T:Dental care for mother with dementia	

Q:My mother has many cavities and her teeth are falling off in bits and pieces and her bridge is also in bad shape. 
 I don't know what to do. 
 Her regular <professional_practitioner> wouldn't work on her since <time_period> because they feel her dementia is getting worse and they don't want the liability of her biting them even though I know she won't. 
 The problem she has is she just won't open her mouth. 
 They suggested <institution> who have all the equipments but they work in stages and by the time they will actually work on her will probably be <time_period> from now. 
 She had <num> teeth extracted <time_period> by <professional_practitioner> who was very nice but he doesn't do cleaning. 
 I don't know if he's willing to pull more teeth from her since it's <time_period> and my mom is a little worse off than before. 
  So first thing first. 
 Does people with dementia just don't get their teeth cleaned or fixed? My poor mom has that look you see of women in their <age> with no teeth because she has quite a few missing in the front area. 
 Implants are out because they are very complicated and also take too long and painful I heard. 
  
A:That's tricky. 
 does you mom do well with mild anesthesia? If so,  perhaps they can knock her out and use crowns instead of implants? Dentures are usually not a good option for people with AD/dementia because they will keep pulling them out. 
When I had to take my gma,  they put her on <medicine> but after she got bad (mentally) I couldn't take her anymore. 
A:I'm reluctant to put her under fearing the anesthesia will worsen her dementia. 
 Yes if she got dentures she will certainly pull them out. 
 The problem is she won't keep her mouth open too long and will start to cause problems by not holding still if she's there too long. 
 <time_period>  I was taking her to her <professional-practitioner> every <day> for <time_period> at <time_period> each to get all her filings done but even that she still has new cavities and at this stage she won't sit still like before. 
 So your GMA just went without dental care? I was told bad teeth needs to be pulled out fearing infections. 
 I rather do it myself if I could. 
 Just kidding. 
 
A:Yes,  my gma went without dental care but luckily her teeth weren't bad. 
 But you are correct,  bad teeth need to be fixed or come out. 
 
A:I worked in <institution> for a number of years and I remember the difficulty finding <professional_practitioner> willing to work with people who had dementia. 
 It is sad,  but understandable. 
 They are difficult to work with when following instructions and describing their symptoms is so integral to the work being done. 
  Here is a link about dental care for people with Alzheimers:  If the above link isn't working for you,  try this one:  It may help you. 
 If you're not in the <location>,  ignore the part about finding an <professional_practioner>,  but you can contact your local <institution> for a list of <professional_practitioner> more likely to work with your mom. 
 You may even find the information online,  but if not,  telephone them as they are extremely helpful. 
 (eta: Not sure why the first link isn't working. 
 Some of the time it does and some of the time it doesn't. 
 If you get the page not found response at the Alzheimer's Society page,  use the 'search our site' box and type in or copy & paste: Dental care and dementia & it will take you to a page listing the article,  then click on that article and it brings you to the link I posted above. 
 Or just use the tinyurl link instead - it's the same result. )Post Edited (baby dumpling) : 5/2/2012 11:18:42 AM (GMT-6)
A:Thanks a lot. 
<professional_practitioner> think all Alzheimer patients are violent and will hit them so for insurance liability reasons they say no. 

A:But are some Alzheimer patients really that violent? And is it due to confusion or anger issues from the brain?



A:Luckily I can't tell you because my mom has never been like this. 
I've seen movies of people getting pretty violent though. 
 It's scary. 
 
A:My mom is unpredictable. 
 Sometimes she knows how to brush once I start it for her and other times she takes it and brushes the sink with it. 
 I try and make sure it's clean daily. 
 Her teeth are falling out so there isn't much left and all <professional_practitioner> we've seen say just let her be and forget about trying to replace them. 
 I notice a lot of >professional_practitioner> just like to give up because the patients are old and they think it's a waste of time and $. 
  
A:In the past <time_period> my mom has had <num> teeth broken off. 
 She has so many spaces in her mouth that it cannot be ignored anymore. 
 Has anyone had dental implants done on a PD or dementia patient. 
 Is it dangerous to do with the condition?

A:It's not dangerous per se,  but in order to to do implants on a dementia patient,  it requires sedation - in most cases and they normally don't respond well to sedation (causes more confusion as they're coming out of it). 
 But you should find a <professional_practitioner> in your area that specializes in geriatric care or dementia patients; her <professional_practitioner> might be able to help you find one. 
  
A:I actually found a place that specializes in Autistic children and PD/Alzheimer's patients. 
 Hopefully they know what to do. 
 I have a consult in <time_period>. 
  Teeth is so important. 
 Sounds lame but it's true. 

A:Not lame at all! Teeth ARE important. 
 sure food can be mushed up but it's not the same. 
 I'm glad you found someplace to take her. 
 Let us know how it goes okay?
A:If they can do implants for her then I'm sure it will cost an arm and a leg and then some but. 
 I'll work <num> jobs if I have to pay it off. 
  
A:She doesn't have dental insurance or money of her own? If not,  tell the <professional_practitioner> this and they might be able to get you a discounted rate. 

A:What they will do is a payment plan. 
 Most places are like that now. 
 They still need to make $. 

