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He has to pulled them out and get dentures. In the meantime, the dentist prescribed an antibiotics and a rinse. Both medications worked like magic, and he is now pain free. I dread putting him through the treatment. He'll be uncomfortable all his life with the dentures. What if I wait till pain comes back and then just have him use the rinse? I'll appreciate any advice.

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I had forgot to mention in my earlier posting that if one gets dentures, it will consist many follow-up trips to get the dentures adjusted. My Mom had spent more time in the dentist chair than at any other doctor because she refused to get use to her dentures.

Mom would put the dentures in to eat, and take them out a minute after her meal, wash and soak them. Did the same thing at lunch, again at dinner, and any time she had a snack in-between. Eventually with taking the dentures in and out so many times the dentures would break. Then back into the dentist chair she would go. It always pained me to see her struggling to snap in the dentures and the struggling to unhook them.

So that is something to think about.
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I'd even consider getting a second opinion from an oral surgeon. Many dentists are too aggressive in their treatment, particularly with the elderly. My mom is 95 (96 in a couple of weeks) and still has her natural teeth. A few have broken off and her dentist "rebuilds" a fake tooth that looks great and works just fine. Now that's not six teeth...but I'd want to make sure that pulling that many teeth is really necessary, particularly with a patient with advancing dementia. And that the dentures would be necessary and not just a cosmetic fix.
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Dementia patients vary in their abilities, but many are not interested in dentures. They can clinch their mouth and not allow them to be inserted. They may take them out and leave them somewhere in the facility or even place them in a trash can. They are not able to appreciate why they need them. Due to these struggles, many end up not using them.

I suppose you do what you have to do, but I would keep in mind that dentures are not problem free. There are fit issues too. I'd discuss all my concerns with the dentist to confirm that he knows what you are up against.
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My experience with my father with dentures was how simple it was to clean them. My mother and a friend's mother endured their natural teeth breaking and rotting because they didn't get effective dental hygiene. I'm not sure how bad dentures are, or how hard they are to take care of. My father only had quite mild dementia, so he did fine.
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Thank you all very much for your replies. I didn't know you could get sepsis from this! And it's a great suggestion to ask if extractions are recommended just for dentures. The dentist wants to remove 6 teeth, so I am assuming Dad won't be able to chew at all. Thank you and God bless!
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I agree with Sunnygirl, would it be possible for your Dad to still eat with a couple of teeth missing? Unless it is the front teeth, I could understand him wanting dentures.

Why I ask is that my Mom has dealt with dentures since she was in her 20's, and refused to be seen in public without them, as some were her top front teeth. And refused to eat with out them. A couple months ago Mom developed accelerated dementia due a head trauma, and now doesn't use her dentures at all. At the nursing home she is now eating solid food without any problems. And I noticed majority of the patients in Mom's wing aren't wearing dentures and they dive into their solid food.
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I would make sure the dentist regularly works with seniors and people with dementia. He needs to understand things like palliative care if that is what your dad has chosen. Keeping the patient as comfortable as possible is the key.

Could your dad still chew with the missing teeth? Are there enough remaining teeth that he could still chew okay? Is there anyway to avoid the dentures? I would do that if all possible. Does he have the funds to have root canal and crowns? Does he have Medicaid? I'd see what they would pay for.

The reason is that as the dementia progresses, the patient isn't able to keep up with dentures. They may hide them, misplace them, etc. They may not allow others to put the dentures in. Dealing with dentures with people who have dementia is problematic. There are so many probables that arise and I know of more than a few dementia patients who stop using their dentures and just eat soft food.
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I think you need to clarify with the dentist, and for yourself, what the treatment options are. I've found this to be very important when discussing options for my mom.
1. He has infected teeth. Is there a low cost, low side effect way of treating this, without extraction?
2. Are the extractions being recommended due to the infection, or simply in preparation for dentures?
3. Why do you believe dad will be so uncomfortable with dentures?
4. How well would dad be able to chew without these teeth, and without
dentures ? Will it have an impact upon his nutrition?

Break the process down into small bits and get answers to each question. With my mom, I usually ask," what if we do nothing?" Or, "what would you do if this were your 92 year old mom with moderate dementia?" Sometimes with elders, less is more.
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I wouldn't wait for the infections to recur, and they will. The Mayo clinic states "the infection may spread to your jaw and to other areas of your head and neck. You might even develop sepsis — a life-threatening infection that spreads throughout your body". Beyond that there is the risk the teeth will eventually break off and cause even greater difficulties later when his dementia is more advanced. Work with your dentist to see if there are any that can be saved and if there are alternatives. I was able to take the x-rays to other dentists for a second opinion when my mom needed dental work...good luck.
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