Noah is also the chair of Montgomery County’s Dementia Friendly America initiative and an active member of its Speakers Bureau. In this article Noah shares personal experiences associated with dental care for his grandfather and its impact upon developing a dementia friendly dental practice.
One of the toughest challenges my grandfather faced when diagnosed with Dementia was keeping his mouth healthy. With a progressively decreasing ability to perform daily oral health routines, it became essential that he be seen by a dentist multiple times yearly for check-ups and cleanings.
There were more than a few hiccups in receiving dental care at an office; his confusion about where he was and why services were necessary, fear of the provider and equipment, an inability to navigate the cumbersome equipment and multiple visits that were less than what we, or the dentist, considered successful. Making matters worse was that because of his inability to perform regular oral care for himself, plaque was building up at an astounding rate between visits, leading to several new fillings and crowns to fix decaying teeth.
Understandably so, my grandfather was resistant to others performing his twice daily oral care routine and he no longer had the ability to manage it on his own. Have you as an adult let another adult brush your teeth? It’s extremely personal and something most of us haven’t let another do since we were children. This was just one hurdle we had to jump every day, twice per day. And we had so many more questions...
Would my Papa remember to brush that morning? Did he remember what floss was or where he had left it last time he used it? Did he understand how to effectively use the toothbrush; at a 45 degree angle and aimed at the gumline? Was any of this even of interest to him while he was battling depression from his diagnosis? Was I going to be patient enough that day to work through his regular interruptions and repeated questions all the while trying to make dentistry fun for him so he wouldn’t resist or fight me? These were just the questions we had pertaining to his oral health.
Most frustrating though was the realization that we as a family, a family of dental providers, were struggling so mightily with something we’ve been doing for the last 35 years in private practice. It was an eye opening sign for change.
That year we set out to create a Dementia friendly house calls dental service that provides home bound clients with access to the same quality care one would receive in private practice, and without the stress, hassle, struggle and fear of leaving home. With modern portable dental equipment and a newfound understanding of Dementia, through Montgomery County’s Dementia Friendly America orientation, we were able to make necessary adjustments in care which allowed us to get necessary x-rays and provide appropriate care at each visit, maintaining Papa’s smile without the need for emergency care and ensuring his ability to eat and communicate properly. His daily care improved as well with the help of hand-over-hand technique and mirroring technique, along with properly easing him into the routine and playing music to soothe his confusion.
The biggest change came from the change in environment itself though; from noisy, confusing and hard-to-navigate dental office to safe, comfortable and familiar living room. My Papa was relaxed and comfortable there; on his couch, watching Blue Bloods, waiting for the dentist...to come to him.
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