later stages and dental treatment

Timmyd · August 20

DW is stage 6. Her last routine visit to our dentist was in February. She could not comply with basic instructions and we were unable to get her teeth cleaned. Fortunately her check up prior to that was successful and no issues were identified.

Yesterday while eating, a crown fell off one of her molars. I saved the crown and it looks to be in good shape. She has no pain or discomfort. Our dentist cannot get us in until next week, but said as long as we are careful with only soft food we should be good until then.

I am having a hard time imagining DW providing the necessary compliance to complete whatever work is needed. Does anyone have experience with dental work in later stages and how to deal with resistance to care?

lizfourgod · August 20

I don’t but I imagine sedation can be done? Or would that be in hospital setting only?

Goodlife2025 · August 21

We are not there yet but my first thought was also - sedation may be your only option. For some dental procedures I think they use a light sedation - Versed. I am not familiar with its use and dementia. Hoping others may have more information.

Persuasion · August 21

According to my dentist, sedation is done frequently. Your dentist should be able to either do it her/him self or recommend someone.

Timmyd · August 21

Thanks everyone for the help. Our dentist that DW has been seeing for years only does nitrous oxide. If that fails, I assume she will be able to recommend a sedation dentist with ALZ experience. Wish us luck!!

rplynch · August 21

https://alzconnected.org/discussion/comment/280511#Comment_280511

I'm right there with ya. DW (Stage 6b dementia/alzheimers) hasn't been to a dentist in a year. I'm riddled with guilt but just can't imagine her sitting through a dentist visit. I'm thankful for the post and instruction.

annie51 · August 21

https://alzconnected.org/discussion/comment/280511#Comment_280511

Good luck @Timmyd! Many of us debated on whether or not to do dental care visits but you’re kind of stuck when it’s a missing crown. It’s probably necessary to fix that. 😬

fesk · August 21

For people who have given up going the dentist, you may try a visiting dentist. They don't do everything but have strategies to get cleanings done, can check and maybe head off issues. For instance, when there is decay, there is a substance they can put on it to arrest it so there is no further decay. My mother is advanced and we've been doing the home visits for years.

dcare45 · August 21

I'm also following this post. My DW had a cap fall and I had to actually hold her legs while a Dental Assistant held her hand while she threw her head back and forth while the Dentist tried to work. It was a horrible situation. That was the last time we were at the Dentist. I will be interested in any sedation that won't send her quicker down the dementia highway.

Timmyd · August 25

Today was our appointment with DW's usual dentist to try and get the crown back in. We were able to get enough compliance from DW for her dentist to cement the crown. The dentist would have liked to have more time to do a more complete solution, but the crown is back on for now.

I spoke with our dentist at length about the path forward. We got a referral to a sedation dentist. From what I gather, once you get to stage 6 and beyond, problem teeth are extracted. I will talk with the sedation dentist about our specific situation. I am curious if it is appropriate to have a visit for a thorough cleaning / exam to try and get out in front of any future problems, or if instead, we wait for a problem to appear before scheduling the visit.

From what our dentist told me, each sedation dentist has their own approach as to what specific medications are used for sedation. This is based upon the specifics of the patient involved and the drugs the dentist is most comfortable administering.

Goodlife2025 · August 25

Thanks Timmyd - Glad it went well; I will look forward to hearing what the sedation dentist tells you

later stages and dental treatment

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