Dental Decision

Ljohnston

Does anyone have experience with a late to mid stage Alzheimer's patient with 1 tooth abscess and 3 pulp exposures. Oral surgeon wants to put my dad under general anesthesia and extract all teeth. What will a 2-3 hour surgery like that do to a person in this stage? will there be much recovery or do we just let nature take its course? Thank you for your thoughts

Carl46

What the oral surgeon is recommending is standard practice in this situation. However, general anesthesia can make dementia permanently worse and is to be avoided in patients with AD. OTOH an abscess is painful and possibly life-threatening and needs to be dealt with. I'm not a doctor but I think extraction of the four bad teeth without general anesthesia would be the safest course of action.

SDianeL

anesthesia is not good for people with dementia. Many decline after. Some return to baseline but you can’t know that ahead of time. In addition if they pull all the teeth, fitting for dentures will be very difficult if not impossible. Your LO may not be able to use dentures and will have difficulty eating. Someone posted here and said if you have to make difficult decisions, to play it all the way out. I would not put my LO in late stage dementia through that. Can they just treat the bad ones and infection to keep the pain down?

Ljohnston

https://alzconnected.org/discussion/comment/243289#Comment_243289

yup common for sure if you or i had a few bad teeth. ive been to three dentist including and oral surgeon and they all say only an oral surgeon in a hospital setting would do this procedure.

Ljohnston

https://alzconnected.org/discussion/comment/243292#Comment_243292

Thank you for your imput, yes trying to play it out and decide about puting my LO through that procedure is a difficult decision knowing for you or i we would see a dentists and have the tooth/teeth pulled.

harshedbuzz

@Ljohnston

This is a difficult decision as the stakes are high.

You can expect a worsening of symptoms with general anesthesia and the trauma of the surgery itself. But that might be a necessary trade-off. That said, he could become septic or develop endocarditis and require longer term hospitalization which would have the same impact of his progression.

HB