dental care for bedridden mother w/Alzheimer's

jimabassplayer

I've been caring for my 89 yr old mother with Alzheimer's for several years. She fell & broke her hip this past February, & has been bedridden since. She has decay in her bottom teeth, & one tooth is nearly completely rotted away. As she can't walk, I can't get her to a dentist; & even if I could, she would likely not cooperate (and this tooth needs more than a filling; it's rotted).

It can't be salvaged, and because of her Alzheimer's, it can't be pulled. She'd never tolerate the gauze in her mouth and it would be bleeding endlessly.

How are such patients normally treated for serious dental rot? I need help. Her tooth is horribly rotted away.

persevere

Do you have hospice care? Sounds like she would qualify. I strongly recommend you look into it if not. I’m not sure how they treat dental stuff but their job is to make sure she’s comfortable. This doesn’t sound comfortable.

jimabassplayer

Yes, we have hospice care. And I've been asking the nurses for months what to do about her teeth. They have no idea.

April23

Could you look into a mobile dentist? They could at least let you know what options you have or have some ideas on how to manage it. Also any chance she has a former dentist that would be willing to talk to you? I called my dad’s old eye doctor once and asked some questions and they were great.

jimabassplayer

Thank you. I spoke with her dentist this past summer and he has no idea what to do. Getting her to a dentist would be very difficult, but not impossible.

But as the tooth is beyond repair, I imagine that extraction is the only option. In her condition, she will not tolerate any gauze or anything in her mouth. And as the location is bottom front, it will be aggravated by everything she eats and drinks. I have no idea how a tooth (particularly in the front) can be extracted and heal properly in a person with advanced Alzheimer's.

pmiles1124

why do you think she would bleed alot? Is she on blood thinner? The tooth will probably come out very easy. The body will come into action and start healing. Amazing how God thought of every detail. I would think the worst part is getting the anesthetic in.

jimabassplayer

Yes, the Lord is great and His design perfect.

My Mom is on blood thinners, but even with people not on blood thinners (like me), there was bleeding with the only tooth extraction I ever had. And the area of the extraction had to be avoided for several days.

Regarding anesthetic, the oral surgeon told me at the time of her previous extraction, that she cannot be put under with her Alzheimer's. They removed the tooth while she was awake. She was given a pill by her doctor to calm her, and by the grace of God was fine that time.

And even more miraculously — didn't bleed…

…until about 5 hours later, when she spit. Then she bled for two hours. If she did that now, it would be horrendous, as she can't follow directions.

At the time of the previous extraction her dementia was far less severe than it is now. At that time, she was like a four old. Not great, but enough to understand and attempt to follow directions. Now, she's like a newborn, and can't understand or follow directions.

Also, the previous extraction was a back tooth. This one is in the front, on the bottom, impossible to avoid when eating. She would be aggravating it every time she ate.

April23

A mobile dentist would come to your mom. Even if she doesn’t cooperate, they might be able to give you some guidance and are familiar with working with PWD.

jimabassplayer

https://alzconnected.org/discussion/comment/261975#Comment_261975

Thank you. I've checked, and thus far can find no mobile dentists in this area. The closest I can find are in metro NYC and Philly, both about 130 miles away.

harshedbuzz

@jimabassplayer

I'm sorry you are facing this with your DM.

Is the tooth causing pain? If it's as decayed as you suggest, it may be dead and more of a cosmetic issue now. If it were causing pain, it might be worth discontinuing the blood thinners and finding a special needs dentist willing to sedate her and have a medical transport company bring her to and from.

HB

jimabassplayer

I don't think it's causing her pain presently.

While it would be difficult getting her to a dentist, the bigger problem would be the recovery. She's like an infant and can't follow instructions. Any extraction at the front of her mouth would be constantly irritated when she ate, and she'd be fussing around the wound with her tongue.

The lady who comes to help wash her on weekends looked at it and said she would leave it alone for now. Thing is, decay gets worse with time, not better. And there is decay at the gumline on most (if not all) of her bottom teeth. I don't know what to do.

April23

If it goes long enough, it may fall out on its own. This is a common dilemma, one I am starting to face myself. Two months ago, my dad had a cleaning outside his facility and a root canal and did amazing. The mobile dentist just came recently and dad wouldn't even open his mouth. I know he has areas of decay also and wanted to address them. But what can I do? I will try again in three months and have the facility care for his teeth the best they can in the meantime.

Dad has at least two teeth that need extraction but they aren't bothering them so for now I'm not doing anything as the mobile dentist suggested. It doesn't mean I don't worry about it though.

jimabassplayer

Hope things go better for your Dad.

I considered it falling out on its own, but that the presents the same problem — bleeding and an open wound. Falling out on its own may be an even bigger problem, as it won't be in a dentist's office where they can try to handle it (at least initially).

It's not a good situation at all.

JesseLee

I'm sorry you're dealing with this! How about antibiotics for infection? Maybe the least bad option. My dad isn't there yet but like you, mobile dentist isn't available. There may be nothing you can do absent infection and pain control, sorry to say.