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DaraDara Asked June 2019

What do you do about dental care when he needs extensive work but cannot afford or endure the actual work?

S0 always had impeccable teeth, flossing and brushed after every meal so it took me a few years to notice he had stopped taking care of his teeth, even after his diagnosis of dementia. When his front tooth snapped off and I brought him to a local dental chain I discovered the extent. He needed $8,000 worth of work and probably dentures. The first step was to remove the tooth still left in the gum that had snapped off but when we returned for the procedure he refused to let them do it. He said he didn't trust them. I brought him to other dentists but the only one he liked actually told me he just couldn't deal with him. He is very suspicious and makes any professional explain over and over what and why which can go on for quite a time. Plus he now refuses to clean his teeth anyway and instead insists that someone else did this to him. Someone comes in during the night and injures his teeth. He tells me I have to make them stop. So at this point I don't know what or where to go. He has limited dental insurance so anything he did I would need to pay and have him slowly pay me back. But I don't have anywhere to take him or any assurance he will actually sit for the many procedures. Yet his teeth are hurting him and it's getting hard for him to chew.

Countrymouse Jun 2019
The American Dental Association offers a website called mouthhealthy.org, which includes tips and resources for caregivers. It was not all that helpful. Essentially, the key advice was "I wouldn't let it get this bad." 😡

There are dental hospitals but not terribly near you, certainly too far to go in the vague hope that they might be able to do the work.

Does your husband trust any other species of health care practitioner? Who else is involved in his dementia care and health care? I'm wondering if there might be a wiggly alternative route to getting him in the chair.

Meanwhile - you want to get in touch with these people: https://www.alz.org/manh/helping_you

I see from your profile that this is a bumpy ride for you and I hope that local resources and local support might help. Also - they might just know where you can find a dentist who specialises in dental health in dementia! I'm sorry, I don't seem to be getting anywhere in my search for one.

Countrymouse Jun 2019
The only one he liked told you he couldn't deal with him...

Oh, great. Tremendously helpful.

Did the acceptable dentist have any more constructive suggestions than that to offer?

And, besides, WHAT couldn't he deal with? The repetitive questioning/paranoid interrogation? How far did this dentist get in actually carrying out any examinations or treatment on your SO? If he did any useful work, I think I might go back to him and plead/argue. Maybe a series of shorter appointments could be the way to go.

Otherwise, in line with Ahmijoy's dental college suggestion, you want the US equivalent of the Eastman Hospital. I'll do some quick digging and see what I can find.
Grandma1954 Jun 2019
when it cam to my husband he would not sit in the dental chair, would not open his mouth. And our Dentist is/was a long time best friend and he treated him for as long as he could and the best he could. I could not fault the dentist. And we both disliked the idea of anesthesia for the reasons I sited.

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Grandma1954 Jun 2019
This was my Husband.
He became non compliant at the dental office and the choice was to
1. general anesthesia to do the dental work
2. do nothing.
I chose to ...Do nothing.
I would not have been able to explain why his mouth hurt after removing teeth. I did not want to have to deal with open wounds in his mouth. I did not want to deal with him trying to poke things in his mouth to "fix" a hurt,
I continued with the oral care I was giving him. For the longest time I would brush his teeth then it became a choke hazard so I used the dental swabs Hospice provided.
Anesthesia is risky for people with dementia, the effects can last a very long time and some do not return to the pre surgery cognition level.
You can contact dental clinics, some health departments offer limited dental clinics as well.
You can ask his doctor to prescribe a medication that will relax him. The only problem is you may need help getting him out of the car and into the house after the procedure. If the dentist uses gas that might help him relax a bit if he will permit the mask to be placed on him.

Pureed or finely chopped foods will help with the not being able to chew.
If he has no infections in the mouth you can ask the dentist or his primary about using Clove Oil for the tooth pain. It does help quite a bit.

Ahmijoy Jun 2019
Those chain dental practices can be a nightmare. One advised my elderly neighbor to have all her teeth pulled and get dentures...and she did.

Have you contacted a local dental College? Many are affiliated with large, teaching universities. They are cheaper and the students are supervised by their professors. You can ask them to only do the barest minimum to enable him to chew.

Grandma1954 Jun 2019
This was my Husband.
He became non compliant at the dental office and the choice was to
1. general anesthesia to do the dental work
2. do nothing.
I chose to ...Do nothing.
I would not have been able to explain why his mouth hurt after removing teeth. I did not want to have to deal with open wounds in his mouth. I did not want to deal with him trying to poke things in his mouth to "fix" a hurt,
I continued with the oral care I was giving him. For the longest time I would brush his teeth then it became a choke hazard so I used the dental swabs Hospice provided.
Anesthesia is risky for people with dementia, the effects can last a very long time and some do not return to the pre surgery cognition level.
You can contact dental clinics, some health departments offer limited dental clinics as well.
You can ask his doctor to prescribe a medication that will relax him. The only problem is you may need help getting him out of the car and into the house after the procedure. If the dentist uses gas that might help him relax a bit if he will permit the mask to be placed on him.

Pureed or finely chopped foods will help with the not being able to chew.
If he has no infections in the mouth you can ask the dentist or his primary about using Clove Oil for the tooth pain. It does help quite a bit.

I do not know how this posted twice and I can not delete this one.

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