Broken teeth - remove infected roots?

[Jackie123]

Mum has broken teeth, the local dentist has been keeping a watch on roots, and advised root removal was required as there was infection, so Mum was referred to hospital.

I live over 200 miles away and take Mum for the local dental check ups when I visit, as my brother will not take her for check ups, but my brother, who lives with Mum, did said he would do any follow up.

Both I and my brother find dentristry very difficult.

My brother did take Mum to the hospital appointment.

The hospital thought general anesthesia unwise, and local anesthesia would require several follow ups and I think this was a stumbling block for my brother, who finds Mum very tough to cope with.

Mum said she is not in any dental pain - she will complain a lot about her knees when they hurt, so I guess that is true, though I am not convinced. My brother said that Mum also declared she did not want any dental work done.

I feel guilty for not making the trip down for the hospital appointment as I feel that the outcome may have been different if I had gone with Mum - it is me who has insisted she have fillings when the local dentist said it was necessary.

I also feel like a bad daughter as I know I would not have wanted to do the several follow ups that might have been necessary had they decided the removal should go ahead.

So I continue to feel guilty - is there any advice on how I might dispel that guilt, as it is not helping me, my husband, my Mum or my family.

Jackie

 

[LadyA]

Could they give your mum antibiotics to clear any infection, and then everyone keep their fingers crossed that it doesn't recur? I'm not being flippant. That's literally what we had to do when a rotting tooth crumbled as my husband's dentist was trying to extract it. Some of the root came out, but most of it remained behind. The dentist gave him antibiotics, and said we'd hope that it never gave him any trouble, as he felt it would be way too traumatic for my husband to have it removed under local anaesthetic (apart from anything else, it would take quite a while, and my husband wouldn't understand having to lie on his back and keep his mouth open), and a general anaesthetic was not recommended for him. Thankfully, it never did give him any trouble until he died about three years later.

 

[Jackie123]

That is a good idea. Thank you.

 

[Duggies-girl]

That is a good idea. Thank you.

I agree with @LadyA Antibiotics may see it off and that could be the end of it.

 

[Jackie123]

It is 7 broken teeth but local dentist (who I saw in October '18 with Mum) did not saw how many infected; I'm now wondering why local dentist did not suggest trying antibiotics back in October before referring Mum for extraction, and I'm kicking myself for not thinking to ask.

The hospital dentist (Mum was seen in March '19 and brother went with her) did not suggest antibiotics either.

In fact the hospital dentist does not appear to be venturing an opinion as whether teeth need extraction - my brother has just sent through copy of letter he received and she seems to be leaving it to the family to make a decision....

That seems wrong to me - surely the dentist should give her professional opinion as to what work needs doing.

 

[Bod]

If the pain does start, and antibiotic's fail, then get the work done quickly, under general anaesthetic if needs be.
Ask about special dental services, they deal with the difficult/nervous cases, and are often more used to older patients.

Bod

 

[Lynmax]

I am an expert on gum infections and teeth extractions as I am now on antibiotics waiting to have a third tooth taken out in under a year!

I would have expected your mum to have had X-rays of all her teeth at her previous visit to the dentist, these are very quick and totally pain free nowadays. These will show exactly if any infection is present and how much the teeth might be damaged. A tooth affected by an infection will also be loose in the gum and it is likely that bits of the tooth will break off as they get brittle. The dentist will prescribe antibiotics before an extraction as a matter of course - hence me waiting two weeks for my next extraction!

Interestingly, my dentist, who is perplexed about the recurring infections as my dental hygiene is very good and at my check ups have no signs of surface gum disease, has suggested I have my blood sugar levels checked as high levels of glucose ( ie diabetes) can cause blood to thicken and increase the risk of infections. So I had that test today and await the results.

 

[Jackie123]

To the best of my understanding (from the local dentist) the teeth have gone and it is the roots that are an issue as one or more are infected.

Having now been given a copy of the letter from hospital it is not at all clear to me what (if any) work the hospital dentist thinks necessary.

Once that is established (there may be another appointment in pipeline) then does that dentist (or whoever needs to then involved) judge Mum to have mental capacity to make decision on whether to have that treatment. At the moment brother has reported that Mum said she is not in pain and does not want work done. Obviously that could be rechecked if there is another appointment in case Mum has changed her mind.

Only if Mum is judged not to have capacity to make this decision, does the PoA come into play, and with three adult children holding PoA probably with differing opinions but with the option to act independently that becomes difficult in its own right.

Even to find out what the hospital dentist thinks means I might have opportunity to go down and meet this dentist face to face.

My original post was about how to dispel guilt at being a bad daughter for not having gone down for hospital appointment, but it looks like I am now in a different situation.

 

[Lawson58]

One of the big problems with not treating tooth decay adequately is that the toxins can have an effect on other organs of the body, particularly the heart. My husband has had heart failure for years and we have to keep on top of any dental issues so he never misses his regular checkups. It is a very expensive exercise and I would like to find another dentist but OH is used to going to this one and it's not worth the effort to change.

