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Hi I provide care total care for my mom, she has not been able to follow instructions anymore, so basically I provide her care. Mom is a dementia patient, with many physical ailments. I love my mom, and I have no problems caring for her with the assist of my husband. Problem is when I brush her teeth she swallows the toothpaste and mouthwash, I am reluctant now to even try because she continually does this. I use the lemon swabs now, but I am concerned that it is not enough. Does anyone have any ideas on what we can do?

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I found this article on Aging Care about oral care for those who have difficulty. I also wonder if children toothpaste and mouthwash would be safer to use.

https://www.agingcare.com/articles/oral-care-strategies-older-adults-175335.htm
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It is the toothbrush not the toothpaste that cleans. You can brush her teeth with water. The toothpaste is for the fluoride. There are mouthwashes with fluoride that are alcohol free (eg; CREST Prohealth COMPLETE)....Brush quickly, as they get bored. Maybe you can brush uppers, then lowers at a different time. But constantly talk to her as you brush as this distracts her. I prefer small heads and long handles.

It is not as good as a brush, but buy from your dentist 2X2 gauze(ours is non-woven, rayon polyester formed fabric), as theirs is better and doesn't leave bits of gauze
Wet the gauze with that alcohol free, fluoride mouthwash and gently rub her teeth cleaned. This is if she won't let you brush at all.

There is another product to get between her teeth. BUTLER "Soft Pics"
They are disposible. Another are "go be tweens"They come in packs of maybe8-10 and can be reused if rinsed and dried. Get the smallest .
These all can be found in your pharmacy, grocery stores, wallmarts, etc
Your mom is who she is, these are just ideas.

I also use a Butler END TUFF brush which only cleans one tooth at a time,and mostly the ones far back that you can't reach. The handle is long, and it reaches a specific tooth you need to get. Again a private pharmacy may have or all a periodontal denal office and they could give you one to try, Then order a dozen if you like from that office.

RMEMBER, if you use toothpaste, it really is the toothbrush that cleans her teeth.
Toothpaste is to a toothbrush , as catchup is to hotdog, or sugar to ice tea..Its not necessary....its purpose is to make the toothbrush more fun and to put fluoride on the teeth. So only put a "pea" size amt on the brush.
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My dad is age 97. I take him to the dentist 2 x year. And they sometimes give him fluoride treatments. DO ASK your dentists/hygienist for ideas.

I think it is wonderful that you are so concerned. Your mom won't tell you when a tooth hurts till it is too late. You need to keep her going to a dentist to check for decay. The elderly have dryer mouths and more root exposure which decays quickly.
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Just read the article from the first person to respond.
One more note:
PERIOGUARD or PERIDEX are excellent. They are prescription. Cannot rinse with water afterwards, as it will become bitter. Does stain the teeth like coffee stain, but that comes off with a professional cleaning. This is a great option, but you need to tell your dentist that your mom swallows the mouthwash...Also don't know if they have fluoride. They are to keep the gums healthy, and keep the bacteria level down, but don't think they prevent decay??? ask your dentist/periodontist
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The hygienist told me not to rinse after using the sensitivity toothpaste, so it's OK to swallow. I get the generic brand from the dollar store, for use when the teeth are sensitive to hot or cold food.Just use a very small amount. I agree with the point of talking the whole time, i think that's essential for any task with a dementia patient. Sometimes the beginning of the sentence is forgotten by them before you get to the end of the sentence.
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you can get swabs then dip into mouth wash or saline to wipe her mouth. You can use baking soda to brush her teeth instead of toothpaste so if she swallows it's not going to harm her.
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It's the fluoride that you want to avoid. Fluoride should not be ingested. They do sell toothpaste that doesn't contain it. I buy it for my grandchildren.
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I use all-natural toothpaste "Auromere" which has no fluoride or sorbitol,or mint, it tastes like licorice. Agree that there's no need for any toothpaste, it just makes the job more pleasant. An electric toothbrush might do a better job.
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There is something called oral swabs. It has a lollipop type handle with a little sponge at the end. The sponge has toothpaste in it. Check with ur Dentist. He maybe able to get them for u in bulk at a good price.
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My dad uses Desert Essence tea tree oil toothpaste & neem "wintergreen" with much success! Doesn't matter if he swallows it even though I try to get him not to. He eats nuts often & less animal flesh for protein which benefits his teeth & gums. He has been taking the Curamin supplements since last fall and am amazed how well he fared during the winter when others suffered from cold, flu, & pneumonia. He just finished drinking the lemon ginger with probiotics tea by Bigelow and I placed almonds, pecans, & walnuts around the rim of the saucer. He eats a lot of steel cut oatmeal with chia seeds, bananas, & other fresh fruits. He loves the vanilla almond milk. He drinks a lot of water, too. I'm proud that my dad has such a good outlook on his condition & hoping it stays this way. He likes honey a lot. On occasion when he is coughing a little at night I take him a spoon of creamed honey (which doesn't drip & get messy like regular honey).
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Do *NOT* give PERIOGUARD or PERIDEX if the person is swallowing toothpaste or mouthwash. This product contains chlorhexidine and that's poisonous.
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I bought a WaterPik for my elderly parent and it worked pretty well. The dentist said it was more important to floss than to brush so if you cannot brush maybe you can floss with the WaterPik. That's what it is for. I also use a water pik.
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Plush her teeth while you lay her down with salt or backing soda not to much just wet the brush and dipped the tip of it. The reason why you need to brush her in lay down is, you can see everything down to tonsil,you can be able to swap mucus and so forth. Start to brush from the front teeth slowly,she will figure it out what you were trying to do for her and go to her cheeks,you open your mouth while you brushing her,she will fallow( sometime she may not no what open mean) Most of Alzheimer I have been take care of,I always give them shower after dinner,so I can have them rinse they mouth before I get to brushed they teeth. Most of them will open they mouth while you aimed shower head to they mouth,they will open it and keep water run,they will spits those stuff out themselves, after I dress them while they lay down,I can brushed they teeth without worries about any much food left in they mouth.
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** I meant Bushed her teeth*** NOT Plush her teeth**
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Buy the children's toothpaste which is not dangerous if swallowed. Use a washcloth and just put a little on it. Since dementia is terminal, do not worry about her teeth too much. Keep her safe, comfortable and love her.
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I agree with the suggestion for using baking soda (sodium bicarbonate) or salt. The baking soda in particular is beneficial if swallowed. Here are a couple of web sites with more information:

