Taking Care Of The Uncared For

Many years ago, I attended a dental meeting where representatives of the dental organization spoke about the unmet needs of nursing home residents.  I was moved by compassion and felt an unavoidable desire to do something about it.

I found a dentist (Peter) in the Seattle area that had been treating those who had often been overlooked for quite some time.  I flew up there and spent some days accompanying him to see how he was making an impact.

Upon returning home I purchased dental equipment I would need in order to practice “Portable” dentistry and over the next five years, I provided dental services for the less fortunate in 22 different facilities from Newman all the way to Visalia. At a certain point I had to stop because my back could no longer bend over the wheelchairs to perform treatment.

As you can imagine, I was able to help many people and create many memorable experiences.  At one point in time, I had 8 centenarians as patients.

One of those memories was about John. John lived in downtown Fresno in a nursing home and had a stroke that paralyzed his right side.  He moved mostly by pulling himself along the wall railing with his left hand while in a wheel chair.  He was always singing and only he knew the song or the lyrics as his speech was severely affected by the stroke. 

The dental treatment I provided John was to make him a new lower full denture which had been lost.  It was common for other residents to circulate all the rooms and remove items so someone else could have taken it.  I had made a custom tray for the denture impression and was there to take the master impression for his new denture.

Now, visualize John sitting in his wheelchair, with me standing in front of him with the tray full of gooey impression material ready to put it in his mouth.  Then in the blink of an eye John reached out with his good left hand and grabbed the tray, spit in my face and with his very strong left leg clocked me right between my legs. I stood there squeezing back with my hand while the impression material oozed down our wrists until it set and could peel it off our hands.  The next attempt, occurred when a male nurse assisted and I turned my hips to one side.

Another experience was with Mary in a nursing home on Shields Ave.  She had been comatose for twenty years and was nourished with a feeding tube directly into her stomach. Because no food or water had entered her mouth and she had not had dental cleanings, there were only two pieces of tartar; one on the upper jaw and one on the lower.  Each piece covered most of the teeth on the outside and inside including in between.  I marveled at how they were such a pretty yellow color.  We dentists have an instrument (ultrasonic scalar) to assist in breaking up and removing the hardened deposits. 

She was confined to the bed and had a slow back and forth movement of her head.  How do I clean her teeth with out and assistant?  Well, part of my job is being creative so this is what I came up with.  I laid the scaler at the foot of the bed, placed the suction machine on the left side and ran the hoses up across her. I put the foot control for the scaler between my knees as I laid beside her in bed.  With my left arm I cradled her head and held the suction tube and mirror while the right hand controlled the wand.  Her neck muscles where so strong that we gently rocked back and forth as I removed the tartar.  I looked up to see two nurses smiling in the doorway.  It may have not looked like a normal cleaning, but we got the job done.

One constant theme I have found in my years as a dentist is that everyone is in a different place in their life, but we all need someone willing to go out of their comfort zone to help us and make a difference.