this might seem a strange one, given all the other major after-effects of intensive care, but I got a bit of a shock yesterday to be told I have gum disease. Given my regular daily brushing it was a bit of a shock
When I thought about it I realised I did not brush my teeth for nearly three months while I was in two different hospital intensive care units with covid pneumonia, ARDS, and a pulmonary embolism.
CPAP oxygen, face masks, ventilators, and tracheostomy made it impossible to access my mouth, even if I had the energy to do so.
When I was in a coma on ECMO for a month I do not know what happened, but I have a feeling keeping me alive was the priority.
Has anyone else had experience of unhealthy teeth and gums after ICU?
I am not saying what has happened is solely down to my time in hospital but I suspect it may have had an effect, as 3 months of non-brushing must have had some impact?
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hi Vick, thanks for your reply, as it is not something I had thought about until now, and having gone from healthy teeth to this new scenario came out of the blue. But that huge non-brushing period explains it I think.
Hi. I was the same and did not clean my teeth everyday I was in ICU, clearly it would have been too difficult at times, but even when I was a bit more alert, I did not brush my teeth. Sometimes when I did clean my teeth it made me wretch. Fortunately I have no lasting effects. For me worse was not shaving. One of my nurses did shave me on one occassion. It was funny in that the nurses were very good at making sure you washed each day, but were not so pushy about teeth or shaving.
That is a very good point, I remember on the recovery ward being cajoled to try and basic cloth wash every day, and my first shaky shave was a huge landmark moment.
But I don't remember ever once being prodded to do my teeth.
I agree & when you think how dry your mouth would be too ( and that was once we had woken) - Saliva's tooth-fortifying, germ-minimising proteins and minerals lower the risk of tooth decay and gum disease. A couple of my teeth had pieces break off
Very sorry to hear that.I now have such gum shrinkage that some of the bone is weakening, and am looking at treatment to try and hold that at bay, but have been told what has happened is pretty irreversible, and will need "managed decline".
Oh yes I was on nil by mouth for the first stint in ICU, and yes my mouth was very dry, then I was allowed those sponges on sticks. Slowly I was allowed water and then some food and those ensure drinks. Then I was back in ICU with covid and vented and sedated. Once I came round and was moved to a recovery area in ICU I was allowed to eat and drink as I wanted.
My brother has had a tooth break and one go missing. Dentist said poor oral hygiene so i guess he is the same. Teeth not sorted with masks and ventilator would havebeen difficult i expect
"... I have found it surprisingly difficult to keep my hair washed and cut, my teeth brushed and my finger and toe nails clean and trimmed., while in any sort of hospital. There have been times when the state of my hair and toes have really bugged me,.I left icu with greasy hair, and nails like talons, and i often have to turn assertiveness up to 11 to be able to brush my teeth twice a day.. Washing hands before meals is also surprisingly difficult ..."
So I don't think there's anything odd about what you say.
Luckily my teeth have survived and my finger nails are back to normal but my toenails are still not.
Finger nails for me as well. The nurses were not allowed to cut because of health and safety. When I was in the last few weeks in ICU one of the nurses kindly bought me some clippers so I could do them myself.
Good to know it is not just me with regards to teeth. I also asked to have toenails clipped but they would not do them.I think it was because I was on blood thinners.
A pair of clippers were delivered to me, but after months of immobility i could not reach my feet!
I think the fact that you got so many replies in just a few hours, after this site has been so quiet for weeks, shows that although it might seem trivial compared to the life-threatening reasons for being in ICU at all, it's actually a genuine issue for many ICU survivors.
There are a few nurses/carers who will tackle toenails if you ask nicely. and have no sign of diabetes or ingrowing toenails, but you have to keep asking different people despite all the others saying no. Why they can't use a nail file I don't understand. Finger nails are easier to get done but you still need to be persistent
Friends and relatives who want to help - this is one of the practical things you could do especially when a patient is out of ICU but still in hospital. A nail file would be a useful gift, and/or nail clippers. Also dry shampoo. Maybe dental floss? Good toothbrush and the patient's favourite toothpaste. Things to bring from home could include an electric razor with an adaptor plug to run off a normal socket (some supermarkets sell them, there are no shaver sockets by hospital beds, only in washrooms), maybe an electric toothbrush.
