How do I keep my wife's teeth clean when she refuses my assistance?

Tauno asked...

How do I keep my wife's teeth clean? She is now unable to brush her teeth and refuses to have me try to brush them for her. I recently had to have her sedated in order to have her teeth fixed and cleaned. That was very, very expensive, because the sedation is not covered by my dental insurance.

Expert Answer

Dr. David Blende, DDS, has more than 20 years' experience providing comprehensive dental care. His practice, the Blende Dental Group, serves the phobic, disabled, geriatric, and medically compromised communities through sleep dentistry. A division of his practice, Bay Area House Call Dentists, delivers dental services to senior communities and private homes in the San Francisco Bay Area.

While not knowing the specifics of why your wife is refusing your efforts to brush her teeth, in general, there are a variety of reasons that people are not comfortable nor compliant having people other than themselves enter their mouths "“ the mouth is considered a very private area.

When we see patients that require their family members or caregivers to provide oral hygiene, the patient is often intellectually or physically challenged, or they just don't believe they need to have their teeth cleaned.

What we do know is that the mouth can become a nest of infection when regular oral hygiene care is not maintained. Inflammation of the gums and possible abscesses occur. The bacteria in the mouth and enter the bloodstream, causing potential issues for the heart, lungs, and kidneys. It is imperative that those that want to experience long lives keep their mouth clean. In fact, one of the leading causes of death in elderly people is aspirant pneumonia and what happens in that particular situation is that that patient chokes on and/or inhales a certain amount of bacterial load that is present in the mouth because the mouth is not clean.

So what can you do to gain access to your wife's mouth? With some of our patients, we cradle their head in our lap; we may sing them a song; we massage their face. Once a bit relaxed, we will work around to the inside of their mouth, possibly with a washcloth and we try to make the teeth cleaning as relaxing an experience as we can.

Another device that your dentist can give you is a soft bite pillow which you can put into your wife's mouth and turn sideways. If your wife continues to bite on that, this will provide access to her mouth and you can then use a brush. I would encourage you not to use toothpaste because people tend to taste the toothpaste and that has the capacity to create a series of swallow reflexes. I would just use warm water and brush as vigorously as you can "“ primarily the root surfaces where the teeth enter the gums.