So much of our body is “hidden” from the world, whether it be our private areas covered in clothes, our toes snuggly fit in our shoes, or even our teeth, that upon close inspection, can have serious problems. “Open wide and say, ‘ah-h-h,’” is a simple, innocuous request that most of us would comply with without a second thought. Trying to persuade an Alzheimer’s patient to do so can be anything but simple.
Mom woke up a few weeks ago to discover that one of her teeth had cracked in the night and a piece of it was lying on her pillow. When she refused to let a dentist examine her, we called on the assistance of Yad Sarah, an exceptional volunteer organization who lend medical equipment to the general public as part of their goal to keep the ill and elderly in their homes rather than in a hospital. Yad Sarah also offers home dental visits.
The dentist who came to the house was a seasoned practitioner in dealing with recalcitrant patients. At first Mom refused to open her mouth, but Dr. Mansur did a great job persuading her to do so. It was a drawn-out negotiation between myself, Mom, my dad and Dr. Mansur, all vying to relay the same message: Dr. Mansur only wanted to look at her teeth, not take them; Mom would not have to give them to anyone.
Dr. Mansur discovered that one of Mom’s teeth was indeed cracked. Another was completely pushed inwards inside the mouth. A third may have sustained damage due to night grinding, also called bruxism. I remember that Mom used to wear a night guard, though she hasn’t done so for many years now. From what I saw, there was a huge gap at the side of her mouth where some of her teeth were seemingly missing.
As Dr. Mansur confirmed, no dentist would work on Mom without an x-ray, preferably panoramic, of the affected area. She pointed out that the biggest problem was the cracked tooth. How large was the crack? Had it affected the root? Was there an infection?
We all also realized that if it took that much effort to get Mom to open her mouth, there was no way we could subject her to an x-ray without some form of anesthesia. And neither could the work be done except under anesthesia.
With Dr. Mansur's letter of explanation, Daddy must now request an appointment not at the local dental clinic but at the hospital’s oral and maxillofacial clinic, the only clinic in the area that has the ability to perform oral surgery under full anesthesia.
This is sort of like the chicken and egg question. Will we receive an appointment for Mom’s x-ray and dental work, or must we get the x-ray and then return to the doctors? It would certainly be best for all concerned to put her under only once.
If we were dealing with a woman with all her facilities, we would not be in this predicament. We must weigh the costs of doing nothing versus fixing the problem. So far there seems to be no sign of infection, but Dr. Mansur stressed that this could change at any moment. And so we are forced to look closely at this part of Mom’s hidden body. The instinct to turn away is strong, but we are her guardians, both spiritually and physically, and we must face her health issues head on.
I personally do not like visiting the dentist. Ever. Perhaps it’s a childhood fear coming to the fore from having teeth pulled to make room for braces, or the braces themselves. (I famously—and completely by accident—once bit my orthodontist’s finger.) Whatever the case, now that I’m an adult, I advise eating cake before you land in the dentist’s chair. That way, if you end up not being able to eat for a few hours, you’ve had your sweet fix. This recipe for Russian Pie is from my very good friend Sharón. She doesn’t know why it’s called that; her mom used to make it all the time and now it’s a favorite of her sons. I think it’s become one of my favorites now, too.
Strange name but luscious dessert. Everyone should try it. Thank you to Sharón Benheim and her lovely mom.
4 eggs, separated
2 cups sugar
¾ cup vegetable oil
2½ cups flour
1 tsp vanilla
1 large jar of apricot jam
Separate eggs and put whites aside. In a large bowl, mix yolks, 1 cup sugar, oil, vanilla, and flour to make a thick dough. Spread on greased baking pan. Cover cake base with apricot jam. Meanwhile, beat egg whites and gradually introduce 1 cup sugar until stiff peaks form. Gently spread on top of jam. Bake at 350° for 30 minutes until top is lightly browned and flaky.