 

[charlie10]

Jackie you're not a bad daughter....if you were, you wouldn't be worrying like this! One of the challenging things about this illness is the speed it can change....it's like trying to hit a moving target I can't really offer any advice on the teeth (tho I really sympathise, root canals are my bete noire!)....I'm fairly sure my pwd has dentures, so hopefully won't have a dental problem (but never say never ). Hope you manage to sort it, I know how hard it can be when you live far away!

 

[Helly68]

I concur with Charlie, this is really difficult.
My Mum has large old filings which may one day trouble her.The dentist didnt want to do a lot of work as it would have been very difficult to get her to comply. Now she would have to have an anaesthetic, which comes with its own risks.
I would see if you have a specialist dental surgery as Bod suggests, and ask for a second opinion, because of the challenging circumstances. We found that Mummy couldn't tell us what was wrong until very late on with a burst appendix. I still feel guilty that we didn't catch that earlier....

 

[Jackie123]

Thanks Charlie and Helly, much appreciated.

 

[charlie10]

Hi Jackie again, just a quick thought....if you do need to go ahead with it could they perhaps give her a sedative then give her a local when she's away with the fairies?....like they do for a lot of operations nowadays. There might be a reason they can't, otherwise they would have suggested it but....

 

[anxious annie]

Hi Jackie
I know what you mean about the guilt. I live a 3 hour journey from mums and my sister lives in the same town as mum but works full time , whereas I'm retired. I do all dr/ hospital appointments when I'm up but is difficult to coincide appointments with visits. I took mum to the dentist for an hour appointment on my last visit, but she needed a short X-ray appointment the following week so I thought my sister would do that. But no she can't so is made for next month when I'm back as closed during my Easter visit. I feel guilty that I didn't go back for the short appointment, tho resentful that I'd be doing a long journey for 10 minute appointment. Mum is supposed to be having a tooth out and the dentist wasn't absolutely sure she'd get it all out, so I was thinking of referral to hospital. Am not so sure now as people seem to be suggesting a general anaesthetic not the best for psd, so maybe be better trying her local dentist first? Am not sure what would be best, and everything takes so long to get sorted when I'm only there monthly. Sorry for jumping on your thread but was wondering what to do for the best for tooth extraction.

 

[Jackie123]

Just to muddy the waters I had a very good response from local dentist (didn't expect that, it was very kind, I had sent an update) which indicates that there was a risk of infection in October, rather than infection, but not withstanding that I think the Consultant Dentist did find infection in March, I have asked my brother for confirmation of that, but there is a significant risk that brother will say he can't remember.

I have asked the hospital (specialist dental unit) whether they can arrange the follow up review for my next visit, and if not whether I can have phone consultation.

Annie - my brother is 5 minutes from the dentist but wont take Mum for check ups; the medical practice wanted Mum in for blood pressure check and he decided it wasn't necessary and so I arranged - luckily the medical practice bent over backwards to fit me in a few days later when I was on a sceduled visit, and as a result I will now be taking Mum to 6 monthly pratice nurse appointments - my brother lives with Mum and doesn't have a job! You have my empathy.

 

[Lynmax]

Sorry that I was off topic of your initial post. You really have no reason to feel guilty but we all do it I think! There always seems to be something to worry about with our pwd and its made so much worse when you live far away. It is a shame that your brother could not help with these appointments but sometimes we just have to put up with things.

I don't know how my sister in law does it but she arranges all her mums medical appointments for when she visits - she lives in Arizona and her brother lives here in the UK but his sole contribution is ordering a weekly food delivery and a monthly visit! OK, he lives 100 miles away but a lot nearer than the US!

 

[Jackie123]

I didn't find your post off topic- fingers crossed that your results come back OK; my teeth play up when I am stressed, so maybe that could be part of the explanation for your issues. The reason I found is that that when stressed your ability to fight infection etc is switched off, as all your resources go to fighting or running away from the tiger.

 

[anxious annie]

Hi Jackie, I hope you manage to get the "teeth"sorted. Am glad that the medical practice is being helpful about fitting in appointments to coincide with your visits. I've managed to get a phone call booked with mums local dentist next week, so will be able to chat about the best way to move forward with mums extraction. Good luck with your brother, it must be very frustrating. I find I have to "bite my tongue" at times with my sister , tho I appreciate that she doesn't have very much free time as she does work.

 

[Jackie123]

Thanks Annie, hope things get sorted with your Mum as quickly as possible. What may be worth being aware of is that if your local dentist does do a referral to hospital, that appointment may take a long time to happen (5 months for our Mum) and might also be for a consultation in the first instance, as that is what has happened for us.

 

[anxious annie]

Thanks for that information, Jackie. I did wonder if there would be a long wait for the extraction and if there'd be a consultation first, despite local dentist referring with all the relevant information. As the hospital is a further 50 minute drive from mums (plus the usual 3 hour trip to get to mums in the first place) , I'm thinking that when I have the telephone consultation with the local dentist next week I will be in favour of her attempting the extraction if she feels there's a good chance of removal and take it from there.