articles.mercola/sites/articles/archive/2015/02/02/11-health-benefits-baking-soda.aspx

md-health/Drinking-Baking-Soda.html

At your mother's age, the main concern should be her gums, so make sure you get down into the gum line. Using a soft bristle brush, wet it with hydrogen peroxide before adding baking soda for a double cleansing whammy. The H2O2 bubbles up, helping to remove debris and killing pathogens as well. The more bubbling, the greater the presence of bacteria.

Please do NOT give your mother anything with fluoride, neither toothpaste nor mouthwash nor supplements. The public was sold a bill of goods touting sodium fluoride as beneficial to the teeth (which it is not) when the industry hit upon the perfect way to profit off a substance that is an industrial waste product and was formerly sold as rat poison. Studies show that sodium fluoride lowers IQ when given throughout childhood. Can't be doing any good to someone suffering from dementia!
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I agree that toothpaste is not absolutely necessary. I'm a dental hygienist. The friction of the brush is what removes the plaque. Toothpaste is a relative recent invention and has stain removers and some have fluoride. Swallowing the fluoride can upset the stomach. I disagree with dejavuagain...fluoride is amazing at remineralizing teeth. Those studies are using massive doses, not the dose that is in a squirt of toothpaste. I've had fluoride since a child, I'm in my 60's and my IQ is quite high actually. Sugar is also poison in high enough doses. Anyway...enough said. We're not here to argue the pro's and con's of fluoride as that debate will go on forever.
Watch out for sodium bicarbonate if she's on a low sodium diet. If she has xerostomia from medications, alcohol mouthwashes should be avoided. Biotene brand makes products for people suffering from this (from dentifrice, oral gels, gum, and mouthiness) Great stuff! I am glad to read that you are helping your mom with her oral health as much as possible because it can affect her overall health.
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Dental care is vital to gut health so if you're already familiar with using swabs, Toothette Oral Care also makes a suction toothbrush, my mom's Dr / Home Health Care approved a suction machine, and this works perfectly. I agree with using natural products, not Perioguard, etc, which should only used for inflammation or infection. We use the Nature's Answer Periowash, Cool Mint Flavor. This is a great product, probably available online. I buy it at Whole Foods Market.
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Please do not use Peridex. It can be toxic if swallowed. Use a soft toothbrush on mom and if she swallows a little toothpaste it won't hurt. You can also buy children's toothpaste as toothpaste works as "soap". You can also ask your drug store if they sell the sponges on a looks like lollipop stick. Even when our residents just get them swabbed with water alone, it is better than not doing anything at all. If your loved one is in a facility, please ask your SW or facility if they have a mobile dentist/hygienist that visit their residents. They can provide on-site dentistry without ever having to remove them from their community.
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Harpcat, I don't want to get into a debate about fluoride either, but I need to point out that there is no way to regulate how much fluoride someone is absorbing if they are getting it in toothpaste and mouthwash. If someone is actually swallowing the dentifrice or mouthwash the dose is increased compared to spitting and rinsing with water. Add to all that the fluoride ingested if one happens to live in a town with fluoridated water. I could go on, but I think one can see that self-medicating with toothpaste and forced medication from municipal water supplies is the stuff of voodoo medicine.

Re sodium bicarbonate: Unlike fluoride which at the very least should be regulated as to the amount being administered, baking soda is benign. Even someone on a low sodium diet won't be taking in very much from the little bit of powder that would adhere to a toothbrush. If there is a medication being given where sodium needs to be minutely controlled, that is a matter to be taken up with one's doctor.

P.S. I'm not a dental hygienist, but I do have a background in nutrition and herbal studies.
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