN CAREFULLY…
DO NOT ATTEMPT TO REPAIR THEM YOURSELF…. do not buy a self-repair kit sold online or at the local pharmacy. It won’t work, and the denture(s) will instantly become irreparable! They should only be repaired by a professional laboratory technician, so please heed my warning! Call your dentist…it’s a quick and affordable repair.
It is critical to clean the gums, and if possible, the tongue, cheeks, and palate daily to remove dangerous bacteria and fungi. I recommend using a soft or extra soft toothbrush and Cleanadent Paste from www.DrBDentalSolutions.com, the ONLY denture care system to earn the American Dental Association Seal of Acceptance. I also recommend using a soft or extra-soft toothbrush and Cleanadent Paste to clean the denture. Never use the so-called “ Denture Brush” or regular toothpaste. They are far too abrasive and will create microscopic scratches that allow pathogens to colonize. We sure don’t want that! If dexterity or gagging is a problem, I recommend the convenient, individually packaged Cleanadent Wipes.
Clean the dentures by soaking the dentures in a Sonic Cleaner using concentrated professional strength Liquid Crystals from Dr. B- the ONLY soak cleanser that kills Candida, Strep, Staph, E. coli & more. These pathogens are the major causes of Pneumonia, Thrush, Respiratory Diseases, and Digestive Disorders.
If there is a soft reline, soak the denture in lukewarm water for no more than 10 minutes and bacteria-free. If the denture has a reline material in it, brush very gently not to damage the reline material.
Partial Dentures (Some Real Teeth Remaining & a Denture Replacing the Missing Teeth)
To clean them, brush the remaining real teeth as I instructed previously and remove the partial dentures as described above (except using your thumb or index finger under the clasp and pull down if it is an upper partial denture or under the clasp and pull up for a lower partial). You can use Cleanadent Paste to brush your natural teeth and your partial denture, or regular toothpaste for your natural teeth, but never use regular toothpaste on your partial denture!
There are three types of partial dentures you may see as a caregiver. And again, you may be fooled, not knowing there was a removable appliance in the mouth in the first place. I never knew my grandmother had a partial denture until she got sick, and I saw it in a glass in her bathroom!
The first type is a denture where the base material is predominantly metal. Patients find it the most comfortable, and it fits like a glove. You clean it by brushing it everywhere with a soft or extra-soft toothbrush brush &/or soaking it for 20 minutes with Liquid Crystals in a Sonic Cleaner. If you do not remove it and brush the remaining teeth, food and bacteria will collect around and under the clasps (that hold it in on their real teeth), eventually leading to decay and possible tooth loss. I get the occasional call that the patient’s partial is loose and rocks. I usually go intending to tighten a clasp but find the unfixable clasped tooth rotted and broken off. This can only be repaired by extracting the broken-off root left in the gum and adding a new clasp on a different healthy undecayed remaining tooth. It sounds difficult, but I can do it at bedside.
Valplast (soft, flexible partial denture) is also a very popular choice when deciding what partial denture is right for you. No metal is showing, sometimes the clasps are clear, and it looks very natural in the mouth. It is somewhat soft and is kinder to the tissues making it easier to get used to. But this type of partial due to its material attracts a bit more food and bacteria (the material by nature is more porous).
It must be removed at night and perhaps after also after every meal should the individual cooperate. Soak it with Liquid Crystals in a Sonic Cleaner for 10-20 minutes in lukewarm water (never hot), then leave it clean in a case or clear glass overnight.
If you step on it or accidentally put it in the washing machine, it is not repairable,e so be careful!
It is also extremely difficult should a tooth break off as you cannot add a new clasp. So this is a major con when deciding which partial is right for a patient with dementia. I always advise a metal partial or an all acrylic partial denture as it is easier to repair and adjust.
The third type of partial is an all acrylic (all plastic) partial with wire clasps. It is totally repairable (exactly like a complete denture), and you can easily add a new wire clasp when needed. It can also be converted easily to a full denture if all teeth are lost or, unfortunately, become unsalvageable in the future.
This, of course, also needs to be removed at night, and again the clasps are food traps that eventually will cause decay. This partial (which is sometimes referred to as a flipper) can cover the palate or can replace one or more teeth that are missing clasping just to the teeth adjacent to the missing tooth (teeth) easily.
My only word of warning is to be careful when the flipper is small enough that it can be swallowed. If the patient has dementia, you need to think carefully about the repercussions if you can’t find it in the mouth.
This type of partial denture must be watched and must be removed every night or perhaps permanently removed if there is even the slightest possibility of swallowing it!
If you are reading this and the individual you are caring for is in a Nursing Care Facility, my best advice is to have the patient’s name placed in the patient’s partial or full denture. If a lost denture is found, they can easily identify the rightful owner.
I have worked in many nursing homes over the years, and identifying a found denture is a lost cause. A denture lab can easily place a name into the denture. If the nursing home does not provide that service, take them to your personal dentist to get this done. Do it… I promise you will thank me. I always place the name on every denture. Some states prefer an ID number, but that proves to be a waste if there isn’t a central ID system in place.
- Brush their teeth at least twice a day. If you can only brush them once, choose nighttime. At night there is a huge buildup of collected food AND a full day’s worth of bacteria.
- If a full or partial denture is worn, remove it, soak it in Liquid Crystals in a Sonic Cleaner for 20 minutes and leave it in a clear glass or denture container. Never wrap a denture in tissue, or an accident will eventually happen.
- Use a mouthwash if swallowing it is not an issue. And Alllday xylitol gel if swallowing toothpaste occurs.
- Use soft picks if they allow under crowns and or bridges (especially after eating anything stringy like chicken, meat, corn…) and consult with a dentist if bleeding gums persist.
- Never attempt to repair a broken denture. Leave it to the professionals.
- ID’s should be placed in every denture no matter where they reside.
- Take out dentures before going to the hospital or in the ambulance.
I hope that this manual will help you improve the oral health of the individual that you are caring for.
Contact me using the form below if you want to be one of the first individuals to try my toothbrush.
Also please feel free to contact me for any reason whatsoever. Just remember I am located in Manhattan and chances are there is no Housecall Dentist (YET) in your area to refer you to.
I promise I am working hard on changing that!