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My mother is 92, has advanced dementia, has been on hospice for 9 months and now has a very loose bottom tooth (premolar). It doesn't hurt and it doesn't seem to be infected. Mainly it annoys her when she's eating. She is not ambulatory and can't help with transfers anymore. Just getting her in a car is a feat. The last time I took her to her dentist was nearly a year ago...it was a nightmare for us, her and I suspect the dentist as well. The whole process caused her a great deal of confusion and anxiety and all they did was x-rays. I am trying to keep her life as quiet and comfortable as possible these days. I have a hard time imagining her getting her tooth pulled in a dental office BUT, all that being said, if going to the dentist is the better choice, we'll do it. Our hospice nurse said we could let the tooth fall out on it's own if we're worried a dental visit would be too traumatic for her. That sounds really good to me and is the direction I'm currently inclined to go. I'm thinking once the tooth comes out, her nurse could help me watch for and treat infection. So, I guess basically I'm looking for validation (if validation is warranted) but also hoping some of you might have some insights and experiences that would help me think this through.

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Agree with all of the above. I am a Dental Hygienist. If the tooth is loose, then she has lost the bone support that normally holds it in. Normally this is not a painful process, and the only down side is may interfere with eating comfortably. The most tx that could be done is a mobile dental unit in the area could numb the tissue and extract the tooth, making eating easier. If you don't think it is interferring with ability to eat, I would leave it alone. The stress and hardship of going into an office is not warranted in my opinion.
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TouchMatters May 23, 2021
Thank you for providing your expertise as a dental hygienist. Very helpful. Gena/Touch Matters
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I agree with the nurse, although I may also be tempted to suggest to mother that if its bothering her she should just pull it out. Moving it repeatedly will just speed up the process. There is no reason why she should get an infection, we don't normally when teeth either fall out or are taken out but if you can somehow get her to rinse with salt water every hour when it first come out, it will heal from underneath very quickly and the salt will act as an antiseptic.
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Reply to TaylorUK
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I'd ask a dentist or a dental nurse to come to her to have a look at it. The problem with allowing it to fall out on its own is that it is just about the perfect size for choking on. Especially if it happens because/when she is eating.

I know that "peripatetic" services aren't widespread, and they may not even be offered at all in your area, but if you don't ask you don't get!
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Reply to Countrymouse
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If she is 92 and under hospice care, I would certainly leave well enough alone. Putting her through the trauma of it all just doesn't make any sense does it? You want her to be calm and comfortable in her final time here on earth.
If her tooth bothers her when she eats, you may want to give her just soft or pureed foods at this point.

My husband had several loose teeth before he died, but was already on a soft food diet because he was an aspiration risk, so he never complained about them.
I wish you and your mom the best.
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gdaughter May 23, 2021
Maybe Hospice knows a resource?
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I don’t think I would bother with bringing her to the dentist. Let the tooth fall out on it’s own.

I suppose that you could call her dentist and see what he recommends. He may be able to advise you in regards to the best option for her.

Best wishes to you and your mom.
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Reply to NeedHelpWithMom
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her and I suspect the dentist as well.

Suspect the dentist of what?

I am sure it is uncomfortable for her. There are traveling dentists, one visited my mom's memory care facility. See if you can find one. Try calling the Area Agency on Aging to ask if there is such a service.
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TouchMatters May 23, 2021
Thank you. I was going to ask about this.
Never heard of traveling DDS in Marin County (California).
Often we don't know what is available until we need the service and do our research. Gena/Touch Matters
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Unless you use medical transport (like an ambulette) and get some anti-anxity meds to give her before the extraction, I would just let the tooth fall out.

There may be a larger issue (like extensive gum disease) going on which is causing her teeth to loosen, meaning that this is not the last tooth that she will lose, but you need to decide if the trauma of dental treatment at this point is worthwhile.

Near the end if her life, several of my mom's teeth broke off due to dental caries, even though she was in a NH and receiving ongoing dental care. We elected not to proceed with extractions or treatment.
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Reply to BarbBrooklyn
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I had the same dilemma with my Husband.
To bring him to a dentist meant having to put him at least into Twilight sleep.
Then after any dental work, and I knew there were teeth that should be pulled to try to keep him from picking at the wounds in his mouth would be almost impossible then to try to care for the wounds in the mouth would be difficult not to mention any follow up.
I made the decision NOT to do any dental work on him.
He did not exhibit any of the pain signs.
He did loose a tooth or two.
By this time he was on a soft/pureed diet.
He still did allow me to brush his teeth daily and I did watch for redness, tender areas and other signs that would indicate an infection.

You are making the right decision.
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Tough situation. My 95 yr old mother on hospice for 2 yrs for chf and metastasized breast cancer. She has squamous cell carcinoma and always needed to see the dermatologist every 3 months to have her squamous cell tumors removed by MOHs surgery, or just shaved off like in this past year. She has a squamous cell tumor growing out of her left cheek now and it gets bigger by the day. I can’t get her out to the dermatologist anymore. She has accepted this. But it does bother her and it’s going to get worse. What a dilemma. Took her to the dentist over a year ago because the implants in her lower left jaw were loose. Dentist ended up removing the 4 teeth attached to her jaw because of bone loss. Nothing could stay attached anymore. But that was our last trip out to the dentist. Just hoping the rest of the bone in her mouth is strong enough to hold the rest of the implants. These last minute things in their lives make day to day living more uncomfortable. We just do the best we can.
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sunshinelife May 27, 2021
Look into Dr Christophers black Drawing Ointment. There are videos you can watch by people who had the same/similar problems with the skin. They share their own experiences with mohs & black ointments...and the good results No brands were mentioned, no money requested. I mention Dr Christopher due to experience with his product. Quality products by his family. Interesting the ibody rejected the dental implants, yet not the natal teeth. A tea of BARBERRIES...1 pint distilled water just boiled...Add 1oz berries...stir...let sit over night covered in the pot. Strain...Store refrigerated in a covered glass container. drink warm or cool..1/2 cup x 3 times daily. My Grandfather joked about "marrying his dermatologist " due to the number of visits for skin lesions...The scaring from the mohs is not good. I gave him the above , plus got him to have 1 or even 2 if possible colonic irrigations a week ongoing..Its been about 18 months now since he began the above. His dermatologist had 'nothing to slice into' his last 2 visits grandpa reported. I am pleased and relieved. My Grandpa turns 86 in October. In my humble opinion it is not length of life that is important, it is the 'quality' of life.
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Do Not take her to a Dentist. It would be a unnecessary traumatic experience!

Of course just wait til the tooth falls out but you can help it fall out by just wiggling it several times a day and when it gets loose enough it will come out.
Then she can rinse her mouth with mouth wash.
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gdaughter May 23, 2021
salt water way better.
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