Hi there, was in coma for a month...well a week and then sedation. My family started brushing my teeth....it's a natural tooth paste so you can swallow when you can't spit it out. They said my breath started killing them hahahaah no pun. So they would between sedation when i was semi there...brush etc. I can't remember it but i only remember the smell and taste! The videos they have are quite funny, Well not for them but for me. Anyways good luck!!
Hi Jake, thanks for your thoughts, I have actually been home for a little while now, but the problem has only come to light in the past week as there have always been bigger post-ICU heart, lung, brain, physio etc issues to be attended to.
Also, when I was ill it was during one the lockdowns, so no family visits, and the nurses were totally rushed off their feet to such an extent that the daily washing was not guaranteed.
From the number of replies, it would seem dental hygiene is an important but often overlooked part of being in ICU.
An interesting question. I have had to ask! My wife said that whilst in a coma ( I had a tracky and feeding tube) the nurses cleaned my teeth. Once I came round and had the strength to do so I started to clean them.Personal hygiene, from what I have read in my notes, was very important to the nurses. It was intimately carried out and reported on when there were issues. This was so important when every entry and exit point had a tube in it :-).
I do remember what I thought was the first time I had my hair washed (there is a photo as well) when my head was resting in an inflatable bowl. My first shower was such a laugh. If you can imagine a an old naked man who could hardly stand it was absolutely the best.
When I was aware of being shaved I was amazed that I had survived the previous shaves. There is an art and some nurses didn’t have a clue. In reality the least of my worries.
So to answer your question I haven’t had any issues with my gums or my teeth.
When patients are on a ventilator the nurse looking after you will try to brush your teeth but as you can imagine access is difficult. I think at the height of the covid crisis when staff were very stretched this might have been missed at times.
It was the height of the pre-vaccine covid second wave when the ICU staff were totally overwhelmed, so it was missed on a fairly regular basis, as they rushed around firefighting the constant emergencies taking place on the wards.
I too am having problems with my teeth since being unwell. I thought it was just me!
I was in ICU for 6 weeks, ventilated for 4 weeks and in hospital for 3 months. It’s was probably only the last 2-3 weeks that my teeth got cleaned (after me asking). I completely understand that whilst I was critically ill my teeth were not a priority, but once I was recovering on the ward I think it should have been.
I started asking the staff to help me clean my teeth before they washed me, as I was too exhausted to clean them after all the turning, pulling and pushing of being washed! I also ‘retched’ every time I cleaned my teeth, this carried on for sometime after I left hospital and still does sometimes (18 months on). Not once did my teeth get cleaned before I went to sleep at night, mind you by then I was completely exhausted!
I’ve seen my dentist once since leaving hospital, but I struggled with him putting instruments in my mouth, I panicked and started retching. He was so patient and kind to me (this panicking was a new experience for me, I’ve never had a problem with going to the dentist before).
I have an appointment to go back in October, I’m really hoping I’ll do better this time as I am really concerned about what’s happening to my teeth.
Thank you for sharing your experience, as I said I thought it was just me!
Thank you very much for your reply, as it is reassuring to know - as the other messages above also confirm - that it is not my imagination about tooth/gum issues.
I was also in hospital for three months, and there is definitely damage that was not there before.
I totally understand that they had other major things to attend to in ICU.
And I can also see that they cannot start interfering and brushing in someone's mouth/head area if that could cause a problem by accidentally hitting something important.
But I am interested to find that whereas eg hair damage is a known side affect after being seriously ill, the dental side is not so well publicised.
Finally, I also had a terrible panic at my recent dental check up, I think it is the intrusion into the mouth area, where we have had so many tense masks/tubes/tracheas/neck invasive procedures.
Being hooked up to all those machines probably didn't make oral hygiene a top priority. It's wild how much those hospital stays can mess with your whole body, including your gums.
I haven't been through exactly what you have, but I've heard similar stories from others who've been in the ICU trenches. Seems like it's not uncommon for dental health to take a hit during those intense medical battles.
As for your concern about your kids' health, I totally get it. It's tough keeping tabs on everything, especially when you're dealing with your own stuff. But hey, at least you stumbled upon this thekidsdentalofficeofphoeni... deal by accident, right? Silver linings and all that.
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