A:They could extract all upper teeth and then place <num> implants on the upper arch. 
 one on each posterior area and <num> more wear the cuspids were. 
 Then a full upper denture would be made to fit over those implants and that denture should fit real tight and she wouldnt be able to take it out. 
 The placements of the implants she would need to very still or lightly sedated. 
 Implants need to knit in the bone for a <time_period> and then a implant metal thingy screw on top of each framework that is in the tissue. 
 Then impressions for a full upper denture. 
  <time_period> later the denture is finished. 
  <name>

A:Thanks. 
 I'm actually kinda confused with this process. 
 I have to get the approval from her <professional_practitioner> to get the <medicine> done. 
 We have an appointment at the <professional_practitioner> <time_period> to see what can be done. 
 I don't know how they will be able to get an <diagnostic_test> of my mom's mouth to see if her bones are strong enough to get the implants. 
 She will not cooperate at all and when she is sedated I want it to be a one shot deal and not do it repeatedly for different steps. 
 I have major phobia whenever I feed her. 
 I'm terrified that more teeth will break off. 
 
A:She could get a <diagnostic_test> done of her entire mouth. 
 It rotates around her head. 
 That way they can see how thick her bones are and how low her sinuses are. 
 If individual <diagnostic_test> need done they could do <diagnostoc_test>. 
 Here and there . 
 Put a wand in her mouth and it show up on a monitor. 
 Neat how thing have improved over <time_period>. 
  Let us know what he recommends from the consultation. 
  <name>
A:Thank you <name>. 
 You are very informed about this. 
 The visit with the <professional_practitioner> early <time_period> was a bust. 
 She said my mom would need too much work done and that implants may not be suitable because my mom's teeth are crooked and they overlap the missing tooth area and so the implant may not fit. 
 It would be at least <num> visits to get all the work done at that office so she suggested I take my mom to <institution>. 
 The should have all the equipments and be able to deal with my mom better. 
 We have not scheduled a visit yet. 
 The digital and <diagnostic_test> sound very cool. 
 Hopefully that will work on my mom when the time comes. 
 I am just worried about how much pain she will be under if and when she does get implants. 
 Maybe I should leave well enough alone and let her eat soft food forever and not risk this? But then more teeth will eventually fall out. 
 Then what?
A:The <diagnostic_test> didn't happen. 
 My mom is not capable of standing alone and holding on to the <num> handle bars AND bit down on this contraption. 
 We were referred to <institution> yet again but the waiting period is <season> so I looked up a <professional_practitioner> that extracted <num> teeth for my mom <time_period> ago. 
 His office said they have an <diagnostic_test> taken of my mom from then but was very blurry. 
 My mom' mental state is way worse now than before so I don't know how this will be taken this time. 
 There are a total of <num> roots that needs to be removed and I don't know if implants will be recommended for her. 
 Sedation will have to be done to remove all the teeth. 
 I just pray it will be done quickly and no lingering damage. 
  Question - what about people in wheelchairs? How do they get <diagnostic_test> taken?
A:<name> ?I'm sorry but there is no replies from you unless the emails are misdirected. 
  Last Friday we saw an <professional_practitioner>. 
 He was very patient and took <diagnostic_test>. 
 It took about <num> and they all had to go inside her mouth and it was very hard on my mom. 
 She has <num> roots that needs to come out and will have to be sedated. 
 I am so worried about the pain and after math of the sedation. 
 Being how my mom seemed to him <time_period> he thought implants was a waste of $ because my mom was non responsive to him and so he assumed she is like this always. 
 Basically a vegetable. 
 She's only like this with strangers. 
 I told him she still needs to eat and pureed food will just send her closer to the grave because as it is she is losing weight rapidly. 
 My poor mom. 
 I feel so helpless. 
 It's <date> and it feels like nothing much has advanced in dental care since <time_period>. 
 Everything is still painful and takes long time. 
 Shame on modern medicine. 
A: <name>; my Mom has a swallowing problem,  and was down to <num> lbs. 
 She has been eating something called Magic Cup and she has gained a lot of weight -- she's up to <num>. 
 You can serve it like ice cream or like a custard,  but my Mom loves it! Maybe this would help since your Mom has trouble with chewing? Here's the website:  <name>:Thanks it looks interesting but. 
 what is it? I can always give my mom plain ice-cream but I just want her to be able to eat real food like meat. 
 Things with substance. 
 I know for myself I can't get full unless I eat bulky foods. 
 Things that satisfies the tummy and not just add calories in liquid form. 
 When I was younger I ate Little Debbie peanut butter wafers and gained <num> pounds in no time. 
 Those were the good old days. 
  A:This is a nutritional supplement. 
 It's like ice cream but has more nutritional value. 
 Maybe you could puree her food and use something like this as a supplement? I know I'd like my Mom to be able to eat more substantional things,  but she can't,  so I have to think of what her needs are. 
 My brother and I just spoke about this <day>; he said she is gaining weight,  but I wish she'd eat more than pureed food and the magic cup. 
 I said the time has come for her to eat what she really likes,  and he agreed. 
 Tough stuff,  I know! Take care. 
  
