Dentist and dementia

[Toopie28]

Ma needs dental treatment.
She doesn't brush anymore and forgets/won't clean her dentures, even when prompted.

So now extensive pain in her back lower tooth.

Dentist wants to do an extraction. Ma freaks out when she has a pain in her wrist. Not understanding why, why, why. She doesn't understand pain anymore.

I believe extraction will be extremely traumatic and painful. She will forget to not eat on that side. Or even brush by mistake. She won't understand why so painful.
Add to that she's on blood thinners. So it's going to bleed for longer.

I don't know what to do. The dentist is very nonchalant and won't even give her anything to calm her down. She said its a back tooth, she's 90 and that's what she would advise. She said root canal too long in the chair and may not work.

Have you guys ever dealt with this?

(I've called around for a clinic that specialises in dementia patients and they have a 6 months wait😫)

 

[SeaSwallow]

Hello @Toopie28 I have not had any experience such as you describe but from your description the dentist does not have much experience of patients with dementia. Would your mum’s GP give her something to calm her down before the extraction.
Six months would be a long time to wait at a specialist clinic, your mum’s pain would probably increase in that time.

 

[Lawson58]

Taking a tooth out when someone is on blood thinners is not straightforward. I think you need to see your GP before you go ahead.

My husband had a tooth removed and then a bridge put in but it was all carefully organised prior to the event and we had no problems. It was a front tooth and he had a gap for a while but now you would never know as it looks the same as the others.

The problem with rotten teeth is that the toxins produced have an effect on the heart so should be dealt with sooner rather than later.

 

[jugglingmum]

When my mum was first diagnosed with dementia I took her to see my dentist (private but had been NHS and had visited care homes - and would have done a home visited if requested)

At the time mum had had some recent unfinished dental work (per mum)

Dentist said if no pain she wouldn't recommend doing anything as it might cause more distress than it solved.

She also said her approach would be extraction rather than crowns/root canal work as in her opinion less pain to deal with in total.

I've recently had root canal work and it isn't pleasant. The first treatment to eliminate the infection left me feeling ill and in pain for several days. The second treatment was ok but still a lot longer than an extraction. At your mum's age with dementia I would be considering an extraction as the lesser of two evils.

Is it possible to find another dentist. Even if they don't specialise in dementia they mightbe more sympathetic.

I agree with others to ask about something to calm her from GP but have no knowledge of blood thinners.

I

 

[canary]

My OH is on blood thinners and had to have a tooth extraction. He had to stop taking the blood thinners for a couple of days beforehand and there were no problems

 

[Toopie28]

Thanks all.
I did end up with another dentist as her usual dentist just made me very uneasy.

My friend tells me I should have a camera crew follow me around as everything is always dramatic -and it was. I was the one that was traumatised.

 

[canary]

Glad its been sorted @Toopie28

 

[Anthoula]

My OH had an extraction earlier this year. He takes Apixaban, and he did not have any problems. Simply didn`t eat for about 12 hours, only had the occasional sip of water until we were sure that the wound had sealed.

 

[Hermann]

How smoothly dental work goes ahead on people with dementia depends largely on the degree of compliance the patient exhibits.

In my mother’s case, compliance has been zero for around five years. Around five years ago, when I first took charge of her and my father’s teeth brushing, my mother had been neglecting her teeth for some time, and there was visible decay in two of them. This decay needed attention. Not one of three dentists we saw could persuade her to sit and have her mouth worked on; she would literally kick and scream.

Fortunately, after a lot of effort, we ended up having a consultation at the local dental hospital with a multi-disciplinary team, where we jointly came to a best interests decision that the work needed on her teeth could only be performed under a general anaesthetic.

The work went ahead at the height of the Covid lockdown. While my mother came round from the anaesthetic, the hospital dentist informed me that she had extracted six of my mother’s teeth.

I was a bit shocked to discover that they tend to do this on people in my mother’s state largely to minimize the chances of decay recurring in the affected teeth and the whole costly business of needing a general anaesthetic recurring with it.

Since I have been brushing my parents’ teeth twice a day (going on five years now) problems with decay in my mother’s teeth have been minimal, at least as far as the dentist, who visits us at home twice a year and just peeks in my mother‘s mouth for a split second, can tell.

Now, if we could only cure her obsessive teeth-grinding!

The dentist tells me there is no cure for this for someone in my mother’s state, but that studies have shown that the most effective remedies are distraction and mild verbal chastisement.

If you’ve got the leisure to sit next to the patient every minute of the day, this strategy might work!

 

[Toopie28]

How smoothly dental work goes ahead on people with dementia depends largely on the degree of compliance the patient exhibits.

In my mother’s case, compliance has been zero for around five years. Around five years ago, when I first took charge of her and my father’s teeth brushing, my mother had been neglecting her teeth for some time, and there was visible decay in two of them. This decay needed attention. Not one of three dentists we saw could persuade her to sit and have her mouth worked on; she would literally kick and scream.

Fortunately, after a lot of effort, we ended up having a consultation at the local dental hospital with a multi-disciplinary team, where we jointly came to a best interests decision that the work needed on her teeth could only be performed under a general anaesthetic.

The work went ahead at the height of the Covid lockdown. While my mother came round from the anaesthetic, the hospital dentist informed me that she had extracted six of my mother’s teeth.

I was a bit shocked to discover that they tend to do this on people in my mother’s state largely to minimize the chances of decay recurring in the affected teeth and the whole costly business of needing a general anaesthetic recurring with it.

Since I have been brushing my parents’ teeth twice a day (going on five years now) problems with decay in my mother’s teeth have been minimal, at least as far as the dentist, who visits us at home twice a year and just peeks in my mother‘s mouth for a split second, can tell.

Now, if we could only cure her obsessive teeth-grinding!

The dentist tells me there is no cure for this for someone in my mother’s state, but that studies have shown that the most effective remedies are distraction and mild verbal chastisement.

If you’ve got the leisure to sit next to the patient every minute of the day, this strategy might work!

Wow. That's dedication! You're amazing!

Ma will not brush her teeth under any circumstances, unless I tell her NOT to and she keeps trying to brush the space thats gone as she "feels" something.

After a day, she wasn't in pain. The doc said give her paracetamol every 4 hours for a least a week.
She's made of steel - LOL.

I do let her rinse with salt water every morning and night tho.

I just don't fight her anymore on some things. Showering is one (she washes from sink, old school) and teeth brushing. Uses her finger.

 

[pandion]

It's interesting to read this as the care home my mum is in has said she hasn't been brushing her teeth, she needs prompting to do it. Says she has done it when she hasn't etc. It's not like her as she always took really good care of her teeth. Maybe a memory thing, I guess.

Also it's made me think about whether the dental surgery is aware mum has been diagnosed with dementia. I've never thought to say anything, and I don't know whether the home have mentioned it to them at all. I guess it would be a good idea to let them know?

 

[Hermann]

Wow. That's dedication!

It’s kind of you to say so, Toopie.

Actually, my parents seem to quite like me brushing their teeth. My mother in particular can start to get quite happy and chatty once she’s got over the initial strangeness of the brush entering her mouth. Sadly, though, she would react very differently if I started probing in her mouth with dental instruments instead.