I went to visit Mom yesterday at AL and her front tooth is gone. This is the third tooth she has lost. I have taken her to the dentist and they advised that due to severe gum deterioration she would have to have all teeth/caps removed and basically have her mouth rebuilt. Never mind the cost, (approximately $28k) she would have to be sedated which is probably not the best idea in her mental/health state. Not only does she look neglected, I worry about her ability to eat. Does anyone have experience or thoughts on what to do here? (side note-she refuses to walk and is bed bound. She refuses all offers of help from aides and basically told me to leave yesterday and leave her alone.) She is falling apart before our eyes and she really doesn't care. Any helpful thoughts are appreciated.

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Implants are not an option, obviously, for a person with too much bone loss; grafts would be required which are not going to happen either. The only option you really have is an upper denture; the remaining teeth would be pulled and she'd be fitted for a denture. She can have LOTS of bone loss and STILL be fitted for an upper denture, no worries there. She can be sedated without general anesthesia for such a procedure, by the way, and also given novocaine to numb her mouth.

If, however, she refuses to do anything at all about the situation, then there is nothing you can do. Making a choice to do nothing is still making a choice. You can't save a person from herself, unfortunately. Right? If she has given up and wants to stay in bed now, then she's chosen her life and it should be respected *in my opinion*. We try so hard to 'fix' our folks when they don't want to BE fixed. You may have to let her alone and she'll be given soft foods to eat. If and when the teeth become abscessed, the traveling dentist can be called upon to come in and remove them on the spot. That's the case in my mother's AL; I signed her up for the traveling dentist and they only work on her if/when it's an emergency extraction situation. She's 93 next month and loses teeth or parts of teeth on a regular basis.

If and when she loses a front tooth, however, she is going to have a major meltdown because she is extremely vain, dementia or no dementia!!! I have no idea WHAT I'm going to do if that day comes............I guess she'll be forced to get a bridge at that point.

God give us all strength, that's my prayer for today. Good luck
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Its not so much gum deterioration, its bone loss. Thats why the teeth fall out. No bone to hold them in. An implant needs bone.

I might get a second opinion. Pulling all her teeth, waiting for gums to heal and then dentures would not cost any 28k.

If Mom has Dementia, I probably would not put her thru anything. I know, she looks sad. I was OCD about my Mom. I wanted her outfits to match so I put everything together but the socks. Do u think they matched up her gray socks with her gray outfit. Nope, they put on brown. Her hair thinned out after she had a thyroid problem. And it was really soft. The aid had no idea how to brush it. It was always brushed flat to her head. It was cut to be feathered back from her face. So when I visited, I had a brush and hairspray with me so I styled it a little. My girls would say don't worry about it but I wanted her to look as nice as possible. She had Dementia.
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Dad will be 91 in a couple months. No dementia, but shortly after his stroke 5 years ago his teeth started to break at the gums. I finally got him to go to a dentist and several roots were removed and he was treated for abscesses.

He has lost more teeth, yes several in the front and he does not care. He chews/gums his food with the remaining teeth. His days of eating steak are over. He has no interest in getting dentures.

So we do not worry about it.
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I worked so hard to get my MIL into a great facility and she also refused to get out of bed! She was totally able to get up and walk but the staff can't force her. Now she has lost her ability to even stand due to muscle atrophy.

Dental care is another challenge. It is very painful to have 1 tooth removed (I had one recently done) and you have to adhere to a special diet and watch for infections. I can't imagine this happening for a dementia patient. Yes, toothlessness is a bad look but the facilities know how to accommodate it with special diets. Even if your LO got dentures (which would require removal of all teeth) she runs the risk of losing them, which is a very common problem. But even dentures require having enough bone mass to stay in place, so even this may not be an answer for her. Most of all, I would be checking regularly for infection in her teeth or gums which, if not caught, can travel to her heart and be a real danger. I'm so sorry there is no "good" solution here.

This is why I have decided to replace any of my future bad or broken teeth with implants. Yes, they are costly now, but your mom's scenario is what many of us have to look forward to if we live long enough. I view it as one less thing my caregiver or family needs to worry about.
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