I Think I Annoyed the Dentist

Marp

I took my sister (Alzheimer's Disease) to a new dentist due to some obvious problems with patient care at the previous one.

My sister has 4 missing teeth going back probably 20 years for the first one.  The last was extracted 2 years ago.  

She has a cavity in one of the teeth opposite one of the missing teeth that can be fixed, but the dentist said that, if we aren't considering tooth replacement for the one below it, we may not want to invest anymore in that tooth and just take it out.

Of course, I just had to ask...."what do you mean tooth replacement?" He mentioned options along with their pros and cons. We also discussed the pros and cons of removing more teeth and assessed the condition of the remaining teeth to determine potential impact on her ability to eat, etc.

At a subsequent appointment with her doctor, I asked his opinion and he said, if my sister can chew and swallow normally, the tooth (far back on the top) may not be missed.  

This week, I took her back for her new patient visit - Yeah we had some work done before she was officially a new patient.  I guess we did that backwards.

The dentist asked what we were thinking about the options he presented last time and brought up another one we might want to consider.

I expressed concerns that some of the options are risky if proper hygiene doesn't happen.  Right now, she is able to maintain her teeth properly with my assistance, but I don't know if she will be able to do that in the future.  I also shared stories I'd heard of Alzheimer's patients refusing to open their mouths for dental care, teeth brushing, etc. I also shared the conversation I had with my sister's doctor. 

After some discussion the dentist told me he worked for 16 months or so as a CNA in a memory care unit.   He said some patients were very compliant while others were more combative, and, of course, it could depend on the day. He seems to get it from that point of view.

The conversation went a bit longer than I had intended; I came prepared with questions, etc, but it still took a while & I think both he and the hygenist were late getting to their next patient.

He did say he could refer us to an oral surgeon for a consultation if I thought that would be helpful with some of my questions. 

He was very nice, as was all his staff, but, when he started talking about his experience in a memory care unit, I wonder if he was getting irritated because I appeared not to trust him.  I wonder if I crossed a line between being a concerned caregiver and a know it all who questioned his professional judgement.

He never pushed anything on us; he presented extraction of the tooth himself initially, I was the one who jumped on the tooth replacement and opened that can of worms.

My sister is still able to sit in the dental chair & follow instructions.  We have her scheduled to get another tooth filled in a couple of weeks and I don't anticipate any problems with that one.

I feel bad I may have offended him or his staff.  They have been very kind and accommodating to us in the short time we have known them.  I also don't want to lose a good dentist (this office has a stellar reputation) because I behave like a turd.

dayn2nite2

I can't say whether or not they were offended, but in dementia, "tooth replacement or restoration" should not even be happening.  Pull the tooth.

Fillings, fine.  Extraction, fine.  Don't even think about going through root canal or implants, none of that.  

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