Advice about going to the dentist?

[Thursdayschild]

My wife has young onset Alzheimer's - she is now 65 and was diagnosed four years ago. She has an MMSE of around 7 ish. But she is physically great. But she has a bad molar tooth - the dentist says he might be able to save it with root canal treatment. But yesterday she was very panicky in the dentist chair - squirming around and he couldn't even get the little cardboard x-ray thingy into her mouth without her being distressed. It was just a consultation visit. I had prepared her with reminders etc. and wrote to the dentist in advance explaining her condition and he was kindness itself and I sat in with her - she follows me everywhere so I have to be around anyway.

If she cannot cope with root canal stuff then an extraction is the alternative and maybe an implant later?

She used to be absolutely fine at the dentist. Any ideas? She is on both Memantine and Donezepil so would some Vallium help? Am I causing such a lot of distress over a back tooth? What do people think? Thanks in advance.

 

[cragmaid]

Hi. In my opinion I would not contemplate putting your wife through root canal treatment, especially for a back tooth. If, and its a big if, she is in pain, then yes, go for extraction under sedation ( not general anaesthetic), but I think you are asking too much of her to comprehend what is happening to her.

Sorry to sound negative, but I know what my late Mum would have tolerated.

 

[Beate]

Have you looked into community dentists? Someone with dementia can be referred to them as they are experts in dealing with "problem patients" - patients who for whatever reason don't just sit down in the dentist's chair and obediently open their mouth. OH will also soon have to have a tooth extraction under sedation, and I'm not looking forward to it, but I know he's in the best hands with them. For dental check-ups they even visit you at home or the Day Centre.

 

[irismary]

Going through very similar with my husband. Finally managed to get an appointment at community dentist as dental hospital could not manage him. Hoping they can do the work - possible extraction and filings - under sedation but could be a general anaesthetic. It never bothered him before but he was exactly the same with the xray card in his mouth. Dental hospital may have been able to xray but they had been hit by the cyber attack and couldn't use some of their equipment. Community dentist may be more experienced and able to spend more time. Hope you can get something sorted.

 

[Tin]

Personally I would go for extraction if there is pain. and enough molars in mouth to chew food. Having experience of root canal treatment I cannot see how a dementia sufferer could cope with the time, treatment and instructions involved. It is awful I know, but I think the option with less stress is the way to go.

 

[jugglingmum]

My dentist (who does or has visited CH and NH for dementia patients) advised to do as little as possible - and if a tooth was removed PWD normally learn to chew as a toddler does, with gums - as anything else is either too distressing for them and they won't learn at this stage how to deal with any variant of false teeth which needs to be taken out and cleaned.

 

[oilovlam]

Sign up to the 'community dentist' - you will probably need a referral by your dentist. They can even come to your house if your other half refuses to go to them....although home visits wouldn't do complicated dentistry.

They will also have a lot more experience on dealing with dementia patients.

It can take a long time to get referred but once you are on their books they will see you quickly for emergencies.

 

[Thursdayschild]

The dentist - many thanks

Thanks a lot for the posts above. they are really helpful. Made me realise my wife is not really comprehending what is going on, despite my best efforts. I have POA so I will go for an extraction with sedation - to leave the tooth in with a big hole in it is risking an abscess.

It was distressing for me to see my OH in such distress at the dentists. I guess a PWD cannot rationalise pain now for gain later. I will try the community dentist, although the practice I have used were great - I will talk to the latter again. I think I will ask the GP too about some sedation - I don't know how Valium and Memantine and Donezepil mix - I sometimes feel my OH is just about holding on some days. At MMSE 7 ish I wonder sometimes if her cognition will fall off a cliff!