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My mom has started to pocket her food on the right side of her cheek. The tooth is bothering her there and no one knows which one it is as she will not allow them to look in her mouth. I brought her to a dentist last year when 3 of her teeth fell out and even having giving her a xanax so she would be more cooperative, (which she was) the dentist said they could not do anything for her unless she was under anesthesia which her primary care physician said no to, for obvious reasons. (BTW, she was not able to have X-rays done due to the logistic of the room and machine placement and she being in a wheelchair) So now here we are months later and we are downgrading her food preparation so that it is pureed and she takes 3 Motrin a day for overall pain. But now she is starting to lose weight as she is not eating as much and we fear if we don't do anything, this is a long and painful road to the end. Any advice?

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Thank you SD for giving us more information and for the steps you plan to take. Those smiles are pure gold. I have one to call to memory from my mothers last days and it's precious to me.
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Thanks for all your comments. My mother does have a DNR. We have been referred to an oral surgeon and will use that route once we have exhausted the speech therapist who has started to observe the situation and make recommendations. My mother is completely invalid. She has macular degeneration, has to be lifted out of her chair with a hoya lift and talks very rarely and when she does it is gibberish. Her quality of life is horrible, but we still can get a smile out of her once in a while. She is only eating 25% of what she usually eats but that has been with mechanical soft food. If it is pureed, she might be back to eating the full meal. She also grinds her teeth ALL the time and getting her to stop that is all but pointless. She will not cooperate to have a mold made and even if we got one, she would not keep one in her mouth. She is not screaming in pain, so that is good and we do know when she is in pain as she tells us, from other situations.
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Sometimes, you have to weigh the benefits vs. the risks. If a dementia patient is still functioning, then I would think that risk of anesthesia vs. living with pain, infection spreading and not eating.

I would explore the least invasive course of treatment. Like cwillie said, what about gas? I know that they were going to use it for my LO when she had 3 extractions last year. But, she did so well, that they didn't need to use it.

I would look for a dentist who works with dementia patients. Try one that accepts Medicaid. They normally do. The one that we dealt with was kind, gentle and patient. So was the staff. With just a Ativan and local numbing, she had 3 extractions with zero problem. It was over very fast and she healed quickly. They were prepared to use gas, but didn't have to.

If you have a DNR, take it to the dentist appointment with you. Our dentist would not treat her without having it in hand.
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There are still dentists who use nitrous oxide sedation, could that be a viable option?
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My mthr has had teeth fall out for the same reason. She is on hospice so she can have stronger pain meds, but refuses to admit her teeth hurt.
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Long and painful are the words that I think are the most important. Whatever would make those words go away. Especially painful. I think I would ask her primary and her dentist to conference over the best course of action given all the circumstances you've mentioned. Fold in a dietician or nutritionist to your health care team to help you purée the healthiest mixture with plenty of protein. The last thing you want is for her to feel hungry.
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